Postural control, motor skills, and health-related quality of life in children with hearing impairment: a systematic review

Assessment of oral health status and quality of life in hearing-impaired children from Syria

AIM

This study aimed to evaluate the oral health status of children with hearing impairments and assess the relationship between various oral health factors and the Pediatric Oral Health-Related Quality of Life.

MATERIALS AND METHODS

This observational cohort study involved 90 hearing-impaired children aged 6-12 years. Diagnostic tools such as pure-tone audiometry were used to evaluate their hearing abilities. Dental health was assessed by calculating DMFT, dmft, Plaque and Gingival indices. The oral health-related quality of life was measured using the POHRQoL.

RESULTS

The severity of hearing impairment varied with 3% having severe hearing loss, 13% having profound hearing loss, and 83% having complete hearing loss. A high prevalence of dental cavities with 93% of children affected was found. DMFT score was similar between males and females (2.5 ± 0.3 vs. 2.3 ± 0.3 respectively). Males exhibited a higher mean dmft score (4.1 ± 0.5 vs. 3.3 ± 0.5), and a higher mean Plaque Index (1.9 ± 0.1 vs. 1.5 ± 0.1). On the other hand, females showed a higher mean Gingival Index (0.9 ± 0.1 vs. 1.1 ± 0.2). Results indicated a decreased OHRQoL with a mean POQL score of 6.4 ± 2.89. Spearman's test revealed a significant positive correlation between POQL total score and DMFT scores (P = 0.000), dmft scores (P = 0.000), Plaque Index scores (P = 0.000), and Gingival Index scores (P = 0.038). There was a weak positive correlation between hearing impairment severity and POQL total score, it was not statistically significant.

CONCLUSIONS

Children who have hearing impairments exhibit poor oral health, and levels of dental caries, which can negatively impact their overall POHRQoL. Therefore, it is highly recommended to start specialized oral health education and comprehensive dental care programs to improve their OHRQoL.

Exploring the Link Between Oral Health Factors and Hearing Impairments in Children: A Cross-Sectional Study

Background Hearing-impaired children may face challenges in communication, social interaction, academic performance, and emotional well-being, which can have a notable impact on their overall quality of life. Beyond these challenges, oral health can also be significantly impacted. The relationship between hearing impairment and dental diseases is an intriguing and interconnected aspect of overall well-being that merits attention and exploration. This study aimed to assess the relationship between various oral health factors and hearing impairments. Methodology This cross-sectional study involved 90 hearing-impaired children aged 6-12 years. To evaluate the children's hearing abilities, diagnostic tools such as pure-tone audiometry were employed. To measure dental health, the decayed, missing, and filled teeth (DMFT) and decayed, missing, and filled primary teeth (dmft) indices, as well as plaque index (PI) and gingival index (GI) were calculated. The chi‑square test was used to identify significant differences between genders. Spearman's test was used to determine the correlation between variables. Results The severity of hearing impairment varied, with 5.6% having severe hearing loss, 8.9% having profound hearing loss, and 85.6% having complete hearing loss. The mean DMFT score was 2.5 ± 1.86, with no significant difference observed between males and females. The mean dmft score was 4.2 ± 3.12, with no significant difference between genders. However, there was a difference in the PI scores between males and females. Males presented a higher PI score of 2.6 ± 0.09 compared to 1.8 ± 0.08 for females. The overall mean PI was 2.1 ± 0.80. The mean GI was 1.5 ± 0.90, and no significant difference was observed between males and females. Spearman's test identified a significant positive correlation between the severity of hearing impairment and both PI scores (p = 0.000) and GI scores (p = 0.000). Conversely, the severity of hearing impairment showed a weak positive correlation with both DMFT scores (p = 0.487) and dmft scores (p = 0.229), but these correlations were not statistically significant. Conclusions The connection between oral health and severe hearing impairment in children is significant and has potential implications. Pediatric healthcare providers, including dentists and audiologists, need to work collaboratively to monitor the oral and aural health of young patients.

