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Didczuneit-Sandhop B, Jóźwiak K, Jolie M, Holdys J, Hauptmann M. Hearing loss among elderly people and access to hearing aids: a cross-sectional study from a rural area in Germany. Eur Arch Otorhinolaryngol 2021; 278:5093-5098. [PMID: 33870450 PMCID: PMC8553687 DOI: 10.1007/s00405-021-06799-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/01/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Hearing loss is common and associated with reduced quality of life, particularly among elderly people. However, many patients do not use hearing aids. We evaluated the use of hearing aids among people with hearing loss by health services availability near their residence in a rural area in the state of Brandenburg, Germany. METHODS Audiometry was performed in a convenience sample of subjects in ten towns and hearing loss was determined, defined as a threshold of ≥ 30 dB in at least one ear and at least one of the frequencies 0.5, 1.0, 2.0 and 4.0 kHz. For each participant, age and gender were collected and whether or not hearing aids were available. RESULTS Among 186 persons with an average age of 74 years (interquartile range 71-81), 97% had hearing loss [95% confidence interval (CI) 95-100]. Among 121 patients with hearing loss who reported whether or not they have a hearing aid, 93 had no hearing aid (77%, 95% CI 69-84). The proportion of hearing-impaired persons who do not have a hearing aid significantly increased with the absence of a hearing aid specialist or ear nose throat (ENT) physician or both in the town where the tests were performed (p trend = 0.001). CONCLUSION Hearing loss is common among elderly people in the study area and many people in rural areas in Germany may not be properly supplied with hearing aids due to lack of hearing aid specialists and/or ENT physicians close to their residence. Interventions to improve this situation are urgently required.
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Affiliation(s)
- Birgit Didczuneit-Sandhop
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany.
| | - Katarzyna Jóźwiak
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Manja Jolie
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany
| | - Josefine Holdys
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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Postural Stability and Regulation before and after High Tibial Osteotomy and Rehabilitation. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Knee osteoarthrosis (OA) is a widespread orthopedic problem and a high tibial osteotomy (HTO) is a common treatment to minimize degeneration of the affected compartment. The primary aim of this study was to evaluate the postural regulation and stability among patients who underwent HTO and rehabilitation. This prospective study included 32 patients (55.3 ± 5.57 years) diagnosed with medial tibiofemoral OA. Each subject completed postural regulation and stability testing (Interactive Balance System), as well as pain intensity (visual analogue scale) and quality of life questionnaires (SF-36) prior to HTO (exam 1), and at six weeks (exam 2), twelve weeks (exam 3) and six months (exam 4) post HTO. For postural comparison, all patients were matched (sex, age, height) with asymptomatic subjects. Significant time effects (exam 1 vs. exam 4) were found for weight distribution index (WDI; ηp2 = 0.152), mediolateral weight distribution ηp2 = 0.163) and anterior–posterior weight distribution ηp2 = 0.131). The largest difference (exam 3: ηp2 = 0.251) and the most significant differences to the matched sample were calculated for the stability indicator (exam 1: ηp2 = 0.237; exam 2: ηp2 = 0.215; exam 3: ηp2 = 0.251; exam 4: ηp2 = 0.229). Pain intensity showed a significant reduction (ηp2 = 0.438) from exam 1 (50.7 ± 20.0 mm) to exam 4 (19.3 ± 16.0 mm). Physical pain was the quality of life parameter with the largest improvement between exams 1 and 4 (ηp2 = 0.560). HTO allows patients to improve their mediolateral weight distribution, whereas postural stability is consistently lower than in asymptomatic subjects. This surgery leads to marked improvements in quality of life and pain.
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Abstract
Background Postural regulation is based on complex interactions among postural subsystems. The auditory system too appears to have an influence on postural control. Objective The aim of this study was to measure the influence of auditory input on postural control and to gain a deeper understanding of the interactions between auditory input and postural subsystems including subjective aspects. Materials and methods In 30 healthy normal-hearing subjects, postural regulation and stability was measured with the Interactive Balance System (IBS; Inc. neurodata GmbH, Wien, Österreich) in 8 test positions with noise (frontal presentation) and plugged without noise. The IBS is an electrophysiological measurement device that measures postural control at the product level (e.g., stability, weight distribution) and the mechanisms of postural subsystems at the process level based on frequency-oriented fast-Fourier analysis of force–time relation. Results At the process level, we found a relevant reduction (ηp2 ≥ 0.10) of postural regulation with noise in the frequency bands F1 (visual and nigrostriatal system ηp2 = 0.122) and F2–4 (peripheral vestibular system ηp2 = 0.125). At the product level, the weight distribution index (WDI) parameter showed a relevant increase with noise (ηp2 = 0.159). No difference between the auditory conditions was found for postural stability (parameter: stability indicator, ST). Substantial interindividual variations in the subjective estimation of the influence of auditory inputs on stability were observed. Conclusion In this study, a shift in the activity of postural subsystems was observed with auditory input, while no difference was seen in ST. This leads to new insights into mechanisms of audiovestibular interaction.
