Complexity of knee extensor torque in patients with frailty syndrome: a cross-sectional study

Abstract

Background: Frailty syndrome is characterized by a marked reduction in physiological reserves and a clinical state of vulnerability to stress. Torque complexity analysis could reveal changes in the musculoskeletal systems that are the result of having the syndrome. Objective: The aim of this study was to evaluate the complexity of submaximal isometric knee extensor torque in frail, pre-frail, and non-frail older adults. A secondary aim was to analyze the torque complexity behavior in different force levels in each group. Methods: A cross-sectional study was conducted. Forty-two older adults were divided into three groups: non-frail (n = 15), pre-frail (n = 15), and frail (n = 12). The data collected included body composition, five times sit-to-stand test, walking speed, and isometric knee extensor torque at 15, 30, and 40% of maximal voluntary contraction. The knee extensor torque variability was evaluated by coefficient of variation, and the torque complexity was evaluated by approximate entropy and sample entropy. Results: The frail group presented a reduction in body mass and peak torque value compared to the non-frail group. Also, the frail group showed worse physical performance (on the five times sit-to-stand test and walking speed) compared to the pre-frail and non-frail groups. In addition, the frail older adults showed reduced torque complexity compared to the non-frail group. Finally, the association between torque complexity and force levels remained similar in all groups. Conclusion: Torque complexity is reduced in the presence of frailty syndrome.

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“…It was first demonstrated by Vaillancourt and Newell ( 2003 ), who observed a progressive decline in the complexity of index finger abduction force (measured using ApEn and DFA α) during low-intensity isometric contractions from young adults (20–24 years) to old adults (60–69 years) to older-old adults (75–90 years). Recent work has extended this age-related loss of complexity to frailty, with a progressive decrease in ApEn observed when comparing non-frail, pre-frail and frail adults aged over 65 (Carnavale et al, 2020 ).…”

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