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Ockerman J, Velghe S, VAN Bladel A, Auvinet E, Saldien J, Klingels K, Bar-On L, Verbecque E. Checks and balances: a meta-analysis on the known-groups validity of functional postural control tests in children. Eur J Phys Rehabil Med 2024; 60:656-670. [PMID: 38842066 PMCID: PMC11407102 DOI: 10.23736/s1973-9087.24.08187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
INTRODUCTION Pediatric physical therapists commonly treat children with postural control deficits. Ideally, pediatric functional postural control tests should therefore be able to identify postural control deficits in children with various disorders. Despite a plethora of available tests, evidence for their validity - especially known-groups - remains scarce. This review aims to determine the known-group validity of available functional postural control tests to differentiate various pediatric pathological groups of different ages from their typically developing (TD) peers. EVIDENCE ACQUISITION PubMed, Web of Science and Scopus were systematically searched (last update: February 2023; PROSPERO: CRD42023408982). Forty case-control studies with a pathological pediatric sample (N.=1331) and TD peers (N.=1889) were included and selected for data-extraction and -analysis. Risk of bias was assessed using the SIGN checklist and level of evidence was scored using GRADE. Random-effect meta-analyses were performed to estimate pooled standardized mean differences (SMD) for the various test types and subclassified based on pathology and/or age. EVIDENCE SYNTHESIS When compared with TD peers, children with underlying pathologies performed significantly worse on pediatric functional postural control test batteries (SMD=-2.21), the Timed Up and Go Test and variants (SMD=2.30), the One Leg Stance test and variants (SMD=-2.14), while the Reach tests showed a smaller difference (SMD=-1.19). Subclassification within the meta-analyses showed that pathology was an influencing factor for the test batteries and the one leg stance test and variants. Age was an influencing factor for the reach tests. None of the included functional postural control tests exceeded a low level of evidence. CONCLUSIONS Pediatric functional postural control tests that assess multiple aspects of postural control (such as test batteries) seem to offer higher known-groups validity than single-task tests (e.g. reach tests). The underlying pathology has a larger impact on the validity of these tests than age. There remains an overall low level of evidence for the known-groups validity of pediatric functional postural control tests indicating the need for research with more homogenous groups and norm reference data.
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Affiliation(s)
- Jorn Ockerman
- Unit of Pediatric Rehabilitation Research of Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Silke Velghe
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Anke VAN Bladel
- Unit of Pediatric Rehabilitation Research of Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Edouard Auvinet
- Health Engineering Laboratory, Centre de Recherche et de Développement ECAM (CERDECAM), ECAM, Brussels, Belgium
| | - Jelle Saldien
- Media, Innovation and Communication Technologies, Department of Industrial Systems Engineering and Product Design, University of Ghent, Ghent, Belgium
| | - Katrijn Klingels
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Lynn Bar-On
- Unit of Pediatric Rehabilitation Research of Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Evi Verbecque
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium -
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Wang Y, Zhong M, Li Y, Liu Y, Tong B, Qiu J, Chen S. Association Between Hearing Loss, Asymmetric Hearing, and Postural Instability. Ear Hear 2024; 45:827-836. [PMID: 38351499 DOI: 10.1097/aud.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Recent studies have suggested that older adults with hearing loss (HL) are at a greater risk of postural instability than those with normal hearing. However, little is known regarding this association in middle-aged individuals. The relationships between HL laterality, asymmetric hearing, and posture control are similarly unclear. The purpose of this study was to investigate the effects of hearing status on postural control and to explore the dose-response relationship between the hearing threshold and postural instability risk in middle-aged adults. DESIGN This cross-sectional study included 1308 participants aged 40 to 69 years with complete audiometric and standing balance function data from the 2001-2004 National Health and Nutrition Examination Survey. Speech-frequency HL was defined as a pure-tone average at 0.5, 1, 2, and 4 kHz of >25 dB in the better-hearing ear; high-frequency HL was defined as a pure-tone average at 3, 4, and 6 kHz of >25 dB. Asymmetric hearing was defined as a difference in the pure-tone average >15 dB between ears. Postural instability was defined as participants ending the modified Romberg test in condition 4. RESULTS After adjustment for sociodemographic variables, lifestyle, and comorbidities, speech-frequency HL, except for unilateral HL, was associated with increased postural instability (mild HL: odds ratio [OR], 2.33; 95% confidence interval [CI], 1.25-4.35; moderate-to-severe HL: OR, 3.59; 95% CI, 1.61-8.03). Compared with individuals with normal bilateral hearing, participants with bilateral HL also showed a higher risk of postural instability (OR, 2.88; 95% CI, 1.61-5.14). The OR for postural instability among participants with asymmetric hearing compared with those with symmetric hearing was 2.75 (95% CI, 1.37-5.52). Furthermore, each 10 dB increase in the speech-frequency hearing threshold was associated with a 44% higher risk of postural instability. CONCLUSIONS Hearing loss is associated with poorer postural control. Individuals with asymmetric hearing have a higher postural instability risk compared with those with symmetric hearing. Further studies are needed to confirm these findings and the causality. Moreover, future studies are warranted to assess whether hearing aids are beneficial for the restoration of impaired balance functions.