Assessing Postural Control From Birth to Adulthood Among Individuals Born Preterm: A Systematic Review

Premature life exposure, meaning an immature central nervous system, presents a significant challenge for the development of postural control and, in turn, overall motor development. Preventing motor delay thus requires identifying, characterizing, and quantifying deficit in postural control as early as possible. In our study, we reviewed the procedures used in past studies to assess postural control among individuals born preterm, specifically the characterization of participants, the instruments and motor tasks involved, the types of data collected and analyzed, and the outcomes. To that end, we performed a literature search on PubMed, Wiley Online Library, Web of Science, and Scopus using Boolean logic and assessed the quality of the studies with a standardized assessment based on the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Of 35 potential studies, 24 were included; all evaluated infants born preterm, but six did not include a control group of full-term infants. Although the heterogeneity of measurements, variability of instruments, and divergence in motor tasks examined limit definitive conclusions based on quantitative synthesis and the generalization of the results, most studies revealed dysfunctional postural control among individuals born preterm.

Emotional behavioral outcomes of children with unilateral and mild hearing loss

Background

Deaf and hard-of hearing (DHH) children often experience emotional/behavioral difficulties. The impact of unilateral/mild hearing loss (HL) on children's emotion and behavior are unclear. We aimed to describe emotional/behavioral, health related quality-of-life (HRQoL) and parent psychological distress outcomes of school-age children with unilateral/mild HL, compared to children with moderate to profound HL, and in relation to population norms; and identify predictive factors of emotional/behavioral difficulties.

Methods

Data of 339 DHH children, 5-12 years, enrolled in the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), which include demographics, early development, medical/audiological characteristics and parent rated questionnaires of emotion/behavior, HRQoL and parental psychological distress collected at various stages of child's life were analyzed. We used Cohen's d to investigate the outcomes by measuring the mean score differences of both groups with published norms and logistic regression to analyze the factors predictive of emotional/behavioral difficulties.

Results

The proportion of children with unilateral/mild HL and moderate to profound HL who experienced emotional/behavioral difficulties was similar (18.3% vs. 20.6%), with hyperactivity and poor prosocial behavior reported as the predominant symptoms in both groups. Mean emotional/behavioral scores of both groups were comparable and substantially higher than normative population scores. This was also the case for HRQoL and levels of parent distress. Among children with unilateral/mild HL, additional health needs were the strongest predictive factor, demonstrating an approximately 1.7-fold increase in odds of emotional/behavioral difficulties (OR = 1.67; 95% CI 1.29-2.17, p < 0.001) with every additional health need. Early developmental concerns, other than communication milestone and attending mainstream schoolshowed weaker evidence of association.

Conclusion

Children with unilateral/mild HL were just as likely as those with moderate to profound HL to experience more emotional/behavioral difficulties, poorer HRQoL and higher parental distress scores compared to population norms. Our findings justify the provision of early intervention, support and medical services for all DHH children to identify those at risk of poorer outcomes.

Balance Control in Individuals with Hearing Impairment: A Systematic Review and Meta-Analysis

Comprehensive insights into balance control of individuals with hearing impairment are compared with individuals with hearing. Primary sources were obtained from 7 databases including PubMed, LILACS, SCOPUS, CINAHL, PEDro, CENTRAL, and Web of Science. The search period extended from inception until January 5, 2022. The systematic review included 24 studies and 27 trials, with a total of 2,148 participants. The meta-analysis showed a significant difference in the average balance control between individuals with hearing impairment and individuals with hearing, with individuals with hearing having a favorable advantage (p = 0.001). Additionally, average balance control was found to be in favor of individuals with hearing (p = 0.001) when comparing individuals with hearing impairment who participated in sports. Finally, individuals with hearing impairment who participated in sports demonstrated a significantly higher average difference in balance control (p = 0.001) when compared to sedentary people with hearing impairment. Our meta-analysis results indicate a balance defect in individuals with hearing impairment compared to individuals with hearing. In addition, with increasing age, the balance in individuals with hearing impairment improved. Additionally, the dependence of individuals with hearing impairment on the visual and proprioception systems to maintain balance increased. Finally, there was more dependence on the proprioception than the visual system, while individuals with hearing had stronger average balance control than individuals with hearing impairment who participated in sports, when compared to sedentary people with hearing impairment.

Effects of proprioception and core stability training followed by detraining on balance performance in deaf male students: a three-arm randomized controlled trial

PURPOSE

Children with hearing impairment are unable to speak and may suffer from some physical problems such as weakness in postural performance ability and development. The aim of the current study was to explore the effects of proprioception versus core stability training for an 8-week period followed by a 6-month detraining protocol on the balance performance of deaf students.

