Fractal analysis of centre of pressure in textured shoes

Maintaining balance involves complex feedback from the vestibular, visual, and somatosensory systems. Falls are common among older adults, with high recurrence rates, emphasising the need for effective prevention strategies. Traditional clinical assessments often rely on subjective measures, while objective measures such as centre of pressure (COP) sway analysis may miss subtle balance changes. This study evaluates the effects of a textured shoe intervention on COP sway in older women using fractal (non‑linear) and traditional time‑domain methods, because traditional measures may miss subtle changes in the temporal organisation of postural regulation. Twenty-one healthy older women (mean age: 62.2 ± 3.7 years) wore either control or textured shoes for 45 minutes, three times weekly for six weeks. COP sway was assessed barefoot pre- and post-intervention using fractal analysis and traditional time-domain methods. Fractal scaling was assessed in the mediolateral (ML) and anteroposterior (AP) directions to identify changes in postural control mechanisms. Fractal analysis revealed a significant decrease in COP velocity scaling in the ML direction, suggesting more random fluctuations. Group differences in AP COP range were observed but not statistically significant. Other traditional and fractal measures showed no significant changes. Despite the lack of significant between-group differences, fractal analysis identified subtle changes in COP regulation that were undetected by traditional methods. Reported results and the fractal analysis approach offer valuable insights into postural control and may complement traditional measures in balance assessments. While the textured shoe intervention did not demonstrate hypothesised proprioceptive changes, further research with larger samples and longer interventions is needed to explore its potential effects on balance.