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Affiliation(s)
- Yang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Otorhinolaryngology-Head and Neck Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, P.R. China
| | - Mei Zhong
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yifan Li
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yehai Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Busheng Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jianxin Qiu
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Otorhinolaryngology-Head and Neck Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, P.R. China
| | - Shanwen Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
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Melo RS, Lemos A, Wiesiolek CC, Soares LGM, Raposo MCF, Lambertz D, Belian RB, Ferraz KM. Postural Sway Velocity of Deaf Children with and without Vestibular Dysfunction. SENSORS (BASEL, SWITZERLAND) 2024; 24:3888. [PMID: 38931672 PMCID: PMC11207260 DOI: 10.3390/s24123888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Sensory information obtained from the visual, somatosensory, and vestibular systems is responsible for regulating postural control, and if damage occurs in one or more of these sensory systems, postural control may be altered. OBJECTIVE To evaluate and compare the postural sway velocity between children with normal hearing and with sensorineural hearing loss (SNHL), matched by sex and age group, and to compare the postural sway velocity between children with normal hearing and with SNHL, with and without vestibular dysfunction. METHODS Cross-sectional study that evaluated 130 children (65 with normal hearing and 65 with SNHL), of both sexes and aged between 7 and 11 years, from public schools of the city of Caruaru, Pernambuco state, Brazil. The postural sway velocity of the center of pressure (COP) was assessed by a force platform, in two directions, anteroposterior (AP) and mediolateral (ML)), in three positions, namely bipedal support with feet together and parallel (parallel feet (PF)), bipedal support with one foot in front of the other (tandem foot (TF)), and single-leg support (one foot (OF)), evaluated with the eyes open and closed. RESULTS Children with SNHL demonstrated greater postural sway velocity compared to children with normal hearing in all the positions evaluated, with significant differences in the AP direction, with the eyes open (PF: p = 0.001; TF: p = 0.000; OF: p = 0.003) and closed (PF: p = 0.050; TF: p = 0.005). The same occurred in the ML direction, with the eyes open (PF: p = 0.001; TF: p = 0.000; OF: p = 0.001) and closed (PF: p = 0.002; TF: p = 0.000). The same occurred in relation to vestibular function, where the children with SNHL with an associated vestibular dysfunction demonstrated greater postural sway velocity compared to children with normal hearing in all the positions evaluated, demonstrating significant differences in the AP direction, with the eyes open (TF: p = 0.001; OF: p = 0.029) and eyes closed (PF: p = 0.036; TF: p = 0.033). The same occurred in the ML direction, with the eyes open (TF: p = 0.000) and with the eyes closed (PF: p = 0.008; TF: p = 0.009). CONCLUSIONS Children with SNHL demonstrated greater instability of postural control than children with normal hearing in all the directions assessed. Children with SNHL and an associated vestibular dysfunction demonstrated the greatest instability of postural control in this study.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil (K.M.F.)
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
- Laboratory of Informatics in Health, Institute Keizo Asami (iLIKA), Recife 50670-901, Brazil
| | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil (K.M.F.)
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
| | - Carine Carolina Wiesiolek
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil (K.M.F.)
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
| | | | | | - Daniel Lambertz
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
| | - Rosalie Barreto Belian
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
- Laboratory of Informatics in Health, Institute Keizo Asami (iLIKA), Recife 50670-901, Brazil
- Department of Medicine, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
| | - Karla Mônica Ferraz
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil (K.M.F.)
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50670-901, Brazil
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Mohamed ST, Hazzaa N, Abdel Rahman T, Ezz Eldin DM, Elhusseiny AM. Efficacy of vestibular rehabilitation program in children with balance disorders and sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2024; 179:111931. [PMID: 38555811 DOI: 10.1016/j.ijporl.2024.111931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/25/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Asses the efficacy of a Vestibular-balance rehabilitation program to minimize or reverse balance disability in children with sensorineural hearing loss. METHOD Forty-five hearing-impaired children with balance deficits (i.e., variable degrees of sensorineural hearing loss or auditory neuropathy). Thirty-five were rehabilitated with cochlear implants, and ten with hearing aids. Their age ranged from 4 to 10 years old. A Pre-rehab evaluation was done using questionnaires, neuromuscular evaluation, vestibular and balance office testing, and vestibular lab testing (using cVEMP and caloric test). Customized balances, as well as vestibular rehabilitation exercises, have been applied for three months. That was followed by post-rehab assessment, including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test. RESULTS There was a statistically significant difference in all measured parameters (including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test) after rehabilitation. CONCLUSIONS Vestibular-balance rehabilitation intervention positively impacts vestibular and balance functions in hearing-impaired children.