MATERIALS AND METHODS

This is a randomized controlled trial design of three groups in blinded evaluators. The study was conducted at the school gym. A total of 30 participants, of male deaf students, were randomized into three groups: (1) one group receiving proprioception training (PT, n = 10), (2), one group receiving core stability training (CST, n = 10) for 8 weeks, and (3), and control group (CON, n = 10). The Balance Error Scoring System (BESS) test and Y-balance test assess static and dynamic balance at pre- and post-training following a 6-month detraining.

RESULTS

Post 8 weeks of training intervention, PT and CST values showed significant improvements in both static (p = 0.001) and dynamic (p = 0.001) balance. Following the 6-month detraining, only the PT group maintained their improvements in both the static and dynamic balance tests (p = 0.348) and the CST group showed decreases in the balance tests (p = 0.034).

CONCLUSIONS

The results indicate that 8 weeks rehabilitation program (PT and CST) is an optimum training modality to enhance balance in deaf students and PT induces more training effects than CST for maintaining training benefits following the detraining. Clinical trial registry number: IRCT20170312033029N2; URL: https://en.irct.ir/trial/25584; Trial Id: 25584; Registration date: 2017-12-08; Study start date; 2017-12-22.

Vestibular Loss in Children Affected by LVAS and IP2 Malformation and Operated with Cochlear Implant

This is a single center cohort study regarding the prevalence of vestibular loss in hearing impaired children affected by large vestibular aqueduct syndrome (LVAS) with incomplete cochlear partition malformation type II (IP2), fitted with cochlear implant (CI). Twenty-seven children received CI operations at 0.4-13 years on one or both ears and tested for vestibular loss with head impulse test, video head impulse test, mini ice-water test and cervical VEMP. Vestibular loss was found in 19% of operated ears and in 13.9% of non-operated ears. The difference was not statistically significant and was not significantly modified by age at implantation, age at testing, sex, presence of SLC26A4 gene mutation or bilaterality. However, the presence of anatomic anomalies at the level of the vestibulum or semicircular canals was significantly associated with a higher incidence of vestibular loss in CI operated children but not in those non-operated. No other factors, such as the surgical access, the electrode type, the presence of Gusher perioperatively, or post-operative vertigo modified significantly the prevalence of vestibular loss. In conclusion, LVAS/IP2 appears to be the major determinant of vestibular loss in these children, with a less obvious impact of CI, excluding the cases with vestibulum/canal anomalies: this group might have a higher risk for vestibular loss after CI surgery.

Efficacy of fine motor and balance exercises on fine motor skills in children with sensorineural hearing loss

BACKGROUND

Childhood hearing impairment is a major disability associated with delayed motor development. The affected Fine motor performance in children with sensorineural hearing loss (SNHL) could be due to dynamic balance deficits and visual-motor incoordination.

OBJECTIVE

This study was designed to investigate the effects of fine motor exercises with or without balancing exercises on fine motor skills in children with SNHL.

METHODS

One hundred and eighty (180) children their age ranged from 8 to 18 years old diagnosed with SNHL were selected. They were divided into three groups, 60 children (control group) practiced only their ordinary activities of daily living, 60 children (fine motor exercises group) practiced fine motor exercises, and 60 children (fine motor and balance exercise) group practiced fine motor and balance exercises. The outcomes were assessed by the Bruininks Oseretsky Test of the motor proficiency second edition scale (BOT-2).

RESULTS

Generally, there was a statistically significant difference between control group and fine motor exercises group where (p <  0.05), besides, there was a statistically significant difference between control group and fine motor and balance exercises group where (p <  0.05). But, there was no statistically significant difference between fine motor exercises group and fine motor and balance exercises group where (p >  0.05).

CONCLUSIONS

The Fine Motor performance of children with SNHL has been improved by Fine motor with or without balancing exercises according to (BOT-2).

The effects of Pilates training on static and dynamic balance of female deaf students: A randomized controlled trial

INTRODUCTION

To evaluate the effect of Pilates training on static and dynamic balance of deaf female.

METHODS

This study is a randomized, controlled trial with concealed randomization and blinded assessments. 19 female deaf students participated in this study and were randomly assigned into experimental (EXP, n = 9) and control (CON, n = 10) groups. Static balance was examined by Balance Error Scoring System (BESS), and dynamic balance was examined by Y balance test (YBT). The experimental group performed a Pilates training program for 8 weeks (three sessions of 60 min).

