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Postural stability assessment in flatfoot subjects trough lyapunov exponent analysis

EUROPEAN JOURNAL OF PUBLIC HEALTH(2021)

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Abstract
Abstract Background Flatfoot subjects presents an increase plantar foot area related to a plantar pressure feedback impairment. The Lyapunov Exponent is considered a nonlinear parameter used to characterize a signal chaotic behavior measuring the information rate loss from time series, i.e., for the Center of Pressure data. This exponent is used to quantify and measure the capability and resistance of subjects to several perturbations. The study purpose was to investigate the postural stability differences among foot posture condition through the Lyapunov Exponent analysis. Methods The sample of the observation descriptive study consisted of 31 participants (23.26 yo ± 4.43 SD) comprising a total of 62 feet, where 15 integrated into the experimental group with bilateral flatfoot condition and the remaining 16 in the control group with the bilateral neutral foot condition. Subjects were screened, before posture analysis, using the Navicular Drop Test and Resting Calcaneal Stance Position test, to characterize each group. All participants were subjected to a bipedal weight-bearing stance posture stability analysis a force platform, both in eyes-open and closed condition. The Lyapunov Exponent was calculated using the Matlab-R2020b (MathWorks Inc., USA) software. Results Regarding the Center of Pressure outcomes, only the Lyapunov Exponent value upon the Antero-Posterior component regarding groups in the eyes closed condition (diff = 3.09°, p = .016) presented a significant result. Conclusion Flatfoot subjects present a significant difference compared to neutral foot participants, in bipedal weight-bearing stance, in the eyes closed condition regarding the Lyapunov Exponent. This relates to increase variability and decrease stability regarding the Antero-Posterior component.
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Key words
Foot Posture, Center of Pressure, Pes planus, Nonlinear method
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