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Affiliation(s)
- Somaia Tawfik Mohamed
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
| | - Nagwa Hazzaa
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
| | - Tayseer Abdel Rahman
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt.
| | - Dalia Mohamed Ezz Eldin
- Physical medicine, rheumatology and rehabilitation, Rheumatology and Rehabilitation Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
| | - Aya Magdy Elhusseiny
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
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Alqudah S, Zuriekat M, Shatarah A. Impact of hearing impairment on the mental status of the adults and older adults in Jordanian society. PLoS One 2024; 19:e0298616. [PMID: 38437235 PMCID: PMC10911586 DOI: 10.1371/journal.pone.0298616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/27/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Hearing loss is a common disorder, affecting both children and adults worldwide. Individuals with hearing loss suffer from mental health problems that affect their quality of life. OBJECTIVE This study aimed to investigate the social and emotional consequences of hearing loss in a Jordanian population using Arabic versions of the Hearing Handicap Inventory for Adults (HHIA) and the Hearing Handicap Inventory for the Elderly (HHIE). METHODS This study included 300 Jordanian participants aged 18-90 years with hearing loss. Each participant underwent a complete audiological evaluation before answering the questionnaires. RESULTS The median overall scores of the HHIA and HHIE groups were 39 and 65, respectively. Both HHIA (Cronbach's alpha = 0.79, p < 0.001) and HHIE (Cronbach's alpha = 0.78, p < 0.001) were significantly associated with the social, emotional, and overall scores. Compared to the adult group, the median emotional and social scores of the older adults group were significantly higher than the adults group (Z = -4.721, p = 0.001), using the Mann-Whitney test. CONCLUSION The present research revealed that psychological disabilities associated with hearing loss in the adult Jordanian population are more frequent and severe than in other nations. This may be attributed to the lack of awareness of the mental consequences of hearing loss among Jordanian healthcare providers and the public.
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Affiliation(s)
- Safa Alqudah
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Margaret Zuriekat
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan
| | - Aya Shatarah
- Bachelor in Speech and Hearing, Jordan University of Science and Technology, Irbid, Jordan
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Tuncer D, Gurses HN. The Effects of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions, and Postural Control in Children With Hearing Loss: A Randomized Controlled Trial. Ear Hear 2024; 45:306-315. [PMID: 37784232 DOI: 10.1097/aud.0000000000001428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
OBJECTIVES To evaluate the effects of core stabilization training on respiratory muscle strength, respiratory functions, and postural control in children with hearing loss. DESIGN We conducted a randomized controlled trial at Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation. Thirty children with hearing loss who were diagnosed with prelingual sensorineural hearing loss were randomly allocated to the study (n = 15, 12.20 ± 1.69 years) and control (n = 15, 11.87 ± 2.20 years) groups. Core stabilization training protocol was performed by the study group for 8 weeks, 5 days/week, whereas the control group received no training. The primary outcome measure was respiratory muscle strength. The secondary outcome measures were: spirometry, postural control tests on Biodex Balance System, and Balance Error Scoring System (BESS). Exercise adherence was recorded via a diary for home sessions. Outcomes were assessed at baseline and the end of the 8 weeks. RESULTS In the study group, a significant improvement was observed in force vital capacity, peak expiratory flow of the spirometry test, maximum inspiratory pressure/expiratory pressure (MEP) of the respiratory muscle strength test; postural stability test except "anterior/posterior stability index", limits of stability test except "backward" and "forward/right", all parameters of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) test except "eyes closed firm surface" of the Biodex Balance System, and total score of BESS. Group × time interaction was found in MEP, "overall" stability index in postural stability test, "overall," "left," and "backward left" of limits of stability test, all parameters of the mCTSIB, and BESS total. CONCLUSIONS Core stabilization exercises were effective in improving respiratory muscle strength, spirometry, and postural control in children with hearing loss.
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Affiliation(s)
- Deniz Tuncer
- Cardiopulmonary Physiotherapy Rehabilitation Department, Institute of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
| | - Hulya Nilgun Gurses
- Department of Cardiopulmonary Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
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Kamel RM, Khaireldin A, Gad Allah MA, Bakhoom RYF, Abdelhakiem NM, Mehrem ES. Efficacy of balance exercises intervention on postural control-related impairment in children with sensorineural hearing loss. NeuroRehabilitation 2024; 54:349-358. [PMID: 38277310 DOI: 10.3233/nre-230284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
BACKGROUND Sensorineural hearing loss is the most common type of permanent hearing impairment and results in postural control and motor deficits in children that may affect or delay all developmental indicators. OBJECTIVE The purpose of the study was to investigate the efficacy of balance exercises intervention on postural control-related impairment in children with sensorineural hearing loss. METHODS Forty students of both genders, ages ranging from 10 to 16 years, diagnosed with severe to profound sensorineural hearing loss, were selected from the Public School for the Deaf and Hard of Hearing in El-Minia district, Minia governorate, Egypt. They divided randomly into two groups, 20 (study group), received balance exercises in addition to their ordinary daily living activities. Meanwhile, the control group of 20 children practiced only the ordinary daily living activities. The outcome was assessed pre-treatment and post-treatment by Humac Balance System and Bruininks-Oseretsky Test (BOT-2) subtest (5) for balance. RESULTS Regarding the Humac balance system and subtest (5) of BOT-2, there was a statistically significant difference between pre-treatment data and post-treatment data of the study group with a p value equal to 0.036 or less. However, no statistically significant difference was observed in the control group with a p value equal to 0.096 or more. Finally, there was a statistically significant difference between the groups with respect to the post-treatment data, where the p value was 0.014 or less. CONCLUSION Postural control of children with sensorineural hearing loss has been improved by balance exercises.