RESULTS

The findings showed that experimental group showed a significant change in static balance (with open eye and close eye) and dynamic balance (dominant limb and non-dominant limb) after 8 weeks Pilates training (p < 0.05). The control also showed no significant changes after training duration (p > 0.05).

CONCLUSIONS

This study showed that Pilates training significantly improve balance in female deaf students.

Postural instability in children with severe inner ear malformations: Characteristics of vestibular and balance function

OBJECTIVE

To investigate the postural instability and vestibular functions in children with severe inner ear malformations (IEMs).

DESIGN

A prospective case-control study.

STUDY SAMPLE

The study group consisted of 10 children using unilateral auditory brainstem implant (ABI) with labyrinthine aplasia or rudimentary otocyst. The age-matched control groups consisted of 10 unilateral cochlear implant (CI) users with normal inner ear structures and 10 healthy peers. All tests were performed to implant users when the implants were off.

RESULTS

All median VOR gains in the ABI group (median anterior, lateral, and posterior canal 0.15, 0.05, and 0.05, respectively, for the non-implanted sides) were significantly lower than those of the control groups (median VOR gains ≥ 0.90 in both control groups). There were no oVEMP and cVEMP responses in the study group. The mean BOT-2 balance scores of the ABI (3.70 ± 1.34) group was dramatically lower than those of the CI (9.40 ± 2.88) and healthy control (16.20 ± 4.16, p < 0.001).

CONCLUSIONS

The postural instability in children with severe IEMs was higher than those in CI users with normal inner ear structures and healthy peers. The level of deficiency in the labyrinthine was more important for postural stability in children.

The impact of hearing loss on three-dimensional lower limb joint torques during walking in prepubertal boys

INTRODUCTION

In children, the impact of hearing loss on biomechanical gait parameters is not well understood. Thus, the objectives of this study were to examine three-dimensional lower limb joint torques in deaf compared to age-matched healthy (hearing) children while walking at preferred gait speed.

METHODS

Thirty prepubertal boys aged 8-14 were enrolled in this study and divided into a group with hearing loss (deaf group) and an age-matched healthy control. Three-dimensional joint torques were analyzed during barefoot walking at preferred speed using Kistler force plates and a Vicon motion capture system.

RESULTS

Findings revealed that boys with hearing loss showed lower joint torques in ankle evertors, knee flexors, abductors and internal rotators as well as in hip internal rotators in both, the dominant and non-dominant lower limbs (all p < 0.05; d = 1.23-7.00; 14-79%). Further, in the dominant limb, larger peak ankle dorsiflexor (p < 0.001; d = 1.83; 129%), knee adductor (p < 0.001; d = 3.20; 800%), and hip adductor torques (p < 0.001; d = 2.62; 350%) were found in deaf participants compared with controls.

CONCLUSION

The observed altered lower limb torques during walking are indicative of unstable gait in children with hearing loss. More research is needed to elucidate whether physical training (e.g., balance and/or gait training) has the potential to improve walking performance in this patient group.

Physical fitness of deaf females

Study aim: The aim of the study was to examine the differences in physical fitness between deaf female soccer players and their deaf peers who did not practise any sport.

Material and methods: The research involved 13 deaf female soccer players and 16 deaf untrained girls. Physical fitness was assessed by a jump test and the Eurofit test. In the jump test, each participant performed an akimbo counter-movement jump (ACMJ), a counter-movement jump (CMJ) and a spike jump (SPJ) on a force plate. The following trials of the Eurofit test were performed: flexibility – sit-and-reach; static strength – hand grip; functional strength – bent arm hang (arm and shoulder muscular endurance); explosive strength – standing broad jump; and trunk strength – sit-ups (abdominal muscular endurance).

Results: Soccer players jumped significantly higher than untrained females in the ACMJ, CMJ, and SPJ, and developed significantly higher power of the CMJ. Relative power developed in the ACMJ and SPJ did not differ between the examined groups. Soccer players were physically fitter than girls who did not play any sport. Significant differences between the groups were observed for all measured trials except for the bent arm hang.

Conclusions: Hearing loss does not significantly determine the physical development or physical fitness of deaf people. Playing sports improves the physical fitness of deaf people in comparison with untrained deaf people.

Health-Related Quality of Life in Children With Low Language or Congenital Hearing Loss, as Measured by the PedsQL and Health Utility Index Mark 3

OBJECTIVES

To examine health-related quality of life (HRQoL) in young children with low language or congenital hearing loss and to explore the value of assessing HRQoL by concurrently administering 2 HRQoL instruments in populations of children.