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[Postural regulation and stability with acoustic input in normal hearing subjects. German version]. HNO 2020; 68:344-351. [PMID: 32219489 DOI: 10.1007/s00106-020-00845-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Postural regulation is based on complex interactions among postural subsystems. The auditory system too appears to have an influence on postural control. OBJECTIVE The aim of this study was to measure the influence of auditory input on postural control and to gain a deeper understanding of the interactions between auditory input and postural subsystems including subjective aspects. MATERIALS AND METHODS In 30 healthy normal-hearing subjects, postural regulation and stability was measured with the Interactive Balance System (IBS; Inc. neurodata GmbH, Wien, Österreich) in 8 test positions with noise (frontal presentation) and plugged without noise. The IBS is an electrophysiological measurement device that measures postural control at the product level (e.g., stability, weight distribution) and the mechanisms of postural subsystems at the process level based on frequency-oriented fast-Fourier analysis of force-time relation. RESULTS At the process level, we found a relevant reduction (ηp2 ≥ 0.10) of postural regulation with noise in the frequency bands F1 (visual and nigrostriatal system ηp2 = 0.122) and F2-4 (peripheral vestibular system ηp2 = 0.125). At the product level, the weight distribution index (WDI) parameter showed a relevant increase with noise (ηp2 = 0.159). No difference between the auditory conditions was found for postural stability (parameter: stability indicator, ST). Substantial interindividual variations in the subjective estimation of the influence of auditory inputs on stability were observed. CONCLUSION In this study, a shift in the activity of postural subsystems was observed with auditory input, while no difference was seen in ST. This leads to new insights into mechanisms of audiovestibular interaction.
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Melo RS, Lemos A, Paiva GS, Ithamar L, Lima MC, Eickmann SH, Ferraz KM, Belian RB. Vestibular rehabilitation exercises programs to improve the postural control, balance and gait of children with sensorineural hearing loss: A systematic review. Int J Pediatr Otorhinolaryngol 2019; 127:109650. [PMID: 31466025 DOI: 10.1016/j.ijporl.2019.109650] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Several studies have demonstrated that children with sensorineural hearing loss (SNHL) exhibit postural instabilities, as well as balance and gait disorders, due to the vestibular dysfunction that they are prone to display as a consequence of inner ear injury. Thus, some experiments have proposed vestibular rehabilitation exercises programs as a treatment to improve these motor skills in children with SNHL. OBJECTIVE Assess the evidence quality of the trials that used vestibular rehabilitation exercises programs to improve the postural control, balance and gait of children with SNHL. METHODS This is a systematic review that surveyed articles in nine databases, published up to July 4, 2019, in any language, using the following inclusion criteria: (1) Randomized or quasi-randomized controlled trials. (2) Participants of both groups with clinical diagnosis of SNHL, aged up to 12 years old, with no physical problems, cognitive or neurological impairments, except the vestibular dysfunction. (3) Using vestibular rehabilitation exercises programs to improve the following outcomes: postural control, balance and/or gait. RESULTS Six experiments, including 153 children, met the inclusion criteria of this systematic review. Two randomized controlled trials (45 children) on the postural control exhibited low evidence quality and four others; three randomized and controlled trials (90 children) on the balance and one quasi-randomized (18 children) on the gait demonstrated very low evidence quality, respectively. CONCLUSION There is promising evidence that vestibular rehabilitation exercises programs improve the postural control, balance and gait of children with SNHL. However, due to the methodological limitations of the trials and low quality of current evidence on this topic, the trials results analyzed by this systematic review should be interpreted with caution. Due to the low quality of evidence observed in this review, we suggest that new trials be proposed on this topic, with better methodological quality, to prove the effectiveness of vestibular rehabilitation exercises programs to improve the postural control, balance and gait of children with SNHL.
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Affiliation(s)
- Renato S Melo
- Post-graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife, Pernambuco, Brazil; Department of Physiotherapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.
| | - Andrea Lemos
- Post-graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Department of Physiotherapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Giselle S Paiva
- Post-graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Lucas Ithamar
- Post-graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Marília C Lima
- Post-graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Department of Maternal and Child Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Sophie Helena Eickmann
- Post-graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Department of Maternal and Child Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Karla Mônica Ferraz
- Department of Physiotherapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Rosalie Barreto Belian
- Post-graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife, Pernambuco, Brazil; Department of Medicine, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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