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Affiliation(s)
- Roshdy M Kamel
- Basic Sciences Department, Faculty of Physical Therapy, Benha University, Qalyubia, Egypt
| | - Alaaeldin Khaireldin
- Orthopedic Department, Faculty of Physical Therapy, Deraya University, Minia, Egypt
- Department of Physical Therapy, Benha University Hospital, Benha, Qalyubia, Egypt
| | - Mohamed A Gad Allah
- Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Deraya University, Minia, Egypt
| | - Ramez Yousry Fawzy Bakhoom
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Deraya University, Minia, Egypt
| | - Nadia Mohamed Abdelhakiem
- Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Deraya University, Minia, Egypt
| | - Elsayed S Mehrem
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Deraya University, Minia, Egypt
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Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. The impacts of exercise training programs on balance in children with hearing loss: A systematic review and meta-analysis. J Bodyw Mov Ther 2024; 37:296-307. [PMID: 38432821 DOI: 10.1016/j.jbmt.2023.11.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/13/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
INTRODUCTION AND PURPOSE According to the prevalence of balance disorders among children with hearing loss (HL), researchers used exercise programs to improve balance in children with HL. So, the present systematic review and meta-analysis briefly summarize findings regarding the impacts of exercise training programs on balance in children with HL. METHODS Science Direct, MEDLINE/PubMed, SCOPUS, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar were searched from inception until November 11th, 2023. Two independent researchers analyzed and extracted the data from potential papers whose eligibility was confirmed. Then, the PEDro scale was used to obtain quality assessment scores. The total PEDro score is 11 and incorporates the presentation of statistical analysis and evaluation criteria of internal validity. Studies that scored 7-11 were considered methodologically "high", 5 to 6 were "fair", and ≤4 were considered "poor". RESULTS 10 studies involving a total of 304 participations were included in the systematic review. Our results demonstrate that exercise training programs positively impact static balance (p = 0.001) with level 1a evidence, the postural sway (p = 0.001) with level 1a evidence, and dynamic balance (p = 0.001) with level 1a evidence in children with HL. CONCLUSION The findings of this systematic review and meta-analysis related to studies with excellent methodological quality revealed that the intended training programs significantly impact postural sway along with static and dynamic balance in children with HL. It is recommended that future exercise training programs be paired with rehabilitation programs for children with HL.
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Affiliation(s)
- Hamed Zarei
- Physical Education & Sport Sciences, (corrective Exercise and Sport Injuries), Corrective Exercises and Sports Injury Department, Faculty of Physical Education & Sport Sciences, University of Guilan, 4199613776, Rasht, Iran.
| | - Ali Asghar Norasteh
- Physiotherapy Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Lauren J Lieberman
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, NY, 14420, USA
| | - Michael W Ertel
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
| | - Ali Brian
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. Balance Control in Individuals with Hearing Impairment: A Systematic Review and Meta-Analysis. Audiol Neurootol 2023; 29:30-48. [PMID: 37557094 DOI: 10.1159/000531428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 05/30/2023] [Indexed: 08/11/2023] Open
Abstract
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.
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Affiliation(s)
- Hamed Zarei
- Corrective Exercises and Sports Injury Department, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran
| | - Ali Asghar Norasteh
- Physiotherapy Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Lauren J Lieberman
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, New York, USA
| | - Michael W Ertel
- Department of Physical Education, University of South Carolina, Columbia, South Carolina, USA
| | - Ali Brian
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, New York, USA
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Melo RS, Lemos A, Delgado A, Raposo MCF, Ferraz KM, Belian RB. Use of Virtual Reality-Based Games to Improve Balance and Gait of Children and Adolescents with Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:6601. [PMID: 37514897 PMCID: PMC10385194 DOI: 10.3390/s23146601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Children and adolescents with sensorineural hearing loss (SNHL) often experience motor skill disturbances, particularly in balance and gait, due to potential vestibular dysfunctions resulting from inner ear damage. Consequently, several studies have proposed the use of virtual reality-based games as a technological resource for therapeutic purposes, aiming to improve the balance and gait of this population. OBJECTIVE The objective of this systematic review is to evaluate the quality of evidence derived from randomized or quasi-randomized controlled trials that employed virtual reality-based games to enhance the balance and/or gait of children and adolescents with SNHL. METHODS A comprehensive search was conducted across nine databases, encompassing articles published in any language until 1 July 2023. The following inclusion criteria were applied: randomized or quasi-randomized controlled trials involving volunteers from both groups with a clinical diagnosis of bilateral SNHL, aged 6-19 years, devoid of physical, cognitive, or neurological deficits other than vestibular dysfunction, and utilizing virtual reality-based games as an intervention to improve balance and/or gait outcomes. RESULTS Initially, a total of 5984 articles were identified through the searches. Following the removal of duplicates and screening of titles and abstracts, eight studies remained for full reading, out of which three trials met the eligibility criteria for this systematic review. The included trials exhibited a very low quality of evidence concerning the balance outcome, and none of the trials evaluated gait. The meta-analysis did not reveal significant differences in balance improvement between the use of traditional balance exercises and virtual reality-based games for adolescents with SNHL (effect size: -0.48; [CI: -1.54 to 0.57]; p = 0.37; I2 = 0%). CONCLUSION Virtual reality-based games show promise as a potential technology to be included among the therapeutic options for rehabilitating the balance of children and adolescents with SNHL. However, given the methodological limitations of the trials and the overall low quality of evidence currently available on this topic, caution should be exercised when interpreting the results of the trials analyzed in this systematic review.
