Measuring regularity of human postural sway using approximate entropy and sample entropy in patients with Ehlers–Danlos syndrome hypermobility type

Ligament laxity in Ehlers–Danlos syndrome hypermobility type (EDS-HT) patients can influence the intrinsic information about posture and movement and can have a negative effect on the appropriateness of postural reactions. Several measures have been proposed in literature to describe the planar migration of CoP over the base of support, and the most used in clinical field are the CoP excursions in antero-posterior and medio-lateral direction. In recent years a growing number of studies have been designed to explore the complexity of the COP trajectories during quiet standing. We assessed 13 adults with EDS-HT (EDSG) and 20 healthy adults (CG) during static posture, evaluating the CoP using time and frequency domain analysis and entropy analysis (SampEn and ApEn parameters). Higher values of CoP displacements in medio-lateral and anterior–posterior directions for EDSG than CG were found; no differences were observed in CoP frequency. The entropy analysis showed lower value for EDSG than CG, pointing out the needing of EDSG to concentrate more attention on postural control, loosing complexity and reflecting a less automatized postural control.

► Pathological participants pointed out difficulties in maintaining posture due to proprioceptive system impairments.
► Analysis of entropy seems to provide more insight into mechanisms involved in the control of quite stance.
► The results of time, frequency and entropy analysis of posture signal should be taken into account in the planning of rehabilitation programme.