METHODS

Data were from 2 Australian community-based studies: Language for Learning (children with typical and low language at age 4 years, n = 1012) and the Statewide Comparison of Outcomes study (children with hearing loss, n = 108). HRQoL was measured using the parent-reported Health Utilities Index Mark 3 (HUI3) and the Pediatrics Quality of Life Inventory 4.0 (PedsQL) generic core scale. Agreement between the HRQoL instruments was assessed using intraclass correlation and Bland-Altman plots.

RESULTS

Children with low language and with hearing loss had lower HRQoL than children with normal language; the worst HRQoL was experienced by children with both. The lower HRQoL was mainly due to impaired school functioning (PedsQL) and speech and cognition (HUI3). Children with hearing loss also had impaired physical and social functioning (PedsQL), vision, hearing, dexterity, and ambulation (HUI3). Correlations between instruments were poor to moderate, with low agreement.

CONCLUSIONS

Children with low language and congenital hearing loss might benefit from interventions targeting overall health and well-being, not just their impairments. The HUI3 and PedsQL each seemed to provide unique information and thus may supplement each other in assessing HRQoL of young children, including those with low language or congenital hearing loss.

Methodological aspects of testing vestibular evoked myogenic potentials in infants at universal hearing screening program

Motor development in infants is dependent upon the function of the inner ear balance organ (vestibular organ). Vestibular failure causes motor delays in early infancy and suboptimal motor skills later on. A vestibular test for newborns and infants that is applicable on a large scale, safe and cost effective is in demand in various contexts: in the differential diagnosis of early onset hearing loss to determine forms associated with vestibular failure; in early hearing habilitation with cochlear implant, indicating the vestibular predominant side; and in the habilitation of children affected by motor skill disorders, revealing the contribution of a vestibular failure. This work explored the feasibility of cervical vestibular evoked myogenic potentials (VEMP) in conjunction with newborn universal hearing screening program. VEMP was measured after the hearing tests and was evoked by bone-conducted stimuli. Moreover, stimulus delivery was regulated by neck muscle activity, with infants rested unconstrained in their parents´ arms and with the head supported by the operator´s hand. This VEMP protocol showed a high level of feasibility in terms of test viability and result reproducibility. VEMP integrated into the newborn hearing screening program may represent a practical method for large-scale assessment of balance function in infants.

Gait ground reaction force characteristics in deaf and hearing children

The link between gait parameters and hearing loss is not well understood. The objective of this study was to investigate the effects of the gait ground reaction forces, their time to peak, vertical loading rate, impulses and free moment during gait in deaf and hearing children. Thirty male children were equally divided into a healthy group and a group with hearing loss problems (Deaf group). Ground reaction forces were analyzed during barefoot walking. MANOVA test was used for between group comparisons. The significance level was set at p<0.05 for all analyses. Hearing loss was associated with increased propulsion lateral-medial ground reaction force (p=0.031), its time to peak (p=0.008), and lateral- medial impulse (p=0.018). Similar vertical reaction forces were observed in both groups (p>0.05). Positive peak of free moments in the healthy group was significantly greater than that in the deaf group (p=0.004). In conclusion, the results reveal that gait ground reaction force components in deaf children may have clinical values for rehabilitation of these subjects.

Quality of Life in Children with Hearing Impairment: Systematic Review and Meta-analysis

OBJECTIVE

To determine the impact of pediatric hearing loss (HL) on quality of life (QOL).

DATA SOURCES

A qualified medical librarian conducted a literature search for relevant publications that evaluate QOL in school-aged children with HL.

REVIEW METHODS

Studies were assessed independently by 2 reviewers for inclusion in the systematic review and meta-analysis.

RESULTS

From 979 abstracts, 69 were identified as relevant; ultimately, 40 articles were included in the systematic review. This review revealed that children with HL generally report a lower QOL than their normal-hearing peers and that QOL improves after interventions. The extent of these differences is variable among studies and depends on the QOL measure. Four studies using the Pediatric Quality of Life Inventory (PedsQL) had sufficient data for inclusion in a meta-analysis. After studies were pooled, statistically and clinically significant differences in PedsQL scores were found between children with normal hearing and those with HL, specifically in the social and school domains. Statistically significant differences were also noted in total scores for children with unilateral HL and in the physical domain for children with bilateral HL as compared with those having normal hearing; however, these differences were not clinically meaningful.