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Affiliation(s)
- Renato S Melo
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife 50670-901, PE, Brazil
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Andrea Lemos
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Alexandre Delgado
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife 50070-550, PE, Brazil
| | | | - Karla Mônica Ferraz
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Rosalie Barreto Belian
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife 50670-901, PE, Brazil
- Department of Medicine, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
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Elshafey MA, Abdrabo MS, Elnaggar RK. Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2022; 22:172-178. [PMID: 35642697 PMCID: PMC9186458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effects of a core stability exercise program on balance, coordination, and severity of ataxia in children with cerebellar ataxic cerebral palsy (CP). METHODS Forty children with cerebellar ataxic CP (mean age: 6.75±1.35 years) were randomly assigned to a control group and an intervention group for 2 months of follow-up. The control group received a standard physical therapy program three times weekly (1 h per session), while the intervention group received a core stability program for 30 min, in addition to the selected physical therapy program. Both groups were evaluated pre-treatment and post-treatment using the Scale for the Assessment and Rating of Ataxia, the Balance Error Scoring Systems scale, Bruininks-Oseretsky tests of motor proficiency, and HUMAC balance system scores. RESULTS We found statistically significant reductions in the severity of ataxia, as well as improved balance and coordination in both groups, with stronger effects observed in the intervention group (P<0.05). CONCLUSION The core stability program can improve balance and coordination in children with cerebellar ataxic CP when incorporated with a standard physical therapy program.
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Affiliation(s)
- Mohamed Ali Elshafey
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Egypt,Corresponding author: Mohamed Ali Elshafey, Shahin street Dakadous Mitghamr, Dakahlia, EgyptE-mail:
| | - Mohamed Samy Abdrabo
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Egypt
| | - Ragab Kamal Elnaggar
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Egypt,Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Leyssens L, Van Hecke R, Moons K, Luypaert S, Danneels M, Patru J, Willems M, Maes L. Postural balance problems in people with intellectual disabilities: Do not forget the sensory input systems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:280-294. [PMID: 34693604 DOI: 10.1111/jar.12948] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 07/06/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This pilot study aimed to explore the impact of visual, auditory and vestibular dysfunctions on the postural balance performance in adults with intellectual disabilities. Additionally, a comparison was made between the subjects with intellectual disabilities and a control group concerning static and dynamic balance tasks. METHOD Thirty adults with intellectual disabilities and 25 control subjects received a postural balance assessment. Additionally, the experimental group was subjected to a visual, auditory and vestibular screening. RESULTS The experimental group performed significantly worse and/or showed more sway compared to the control group for all balance tasks (p < .01) except the timed up and go test. Within the experimental group, a significant positive correlation (rs (24) = 0.513, p = .007) was observed between the number of failed sensory screening items and the number of failed balance tasks. CONCLUSIONS These findings suggest significant involvement of peripheral sensorial deficits in the balance problems that people with intellectual disabilities often experience.
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Affiliation(s)
- Laura Leyssens
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Ruth Van Hecke
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Karlien Moons
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Sofie Luypaert
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Maya Danneels
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Julie Patru
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Melina Willems
- Department of Audiology, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.,Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
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Melo RS, Lemos A, Raposo MCF, Monteiro MG, Lambertz D, Ferraz KM. Repercussions of the Degrees of Hearing Loss and Vestibular Dysfunction on the Static Balance of Children With Sensorineural Hearing Loss. Phys Ther 2021; 101:6322542. [PMID: 34270771 DOI: 10.1093/ptj/pzab177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/16/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the static balance of children with sensorineural hearing loss (SNHL) according to the degrees of SNHL and the function of the vestibular system. METHODS This cross-sectional study was conducted in public schools located in Caruaru, Pernambuco state, Brazil, with 130 children (65 with normal hearing and 65 with SNHL as documented by air and bone conduction audiometry) of both sexes between 7 and 11 years old. Static balance was assessed by a stabilometric analysis using a force platform consisting of the circular area of center-of-pressure displacement of the children evaluated in 3 positions: bipedal support with feet together and parallel (PF), tandem feet (TF), and 1 foot (OF), carried out under 2 sensory conditions each, with eyes open and eyes closed. After balance assessments, the children with SNHL received examinations of auditory and vestibular functions-through audiometry and computerized vectoelectronystagmography, respectively-to compose the groups according to degrees of SNHL and vestibular function. RESULTS The children with severe and profound SNHL demonstrated more static balance instabilities than the children with normal hearing in 5 positions assessed with eyes open (PF, TF, and OF) and eyes closed (PF and TF). The same phenomenon occurred in children with SNHL and associated vestibular dysfunction in all of the positions assessed with eyes open and eyes closed (PF, TF, and OF). CONCLUSION The larger the degree of SNHL, the greater the balance instability of the children. The children with SNHL and associated vestibular dysfunction showed the highest balance instabilities in this study. IMPACT Children with larger degrees of SNHL and associated vestibular dysfunction might require prolonged periods to rehabilitate their balance.
