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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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Manno FAM, Cheung P, Basnet V, Khan MS, Mao Y, Pan L, Ma V, Cho WC, Tian S, An Z, Feng Y, Cai YL, Pienkowski M, Lau C. Subtle alterations of vestibulomotor functioning in conductive hearing loss. Front Neurosci 2023; 17:1057551. [PMID: 37706156 PMCID: PMC10495589 DOI: 10.3389/fnins.2023.1057551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/08/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction Conductive hearing loss (CHL) attenuates the ability to transmit air conducted sounds to the ear. In humans, severe hearing loss is often accompanied by alterations to other neural systems, such as the vestibular system; however, the inter-relations are not well understood. The overall goal of this study was to assess vestibular-related functioning proxies in a rat CHL model. Methods Male Sprague-Dawley rats (N=134, 250g, 2months old) were used in a CHL model which produced a >20dB threshold shift induced by tympanic membrane puncture. Auditory brainstem response (ABRs) recordings were used to determine threshold depth at different times before and after CHL. ABR threshold depths were assessed both manually and by an automated ABR machine learning algorithm. Vestibular-related functioning proxy assessment was performed using the rotarod, balance beam, elevator vertical motion (EVM) and Ferris-wheel rotation (FWR) assays. Results The Pre-CHL (control) threshold depth was 27.92dB±11.58dB compared to the Post-CHL threshold depth of 50.69dB±13.98dB (mean±SD) across the frequencies tested. The automated ABR machine learning algorithm determined the following threshold depths: Pre-CHL=24.3dB, Post-CHL same day=56dB, Post-CHL 7 days=41.16dB, and Post-CHL 1 month=32.5dB across the frequencies assessed (1, 2, 4, 8, 16, and 32kHz). Rotarod assessment of motor function was not significantly different between pre and post-CHL (~1week) rats for time duration (sec) or speed (RPM), albeit the former had a small effect size difference. Balance beam time to transverse was significantly longer for post-CHL rats, likely indicating a change in motor coordination. Further, failure to cross was only noted for CHL rats. The defection count was significantly reduced for CHL rats compared to control rats following FWR, but not EVM. The total distance traveled during open-field examination after EVM was significantly different between control and CHL rats, but not for FWR. The EVM is associated with linear acceleration (acting in the vertical plane: up-down) stimulating the saccule, while the FWR is associated with angular acceleration (centrifugal rotation about a circular axis) stimulating both otolith organs and semicircular canals; therefore, the difference in results could reflect the specific vestibular-organ functional role. Discussion Less movement (EVM) and increase time to transverse (balance beam) may be associated with anxiety and alterations to defecation patterns (FWR) may result from autonomic disturbances due to the impact of hearing loss. In this regard, vestibulomotor deficits resulting in changes in balance and motion could be attributed to comodulation of auditory and vestibular functioning. Future studies should manipulate vestibular functioning directly in rats with CHL.
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Affiliation(s)
- Francis A. M. Manno
- Department of Physics, East Carolina University, Greenville, NC, United States
- Department of Biomedical Engineering, Center for Imaging Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
- Center for Advanced Nuclear Safety and Sustainable Development, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Physics, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Pikting Cheung
- Department of Physics, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Vardhan Basnet
- Department of Physics, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | | | - Yuqi Mao
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Leilei Pan
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Victor Ma
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China
| | - Shile Tian
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Ziqi An
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Medical Image Processing and Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Key Laboratory of Mental Health of the Ministry of Education, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yi-Ling Cai
- Department of Physics, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Martin Pienkowski
- Osborne College of Audiology, Salus University, Elkins Park, PA, United States
| | - Condon Lau
- Center for Advanced Nuclear Safety and Sustainable Development, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Physics, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Monin E, Bahim C, Baussand L, Cugnot JF, Ranieri M, Guinand N, Pérez Fornos A, Cao Van H. Development of a new clinical tool to evaluate the balance abilities of children with bilateral vestibular loss: The Geneva Balance Test. Front Neurol 2023; 14:1085926. [PMID: 36959819 PMCID: PMC10027694 DOI: 10.3389/fneur.2023.1085926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/18/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Vestibular deficits are considered rare in children, but the lack of systematic screening leads to underdiagnosis. It has been demonstrated that chronic vestibular dysfunction impacts the normal psychomotor development of children. Early identification is needed to allow for clinical management, ensuring