Measuring the Local and Global Variabilities in Body Sway by Nonlinear Poincaré Technology

To date, the human balance assessment is mainly achieved by measuring the center of pressure (COP) trajectory of upright posture. However, COP-based metrics provide inconclusive results under certain circumstances, due to the lack of relevance with the body balance mechanism. This paper developed a novel framework to measure the variability in body sway based on the Poincare analysis to enhance the balance assessment. It provided nonlinear parameters SD1, SD2, and their ratio SD1/SD2 as quantitative indicators of the local and global balance regulation capacities. 136 healthy adults were categorized into young and elderly groups and received test on a force platform. COP signals were recorded for 30 s under eyes-opened and eyes-closed vision conditions. The results were analyzed using the two-way mixed-design analysis of variance and show that the technology is able to reveal the effect of age and vision on the balance control by SD1, SD2, and SD1/SD2. SD1 mainly responded to vision, and SD2 was more influenced by age. Due to the information about the subtle adjustment during quiet standing, these Poincare indexes surpassed the conventional COP measurements in demonstrating the balance control behavior. It can be concluded that the supposed method of estimating the local and global variabilities is a valuable approach for the balance assessment.