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Affiliation(s)
- Renato S Melo
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | - Milena Guimarães Monteiro
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Daniel Lambertz
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Karla Mônica Ferraz
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Ciquinato DSDA, Doi MY, Silva RAD, Oliveira MRD, Gil AWDO, Marchiori LLDM. Posturographic Analysis in the Elderly with and without sensorineural Hearing Loss. Int Arch Otorhinolaryngol 2020; 24:e496-e502. [PMID: 33133269 PMCID: PMC7593116 DOI: 10.1055/s-0040-1701271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 12/03/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction Sensorineural hearing loss (SNHL) is a serious public health problem. Some evidence suggests a significant relationship between SNHL and balance disorders. The inability to maintain balance associated with SNHL while standing further increases the risk of falls among older people. Objective To investigate the association between SNHL on the postural balance in elderly individuals of both genders. Methods The sample consisted of 247 (166 women) physically independent elderly individuals, (mean age = 68.4 ± 6.0). The instruments used were the anamnesis and the pure tone audiometry for hearing loss, and for balance a force platform based in measures of center of pressure area and of sway velocity in the anteroposterior and mediolateral directions. Results Presence of hearing loss (HL) was observed in 68% of the participants. We observed a significant association between SNHL and characteristics of balance between the groups with and without HL for center of pressure (COP) area ( p = 0.010), anteroposterior velocity ( p = 0.001) and mediolateral velocity ( p = 0.020). There was a significant difference between the gender groups for center of pressure area ( p = 0.004), anteroposterior velocity ( p = 0.001) and mediolateral velocity ( p = 0.001) with better performance in the female group. Amongst men, there was a difference between the ones with HL and those without it, for COP area ( p = 0.049). Conclusion In the present study, elderly individuals with SNHL exhibited more instability on the postural balance, and elderly men presented worse results in the test.
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Affiliation(s)
| | - Marcelo Yugi Doi
- Pitagoras Unopar University, Stricto Sensu Graduate Program in Rehabilitation Science UEL-UNOPAR, Londrina, Parana, Brazil
| | - Rubens A. da Silva
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP) – UNOPAR, Professional Master’s in Physical Exercise in Health Promotion, Londrina, Parana, Brazil
- Department des Sciences de la Sante, Programme de physiothéapie de l’Université McGill offert en extension – a l’Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable – UQAC, Laboratoire de recherche BioNR – UQAC, Saguenay, Québec, Canada
| | - Márcio Rogério de Oliveira
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP) – UNOPAR, Professional Master’s in Physical Exercise in Health Promotion, Londrina, Parana, Brazil
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Ertugrul G, Sennaroglu G, Karakaya J, Sennaroglu L. Postural instability in children with severe inner ear malformations: Characteristics of vestibular and balance function. Int J Audiol 2020; 60:115-122. [PMID: 32885696 DOI: 10.1080/14992027.2020.1808250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
- Gorkem Ertugrul
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Sennaroglu
- Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Melo RS, Tavares-Netto AR, Delgado A, Wiesiolek CC, Ferraz KM, Belian RB. Does the practice of sports or recreational activities improve the balance and gait of children and adolescents with sensorineural hearing loss? A systematic review. Gait Posture 2020; 77:144-155. [PMID: 32036319 DOI: 10.1016/j.gaitpost.2020.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 01/10/2020] [Accepted: 02/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Balance and gait disorders have been observed in children and adolescents with sensorineural hearing loss (SNHL), justified by vestibular dysfunctions that these children may present, due to the injury to the inner ear. Therefore, some investigations have suggested that the practice of sports or recreational activities can improve the balance and gait of this population. OBJECTIVE Assess the evidence quality from randomized or quasi-randomized controlled trials that used sports or recreational activities as an intervention to improve the balance and /or gait of children and/or adolescents with SNHL. METHODS Systematic review that surveyed articles in nine databases, published up to January 10, 2019, in any language, using the following inclusion criteria: (1) Randomized or quasi-randomized controlled trials. (2) Participants from both groups with the clinical diagnosis of SNHL, aged 6-19 years old, without physical problems, cognitive or neurological deficits, except the vestibular dysfunction. (3) Using the practice of sports or recreational activities as an intervention, to improve the balance and/or gait outcomes. RESULTS 4732 articles were identified in the searches, after the removal of the duplicates articles and the reading of the titles and their abstracts, remained 16 articles for reading in full, being 5 trials eligible for this systematic review. Of the five eligible trials, three used sports activities and two recreational activities as intervention and presented very low-quality evidence for balance and gait outcomes. SIGNIFICANCE Sports and recreational practices seem to represent promising modalities to improve the balance and gait of children and adolescents with SNHL. However, due to the methodological limitations of the trials and the low quality of the current evidence on the topic, the results of the trials should be interpreted with caution. Due to the low quality of evidence observed, we suggest that new trials be proposed on this topic, with greater methodological rigor, to provide high-quality evidence on the effectiveness of sports and recreational practices to improve the balance and gait of children and adolescents 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.