CONCLUSIONS

Our analysis reveals that decreased QOL in children with HL is detected in distinct domains of the PedsQL. These domains-school activities and social interactions-are especially important for development and learning. Future work should focus on these aspects of QOL when assessing HL in the pediatric population.

The effect of interventional proprioceptive training on static balance and gait in deaf children

Children with hearing impairment have balance and motor deficits primarily due to concomitant damage to the vestibular structures. Although early intervention focused on the development of communication skills, investigations of intervention for the amelioration of balance deficits in children with hearing loss have been minimal and inconclusive. Therefore, using an experimental design, the present study investigated the effect of a 12-session exercise balance program based on proprioception training on balance and gait in deaf as compared with hearing schoolchildren. The subjects, 10 deaf and 10 typically developing children were assigned to an experimental and a control group respectively. Taking up the initial differences between the groups through a pretest under different conditions, the participants in the experimental group went through a 12-session intervention program including static and dynamic training with emphasis on proprioceptive system. After this, the participants were tested again. The data obtained was analyzed using repeated measure. A comparison between the control and experimental groups revealed that the intervention program had not significantly increased gait velocity while it had significantly decreased the amount of sway. Thus, it was concluded that an exercise program that enhances somatosensory ability can result in improved balance in deaf children.

Quality and structure of variability in children during motor development: a systematic review

Variability has been perceived to be beneficial to movement organization and execution, being essential to selection of movement patterns during motor development, to obtain flexible patterns and adaptability to different task demands. Human movement variability can be measured by linear and nonlinear tools. Recently, nonlinear techniques have been used successfully to give insight into motor skills control in children, and be able to discriminate pathologic and non-pathologic children. For that, this paper is the first to review systematically studies that used nonlinear measures in children. We intend to describe which mathematical tools are utilized to analyze quality and structure of variability, the factors that influence this variability and methodological procedures which are considered for its analysis, and how they are interpreted in child motor development field. A search was performed by one reviewer in relevant databases and the quality appraisal was conducted independently by two reviewers. In all, 27 articles were identified and 20 were selected for the present review. It was detected a large variation in sample characteristics and methodological issues among studies. In fact, the main importance of this review was due to the attempt to define some parameters and standardize some values for typical children and children with disabilities. It is noted that the results from nonlinear techniques depend on the task being analyzed, the age and the type of mathematical technique chosen. The presence of disability is associated to decreases in complexity and nonlinear tools were considered sensible to investigate the effectiveness of practice and intervention in typical children and children with cerebral palsy. Furthermore, future studies should be more careful in standardizing selection, recruitment and explaining missing data. Future reports also should present details of their results and limitations to favor comparisons and helping in formulating new research questions.

A preliminary randomized controlled study on the effectiveness of vestibular-specific neuromuscular training in children with hearing impairment

Objective:

To determine the effectiveness of vestibular-specific neuromuscular training on motor skills, balance and health-related quality of life in children with hearing impairment.

Design:

Controlled, randomized, preliminary study.

Setting:

Rehabilitation school for children with hearing impairment.

Subjects and intervention:

Twenty-three children with mean age of 7.5–8.1 years with hearing impairment were randomized to either the intervention or the control group. Children in the experimental group ( n = 11) participated in vestibular-specific neuromuscular training for six weeks and the children in the control group continued their regular activities followed at school.

Outcome measures:

Measurement of motor skills (Test of Gross Motor Development-2), postural control (Pediatric Reach Test, One Leg Standing Balance Test and postural sway meter) and health-related quality of life (PedsQL Generic Core Scale).

Results:

Following intervention, the scores of motor skills (Test of Gross Motor Development P = 0.02; throw for distance P = 0.042; kick for distance P = 0.08; jump for distance P = 0.001; 15-yard dash P = 0.001), postural control measures (Pediatric Reach Test P = 0.001; One Leg Standing Test P = 0.03; and anteroposterior sway (eyes open P = 0.007, eyes closed P = 0.03); mediolateral sway (eyes open P = 0.014, eyes closed P = 0.017) and health-related quality of life ( P = 0.01) improved significantly in the experimental group and not in the control group.

Conclusion:

The findings of the study suggest that vestibular-specific neuromuscular training programme may improve the motor skills, balance and health-related quality of life in children with hearing impairment.