Sensorimotor training was associated with selective changes in nonlinear postural control measures in older adults, particularly under reduced visual input, though responses were heterogeneous across individuals.
Key Findings
Results
Approximate Entropy (ApEn) showed a significant between-group difference in mediolateral sway under eyes-open conditions following six months of sensorimotor training.
ANCOVA adjusted for baseline values revealed ApEn_ML_OE: F = 8.7, p = 0.004, η²p = 0.10
This effect size (η²p = 0.10) indicates a moderate practical significance
The experimental group (n = 43) underwent twice-weekly sensorimotor circuit training for six months
The control group (n = 43) served as the comparison with no intervention described
Results
Lyapunov Exponent (LyE) showed significant between-group differences under eyes-closed conditions in both anteroposterior and mediolateral directions, indicating improved local dynamic stability.
LyE_AP_CE: F = 4.0, p = 0.049, indicating a significant effect in the anteroposterior direction under eyes-closed conditions
LyE_ML_CE: F = 13.6, p = 0.001, indicating a significant effect in the mediolateral direction under eyes-closed conditions
These findings suggest that sensorimotor training particularly influenced postural control under reduced visual input
ANCOVA analyses were adjusted for baseline values to control for pre-existing differences
Results
No significant between-group differences were observed for Detrended Fluctuation Analysis (DFA) in any condition.
DFA, which measures long-range correlations in postural sway, did not yield significant between-group effects
This suggests that sensorimotor training selectively affected some but not all nonlinear measures of postural control
The null DFA result contrasts with significant findings for ApEn and LyE, indicating differential sensitivity of nonlinear metrics
Results
Substantial inter-individual variability was observed across participants in their responses to the sensorimotor training intervention.
The study noted that 'responses were heterogeneous, indicating that effects were not uniform across individuals'
Participants ranged in age from 55 to 80 years, with the experimental group averaging 72.40 ± 7.03 years and the control group averaging 73.50 ± 6.08 years
Total sample comprised 86 community-dwelling older adults randomly assigned to groups of 43 each
Heterogeneity of response may reflect variability in baseline postural control, fitness levels, or adaptability within this age range
Methods
The sensorimotor training program consisted of six exercise circuits with eight physical exercises each, progressively adjusted in difficulty over six months.
Sessions were conducted twice per week for six months
Difficulty was progressively adjusted according to 'predefined performance-based criteria'
Training was conducted 'under the supervision of a trained instructor to ensure appropriate individual adaptation'
The circuits focused specifically on sensorimotor stimulation
Methods
Nonlinear methods including Approximate Entropy, Lyapunov Exponent, and Detrended Fluctuation Analysis were used to analyze postural control in both eyes-open and eyes-closed conditions.
Measurements were taken in both anteroposterior (AP) and mediolateral (ML) directions
Two visual conditions were tested: eyes-open (OE) and eyes-closed (CE)
ApEn quantifies signal regularity/complexity; LyE quantifies local dynamic stability; DFA measures long-range temporal correlations
ANCOVA was used as the primary statistical method, with baseline values as covariates
What This Means
This research suggests that a six-month exercise program specifically designed to challenge the sensory and motor systems can meaningfully change how older adults control their balance, but not all aspects of balance change equally. The study enrolled 86 community-dwelling adults aged 55–80 and randomly assigned them to either participate in twice-weekly sensorimotor exercise circuits or serve as a control group. Balance was assessed using sophisticated mathematical tools (Approximate Entropy, Lyapunov Exponent, and Detrended Fluctuation Analysis) that capture the complexity and stability of small body movements — qualities that are thought to reflect how well the nervous system adapts to balance challenges.
The exercise group showed improvements specifically in the complexity of side-to-side body sway when their eyes were open, and in the dynamic stability of both front-to-back and side-to-side sway when their eyes were closed. The fact that improvements were most pronounced when vision was removed suggests the training may have strengthened the body's ability to rely on other senses — such as inner ear and muscle signals — to maintain balance. However, one of the three mathematical measures tested (Detrended Fluctuation Analysis) showed no significant group differences, indicating that the training did not affect all aspects of postural control equally.
This research also highlights that individuals responded very differently to the same training program, which is an important practical consideration. Not everyone in the exercise group improved to the same degree, suggesting that personalized approaches may be necessary when designing balance training for older adults. The findings are potentially relevant to fall prevention, as falls are a major health concern in aging populations, and better postural control under challenging sensory conditions may reduce fall risk.
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Cabo C, Espada M, Parraca J, Santos S, Gonçalves B, Fernandes O. (2026). Analysis of postural control through nonlinear methods in older adults: a randomized controlled trial.. PeerJ. https://doi.org/10.7717/peerj.21706