| | - Afonso Rodrigues Tavares-Netto
- Department of Physiotherapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alexandre Delgado
- Department of Physiotherapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Carine Carolina Wiesiolek
- Department of Physiotherapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil; Laboratory of Pediatric Studies (LEPed), 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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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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Bonne N, Hanson J, Gauvrit F, Risoud M, Vincent C. Long‐term evaluation of sound localisation in single‐sided deaf adults fitted with a BAHA device. Clin Otolaryngol 2019; 44:898-904. [DOI: 10.1111/coa.13381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 05/02/2019] [Accepted: 05/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Fanny Gauvrit
- Service d'Otologie et d'OtoneurologieCHU de Lille Lille France
| | - Michaël Risoud
- Service d'Otologie et d'OtoneurologieCHU de Lille Lille France
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Peñeñory VM, Manresa-Yee C, Riquelme I, Collazos CA, Fardoun HM. Scoping Review of Systems to Train Psychomotor Skills in Hearing Impaired Children. SENSORS (BASEL, SWITZERLAND) 2018; 18:E2546. [PMID: 30081512 PMCID: PMC6111323 DOI: 10.3390/s18082546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this work is to provide a scoping review to compile and classify the systems helping train and enhance psychomotor skills in hearing impaired (HI) children. METHODS Based on an exhaustive review on psychomotor deficits in HI children, the procedure used to carry out a scoping review was: select keywords and identify synonyms, select databases and prepare the queries using keywords, analyze the quality of the works found using the PEDro Scale, classify the works based on psychomotor competences, analyze the interactive systems (e.g., sensors), and the achieved results. RESULTS Thirteen works were found. These works used a variety of sensors and input devices such as cameras, contact sensors, touch screens, mouse and keyboard, tangible objects, haptic and virtual reality (VR) devices. CONCLUSIONS From the research it was possible to contextualize the deficits and psychomotor problems of HI children that prevent their normal development. Additionally, from the analysis of different proposals of interactive systems addressed to this population, it was possible to establish the current state of the use of different technologies and how they contribute to psychomotor rehabilitation.
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Affiliation(s)
- Victor M Peñeñory
- Multimedia Engineering Program, University of San Buenaventura, Ave. 10 de Mayo, La Umbria, 760031 Cali, Colombia.
| | - Cristina Manresa-Yee
- Department of Mathematics and Computer Science, University of the Balearic Islands, Crta. Valldemossa km. 7.5, 07122 Palma, Spain.
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, Institute of Health Sciences Research, University of Balearic Islands, 07122 Palma, Spain.
| | - Cesar A Collazos
- Systems Program, University of Cauca, Cl. 5 No. 4⁻70, 190001 Popayan, Colombia, .
- King Abdulaziz University, Al Ehtifalat St, Al-Ruwais, 21589 Jeddah, Saudi Arabia.
| | - Habib M Fardoun
- Teaching Excellence Department, Ahlia University, Bld 41 Rd 18, Al Hoora 310, Bahrain.
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Thomas E, Martines F, Bianco A, Messina G, Giustino V, Zangla D, Iovane A, Palma A. Decreased postural control in people with moderate hearing loss. Medicine (Baltimore) 2018; 97:e0244. [PMID: 29620637 PMCID: PMC5902301 DOI: 10.1097/md.0000000000010244] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Balance is a complex process that involves multiple sensory integrations. The auditory, visual, and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect balance and therefore increase the risk of falling.The aim of this study was to understand whether hearing loss could influence balance, cervical posture, and muscle activation in the cervical region.Thirteen patients (61 ± 13 years; 161.8 ± 11.0 cm; 70.5 ± 15.9 kg) with moderate hearing loss (Right ear -60 ± 21 dB; Left ear -61 ± 24 dB) underwent: an audiometric examination, a postural examination (with open and closed eyes) through a stabilometric platform, a cervical ROM examination through a head accelerometer, and a sternocleidomastoid electromyography (EMG) examination.A linear regression analysis has shown a regression coefficient (R) 0.76 and 0.69 between hearing loss and the posturographic parameters, on the sagittal sway, with open and closed eyes, respectively. The combination of frontal and sagittal sway is able to explain up to 84% of the variance of the audiometric assessment. No differences were found between right and left hemibody between the audiometric, posturographic, cervical ROM parameters, and in EMG amplitude. ROM and EMG parameters have not shown any significant associations with hearing loss, for both right and left head rotation.Hearing loss is associated to increased posturographic measures, especially the sagittal sway, underlining a reduced postural control in people with hearing impairments. No association was found between the heads posture and neck activation with hearing loss. Hearing loss may be associated with an increased risk of falls.
