{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:01:40Z","timestamp":1787068900775,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Centre for Research and Development","award":["STRATEGMED3\/306011\/1\/NCBR\/2017"],"award-info":[{"award-number":["STRATEGMED3\/306011\/1\/NCBR\/2017"]}]},{"name":"National Centre for Research and Development","award":["2F1\/N\/22"],"award-info":[{"award-number":["2F1\/N\/22"]}]},{"DOI":"10.13039\/501100004166","name":"Medical University of Warsaw","doi-asserted-by":"publisher","award":["STRATEGMED3\/306011\/1\/NCBR\/2017"],"award-info":[{"award-number":["STRATEGMED3\/306011\/1\/NCBR\/2017"]}],"id":[{"id":"10.13039\/501100004166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004166","name":"Medical University of Warsaw","doi-asserted-by":"publisher","award":["2F1\/N\/22"],"award-info":[{"award-number":["2F1\/N\/22"]}],"id":[{"id":"10.13039\/501100004166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Centre for Postgraduate Education in Warsaw","award":["STRATEGMED3\/306011\/1\/NCBR\/2017"],"award-info":[{"award-number":["STRATEGMED3\/306011\/1\/NCBR\/2017"]}]},{"name":"Medical Centre for Postgraduate Education in Warsaw","award":["2F1\/N\/22"],"award-info":[{"award-number":["2F1\/N\/22"]}]},{"name":"Ministry of Science and Higher Education","award":["STRATEGMED3\/306011\/1\/NCBR\/2017"],"award-info":[{"award-number":["STRATEGMED3\/306011\/1\/NCBR\/2017"]}]},{"name":"Ministry of Science and Higher Education","award":["2F1\/N\/22"],"award-info":[{"award-number":["2F1\/N\/22"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Primary osteoarthritis treatments such as a total hip (THR) or knee (TKR) replacement lead to postural control changes reinforced by age. Balance tests such as standing with eyes open (EO) or closed (EC) give a possibility to calculate both linear and nonlinear indicators. This study aimed to find the group of linear and\/or nonlinear measures that can differentiate healthy people and patients with TKR or THR from each other. This study enrolled 49 THR patients, 53 TKR patients, and 16 healthy controls. The center of pressure (CoP) path length, sample entropy (SampEn), fractal dimension (FD), and the largest Lyapunov exponent (LyE) were calculated separately for AP and ML directions from standing with EO\/EC. Cluster analysis did not result in correct allocation to the groups according to all variables. The discriminant model included LyE (ML-EO, ML-EC, AP-EC), FD (AP-EO, ML-EC, AP-EC), CoP-path AP-EC, and SampEn AP-EC. Regression analysis showed that all nonlinear variables depend on the group. The CoP path length is different only in THR patients. It was concluded that standing with EC is a better way to assess the amount of regularity of CoP movement and attention paid to maintain balance. Nonlinear measures better differentiate TKR and THR patients from healthy controls.<\/jats:p>","DOI":"10.3390\/diagnostics12071595","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T20:53:02Z","timestamp":1656622382000},"page":"1595","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Nonlinear and Linear Measures in the Differentiation of Postural Control in Patients after Total Hip or Knee Replacement and Healthy Controls"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9142-5394","authenticated-orcid":false,"given":"Anna","family":"Hadamus","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8452-6824","authenticated-orcid":false,"given":"Michalina","family":"B\u0142a\u017ckiewicz","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation, The J\u00f3zef Pi\u0142sudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra J.","family":"Kowalska","sequence":"additional","affiliation":[{"name":"Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil T.","family":"Wydra","sequence":"additional","affiliation":[{"name":"Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Grabowicz","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-8050","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"\u0141ukowicz","sequence":"additional","affiliation":[{"name":"Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Bia\u0142oszewski","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Marczy\u0144ski","sequence":"additional","affiliation":[{"name":"Medical Centre for Postgraduate Education, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.gaitpost.2021.04.042","article-title":"Effects of total knee arthroplasty for primary knee osteoarthritis on postural balance: A systematic review","volume":"89","author":"Melo","year":"2021","journal-title":"Gait Posture"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e19136","DOI":"10.1097\/MD.0000000000019136","article-title":"Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: A randomized controlled trial","volume":"99","author":"Gianola","year":"2020","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wang, X., Hunter, D.J., Vesentini, G., Pozzobon, D., and Ferreira, M.L. (2019). Technology-assisted rehabilitation following total knee or hip replacement for people with osteoarthritis: A systematic review and meta-analysis. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2900-x"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1001\/jama.2020.22171","article-title":"Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review","volume":"325","author":"Katz","year":"2021","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2106\/JBJS.19.00695","article-title":"Effects of Virtual Exercise Rehabilitation In-Home Therapy Compared with Traditional Care After Total Knee Arthroplasty: VERITAS, a Randomized Controlled Trial","volume":"102","author":"Green","year":"2020","journal-title":"JBJS"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.joca.2017.07.022","article-title":"Projected increase in total knee arthroplasty in the United States\u2014An alternative projection model","volume":"25","author":"Inacio","year":"2017","journal-title":"Osteoarthr. Cartil."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Hadamus, A., Bia\u0142oszewski, D., B\u0142a\u017ckiewicz, M., Kowalska, A.J., Urbaniak, E., Wydra, K.T., Wiaderna, K., Boraty\u0144ski, R., Kobza, A., and Marczy\u0144ski, W. (2021). Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance. Entropy, 23.","DOI":"10.3390\/e23020164"},{"key":"ref_8","first-page":"107","article-title":"The impact of a total hip replacement on jaw position, upper body posture and body sway","volume":"33","author":"Ohlendorf","year":"2015","journal-title":"Cranio J. Craniomandib. Pract."},{"key":"ref_9","first-page":"35","article-title":"The impact of a total knee arthroplasty on jaw movements, upper body posture, plantar pressure distribution, and postural control","volume":"39","author":"Heil","year":"2021","journal-title":"Cranio J. Craniomandib. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.knee.2020.06.014","article-title":"Static balance assessment in patients with severe osteoarthritis of the knee","volume":"27","author":"Dadura","year":"2020","journal-title":"Knee"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.gaitpost.2010.04.002","article-title":"On the role of knee joint in balance control and postural strategies: Effects of total knee replacement in elderly subjects with knee osteoarthritis","volume":"32","author":"Gauchard","year":"2010","journal-title":"Gait Posture"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.gaitpost.2019.07.124","article-title":"Effects of total hip arthroplasty for primary hip osteoarthritis on postural balance: A systematic review","volume":"73","author":"Fernandes","year":"2019","journal-title":"Gait Posture"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.gaitpost.2018.03.003","article-title":"Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: A systematic review and meta-analysis","volume":"62","author":"Blasco","year":"2018","journal-title":"Gait Posture"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/0959-4388(94)90137-6","article-title":"Postural control system","volume":"4","author":"Massion","year":"1994","journal-title":"Curr. Opin. Neurobiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3394","DOI":"10.1152\/jn.01272.2007","article-title":"Identification of the plant for upright stance in humans: Multiple movement patterns from a single neural strategy","volume":"100","author":"Kiemel","year":"2008","journal-title":"J. Neurophysiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1152\/jn.00669.2013","article-title":"Sensory reweighting dynamics in human postural control","volume":"111","author":"Peterka","year":"2014","journal-title":"J. Neurophysiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3389\/fnins.2018.00171","article-title":"Human Postural Control","volume":"12","author":"Ivanenko","year":"2018","journal-title":"Front. Neurosci."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kedziorek, J., and B\u0142a\u017ckiewicz, M. (2020). Nonlinear Measures to Evaluate Upright Postural Stability: A Systematic Review. Entropy, 22.","DOI":"10.3390\/e22121357"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"ii7","DOI":"10.1093\/ageing\/afl077","article-title":"Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls?","volume":"35","author":"Horak","year":"2006","journal-title":"Age Ageing"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Stergiou, N. (2016). Nonlinear Analysis for Human Movement Variability, CRC Press.","DOI":"10.1201\/b19571"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.humov.2010.04.005","article-title":"Center-of-pressure regularity as a marker for attentional investment in postural control: A comparison between sitting and standing postures","volume":"30","author":"Roerdink","year":"2011","journal-title":"Hum. Mov. