Standing Posture in Motor and Cognitive Dual-Tasks during Smartphone Use: Linear and Nonlinear Analysis of Postural Control

Abstract

Analysis of the center of pressure (CoP) during cognitive or motor dual-tasking is widely used to characterize postural control. Most studies use traditional measures of CoP to quantify postural control, but given its complexity, nonlinear analysis of CoP is of growing interest in the area. This study aims to analyze CoP behavior in healthy young adults during standing posture performance while simultaneously performing motor or cognitive tasks on a smartphone, using linear and nonlinear analysis of CoP. Thirty-six healthy participants (23.08 ± 3.92 years) were found eligible for this study. They performed a single task (ST), cognitive dual-task (cog-DT), and motor dual-task (mot-DT). The total excursion of CoP, displacement of CoP in the anterior-posterior and medial-lateral directions, mean total velocity of CoP, and mean anterior-posterior and medial-lateral velocities of CoP were measured with a force plate. Approximate entropy (ApEn) of the anterior-posterior (ApEn-AP) and medial-lateral (ApEn-ML) displacement of CoP were also calculated. The results showed that dual-task costs for the total excursion, displacement in the anterior-posterior direction, mean total velocity, and mean anterior-posterior velocity of CoP were greater during the cog-DT than the mot-DT (p < 0.05). In the nonlinear analysis of the CoP, there was no difference (p > 0.05) between the cog-DT and mot-DT for ApEn values of the anterior-posterior and medial-lateral time series of the CoP. Both linear and nonlinear analyses showed differences between the cog-DT and ST (p < 0.05), revealing a decline in postural control during the cog-DT compared with the ST. In conclusion, performing a cog-DT causes sway impairments and lower postural control efficacy compared with motor single and dual-tasks. Furthermore, both linear and nonlinear analyses were able to distinguish between conditions.