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Affiliation(s)
| | | | | | - Giuseppe Messina
- Sport and Exercise Sciences Research Unit
- PosturaLab Center, Palermo, Italy
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Dewar R, Claus AP, Tucker K, Ware R, Johnston LM. Reproducibility of the Balance Evaluation Systems Test (BESTest) and the Mini-BESTest in school-aged children. Gait Posture 2017; 55:68-74. [PMID: 28419876 DOI: 10.1016/j.gaitpost.2017.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 02/02/2023]
Abstract
This study evaluated the intra-rater, inter-rater and test-retest reproducibility of the Full-BESTest and Mini-BESTest when assessing postural control in children. Thirty-four children aged 7-17 years participated in intra-rater and inter-rater evaluation, and 22 children repeated assessment six weeks later for evaluation of test-retest reliability. Postural control was assessed using the Full Balance Evaluation Systems Test (Full-BESTest) and the short-form Mini-BESTest. Intra-rater, inter-rater and test-retest reproducibility were examined using video assessment. Test-retest reproducibility was also assessed in real-time. Reproducibility was examined by agreement and reliability statistics. Agreement was calculated using percentage of agreement, Limits of Agreement and Smallest Detectable Change. Reliability was calculated using Intra-class Correlation Coefficients. Results showed that the reliability of Total Scores was excellent for the Full-BESTest for all conditions (all ICCs>0.82), whereas the Mini-BESTest ranged from fair to excellent (ICC=0.56-0.86). Percentage of Domain Scores with good-excellent reliability (ICCs>0.60) was slightly higher for the Full-BESTest (66%) compared to the Mini-BESTest (59%). Smallest Detectable Change scores were good to excellent for the Full-BESTest (2%-6%) and for the Mini-BESTest (5%-10%) relative to total test scores. Both the Full-BESTest and Mini-BESTest can discriminate postural control abilities within and between days in school-aged children. The Full-BESTest has slightly better reproducibility and a broader range of items, which could be the most useful version for treatment planning. We propose minor modifications to improve reproducibility for children, and indicate the modified version by the title Kids-BESTest. Future psychometric research is recommended for specific paediatric clinical populations.
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Affiliation(s)
- R Dewar
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia.
| | - A P Claus
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | - K Tucker
- The University of Queensland, School of Biomedical Sciences, Brisbane, Australia
| | - R Ware
- Griffith University, Menzies Health Institute Queensland, Australia; The University of Queensland, Queensland Centre for Intellectual and Developmental Disability, Brisbane, Australia
| | - L M Johnston
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
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de Souza Melo R. Ampleness of head movements of children and adolescents with sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2017; 93:133-140. [PMID: 28109485 DOI: 10.1016/j.ijporl.2016.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/09/2016] [Accepted: 12/10/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Head movements are controlled by the vestibular system. Children with sensorineural hearing loss can present restrictions in ampleness of head movements due to damage in the vestibule-cochlear systems, resulting from injury in the inner ear. OBJECTIVE To evaluate the ampleness of head movements of children with normal hearing and children with sensorineural hearing loss and compare data between groups. METHODS Cross-sectional study that evaluated the ampleness of head movements of 96 students, being 48 with normal hearing and 48 with sensorineural hearing loss, of both sexes, with aged between 7 and 18 years old. The performance of ampleness of head movements was analyzed by a manual goniometric evaluation, according the references proposed by Marques. To the statistical analysis we used the t-Student test in case of normality of the data or the Mann-Whitney test when did not applied the suppositions of normality. RESULTS Hearing loss children showed less mean in ampleness of all movements of head compared to normal hearing children, pointing difference to movements of flexion (p = 0,001), lateral inclination to the right (p = 0,025) and lateral rotation to the left (p = 0,021). CONCLUSION Hearing loss children showed reduction in the ampleness of these head movements: flexion, lateral inclination to the right and lateral rotation to the left compared to normal hearing children.
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Affiliation(s)
- Renato de Souza Melo
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.
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Menendez ME, Ring D, Jawa A. Inpatient falls after shoulder arthroplasty. J Shoulder Elbow Surg 2017; 26:14-19. [PMID: 27522341 DOI: 10.1016/j.jse.2016.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/31/2016] [Accepted: 06/07/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patient falls are one of the most commonly reported safety incidents in hospitals and an important cause of harm. Despite growing interest in postoperative fall prevention, data on the extent and correlates of falls among elective orthopedic inpatients are sparse and confined to lower limb arthroplasty. We evaluated inpatient fall trends after elective shoulder arthroplasty and identified patient and hospital characteristics associated with the occurrence of falls. METHODS We used discharge records from the Nationwide Inpatient Sample (2002-2011). Temporal trends were assessed, and multivariate logistic regression modeling was used to characterize factors associated with inpatient falls. RESULTS The rate of in-hospital falls increased from 0% in 2002 to 1.7% in 2011, despite a downward trend in length of stay (P < .001). Patient characteristics associated with the occurrence of falls included older age, Hispanic race/ethnicity, and lower household income. In decreasing order of magnitude, the comorbidities associated with falls were fluid/electrolyte disorder, opioid use disorder, malnutrition/weight loss, chronic anemia, visual impairment, nonopioid drug use disorder, congestive heart failure, and hearing impairment. Falls were more likely to occur at teaching hospitals and in regions other than the Northeast. CONCLUSIONS The rate of in-hospital falls after shoulder arthroplasty is increasing despite shorter stays. Many of the identified factors associated with inpatient falls after shoulder arthroplasty are modifiable, either by better preoperative planning and care coordination, by optimized medical management, or by improved patient education and engagement.
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Affiliation(s)
- Mariano E Menendez
- Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA, USA; Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, TX, USA
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, TX, USA
| | - Andrew Jawa
- Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA, USA; Boston Sports and Shoulder Center, Chestnut Hill, MA, USA.
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