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Vol. 24. Issue 1.
Pages 30-38 (01 January 2020)
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Vol. 24. Issue 1.
Pages 30-38 (01 January 2020)
Original Research
DOI: 10.1016/j.bjpt.2018.12.004
Complexity of knee extensor torque in patients with frailty syndrome: a cross-sectional study
Bianca Ferdin Carnavalea, Elie Fiogbéa, Ana Claudia Silva Farchea, Aparecida Maria Cataia, Alberto Portab,c, Anielle Cristhine de Medeiros Takahashia,
Corresponding author

Corresponding author at: Universidade Federal de São Carlos, Departamento de Fisioterapia, Rod. Washington Luís, km 235, CEP: 13565-905, São Carlos, SP, Brazil.
a Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
b Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
c Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy

  • Knee extensor torque complexity is reduced in the presence of frailty syndrome.

  • Frail participants showed a reduction in body mass, peak knee extensor torque and decreased physical performance.

  • The relationship between complexity and force levels was similar in all groups.

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Figures (1)
Tables (2)
Table 1. Descriptive characteristics between the 3 groups of subjects.
Table 2. Variables of torque variability and complexity for the 3 groups of subjects.
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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.


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.


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.


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.


Torque complexity is reduced in the presence of frailty syndrome.

Muscle strength
Physical therapy


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