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00221-007-0905-4","article-title":"Regularity of center-of-pressure trajectories depends on the amount of attention invested in postural control","volume":"181","author":"Donker","year":"2007","journal-title":"Exp. Brain Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.gaitpost.2017.05.019","article-title":"Cognitive task promote automatization of postural control in young and older adults","volume":"57","author":"Lajoie","year":"2017","journal-title":"Gait Posture"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"206","DOI":"10.3389\/fnhum.2017.00206","article-title":"Sample Entropy, Univariate, and Multivariate Multi-Scale Entropy in Comparison with Classical Postural Sway Parameters in Young Healthy Adults","volume":"11","author":"Hansen","year":"2017","journal-title":"Front. Hum. Neurosci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.clinbiomech.2014.04.012","article-title":"Postural control strategies during single limb stance following acute lateral ankle sprain","volume":"29","author":"Doherty","year":"2014","journal-title":"Clin. Biomech."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.gaitpost.2014.03.180","article-title":"Balance failure in single limb stance due to ankle sprain injury: An analysis of center of pressure using the fractal dimension method","volume":"40","author":"Doherty","year":"2014","journal-title":"Gait Posture"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/0167-2789(93)90009-P","article-title":"A practical method for calculating largest Lyapunov exponents from small data sets","volume":"65","author":"Rosenstein","year":"1993","journal-title":"Phys. D Nonlinear Phenom."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3311\/PPme.8999","article-title":"Parameter Reduction in the Frequency Analysis of Center of Pressure in Stabilometry","volume":"60","author":"Nagymate","year":"2016","journal-title":"Period. Polytech. Mech. Eng."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"E215","DOI":"10.1161\/01.CIR.101.23.e215","article-title":"PhysioBank, PhysioToolkit, and PhysioNet: Components of a new research resource for complex physiologic signals","volume":"101","author":"Goldberger","year":"2000","journal-title":"Circulation"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0167-2789(88)90081-4","article-title":"Approach to an irregular time series on the basis of the fractal theory","volume":"31","author":"Higuchi","year":"1988","journal-title":"Phys. D Nonlinear Phenom."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1250043","DOI":"10.1142\/S0218127412500435","article-title":"A neuro-fuzzy based model for accurate estimation of the Lyapunov exponents of an unknown dynamical system","volume":"22","author":"Razjouyan","year":"2012","journal-title":"Int. J. Bifurc. Chaos Appl. Sci. Eng."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.ridd.2012.11.007","article-title":"Measuring regularity of human postural sway using approximate entropy and sample entropy in patients with Ehlers-Danlos syndrome hypermobility type","volume":"34","author":"Rigoldi","year":"2013","journal-title":"Res. Dev. Disabil."},{"key":"ref_33","first-page":"15","article-title":"Nonlinear measures in posturography compared to linear measures based on yoga poses performance","volume":"22","year":"2020","journal-title":"Acta Bioeng. Biomech."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1589\/jpts.29.1766","article-title":"Test-retest reliability of linear and nonlinear measures of postural stability during visual deprivation in healthy subjects","volume":"29","author":"Ghofrani","year":"2017","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.neulet.2012.07.020","article-title":"Postural control strategy during standing is altered in patients with multiple sclerosis","volume":"524","author":"Huisinga","year":"2012","journal-title":"Neurosci. Lett."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"192","DOI":"10.5491\/SHAW.2012.3.3.192","article-title":"Fall risk assessments based on postural and dynamic stability using inertial measurement unit","volume":"3","author":"Liu","year":"2012","journal-title":"Saf. Health Work"},{"key":"ref_37","first-page":"145","article-title":"Acute effects of core stability exercises on balance control","volume":"20","author":"Szafraniec","year":"2018","journal-title":"Acta Bioeng. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s12984-018-0465-9","article-title":"On the use of approximate entropy and sample entropy with centre of pressure time-series","volume":"15","author":"Montesinos","year":"2018","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/1743-0003-7-38","article-title":"Entropy of balance\u2014Some recent results","volume":"7","author":"Borg","year":"2010","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"102462","DOI":"10.1016\/j.humov.2019.05.007","article-title":"Dynamics of postural control during bilateral stance\u2014Effect of support area, visual input and age","volume":"67","author":"Raffalt","year":"2019","journal-title":"Hum. Mov. Sci."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/7\/1595\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:40:53Z","timestamp":1760139653000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/7\/1595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["diagnostics12071595"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12071595","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,30]]}}}