Topological data analysis of postural sway: characterizing balance control during childhood development.
Elaheh Azadian, Mahdi Majlesi
PMID 42374465WHAT IT FOUND
Younger children show more complex, oscillatory sway patterns than adults.
Removing vision increased sway size but not its structural complexity, while standing on one leg increased both. These topological markers track balance maturation in healthy children.
Key findings
01Children aged 7–9 years exhibited the highest entropy values, whereas adults showed the lowest, indicating greater sway complexity in younger children.
02Eye closure increased sway magnitude metrics (H1_Wasserstein distance and Total Persistence) by approximately 43% and 46% respectively, but did not significantly change Persistent Entropy or H1_NumLongLoops.
03Single-leg stance increased H1_NumLongLoops by approximately 50% and Persistent Entropy by approximately 8.5% across all age groups except adults.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was cross-sectional, so it cannot show how individual children’s balance develops over time. Participants were exclusively healthy, so the diagnostic value of these TDA metrics for children with balance disorders or neurological conditions is unknown. CoP trajectories were analyzed in their original measurement space without normalizing for height or base of support, meaning some differences between age groups may reflect physical size rather than control strategy. The threshold for defining 'long loops' was data-driven but arbitrary, which may affect reproducibility in other studies. The adult group was small (n=40) and served only as a reference, not part of a continuous developmental trajectory.
Declared interests
The study protocol was approved by the Ethics Committee of Islamic Azad University. No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret higher sway complexity (entropy/loops) in younger children as a sign of pathology. The study shows this is a normal feature of maturation, with children aged 7–9 having the highest values. Clinical decisions should be based on comparison to age-matched norms, not adult standards.