better global development. For this purpose, our research group has developed the Geneva Balance Test (GBT), aiming to objectively quantify the balance capacity of children over a broad age range, to screen for bilateral vestibulopathy (BV), and to quantify the improvement of balance abilities in children. Methods To determine the capacity of the GBT to quantify the balance capacity of children with BV, we conducted an observational prospective study with three populations: 11 children with BV, and two age-matched control groups composed of (1) 15 healthy subjects without the vestibular or auditory disorder (HS) and (2) 11 pediatric cochlear implant recipients (CIs) without vestibular disorders. Results of the three populations have been compared in three different age sub- groups (3-5, 6-9, and ≥10 years), and with results of a short, modified version of the Bruininks-Oseretsky test of Motor proficiency Ed. 2 (mBOT-2). Results Statistical analyses demonstrated significant differences in the scores of the GBT between children aged 3-5, 6-9, and ≥10 years with BV and in both control populations (HS and CI). BV scores reflected poorer balance capacities at all ages. Children in the youngest CI sub-group (3-5 years) showed intermediate GBT scores but reached HS scores at 6-9 years, reflecting an improvement in their balance capacities. All the results of the GBT were significantly correlated with mBOT-2 results, although only a few BV completed the entire mBOT-2. Discussion In this study, the GBT allowed quantifying balance deficits in children with BV. The BOT-2 test is not validated for children <4.5 years of age, and the GBT seems to be better tolerated in all populations than the mBOT-2. Furthermore, mBOT-2 results saturated, reaching maximum values by 6-9 years whereas the GBT did not, suggesting that the GBT could be a useful tool for monitoring the development of balance capacities with age and could be used in the follow-up of children with severe vestibular disorders.
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Hennah C, Ellis G, Doumas M. Dual task walking in healthy aging: Effects of narrow and wide walking paths. PLoS One 2021; 16:e0261647. [PMID: 34936676 PMCID: PMC8694444 DOI: 10.1371/journal.pone.0261647] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022] Open
Abstract
Dual-task walking may lead to gait instability and a higher fall risk in older adults, particularly when walking in a busy city street. Challenging street features such as narrow sidewalks not only discourage walking, but are also likely to be taxing for older adults’ cognitive resources and gait characteristics. The aim of this study was to assess the way older adults’ gait characteristics are affected by walking on a narrow path while performing a challenging cognitive task in lab conditions imitating common urban environments. Nineteen young and eighteen older adults walked on a narrow (40cm) and a wide (80cm) path and performed a cognitive (n-back) task individually adjusted to 80% accuracy. The two tasks were performed separately (Single-Task) and concurrently (Dual-Task). Both groups walked faster, and their step width was narrower on the narrow path. During dual-task walking on the narrow path, older adults showed significant dual-task costs in the cognitive task, gait speed, step width, and stride length. Dual-task walking was associated with decreased gait speed and stride length in both age groups, suggesting that dual-task walking may adversely affect gait, particularly when walking on narrow paths. These conditions may lead to gait instability and an increased fall risk for older adults, particularly when walking along the narrow sidewalks commonly found within the built environment. However, more research is needed in an urban setting to determine the extent of the fall risk narrow sidewalks present for older adults.
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Affiliation(s)
- Charlotte Hennah
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail:
| | - Geraint Ellis
- School of Natural and Built Environment, Queen’s University Belfast, Belfast, United Kingdom
| | - Michail Doumas
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
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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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Daunoraviciene K, Ziziene J, Ovcinikova A, Kizlaitiene R, Griskevicius J. Quantitative body symmetry assessment during neurological examination. Technol Health Care 2021; 28:573-584. [PMID: 32831213 DOI: 10.3233/thc-208003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND A lack of movement coordination characterized by the undershoot or overshoot of the intended location with the hand, arm, or leg is often found in individuals with multiple sclerosis (MS). Standardized as Finger-to-Nose (FNT) and The Heel-to-Shin (HST) tests are the most frequently used tests for qualitative examination of upper and lower body coordination. Inertial sensors facilitate in performing quantitative motion analysis and by estimating body symmetry more accurately assess coordination lesion and imbalance. OBJECTIVES To assess the body symmetry of upper and lower limbs quantitatively, and to find the best body symmetry indices to discriminate MS from healthy individuals (CO). METHODS 28 MS patients and 23 CO participated in the study. Spatiotemporal parameters obtained from six Inertial Measurement Units (IMUs) were placed on the upper and lower extremities during FNT and HST tests. All data were analyzed using statistical methods in MATLAB. RESULTS Asymmetry indices of temporal parameters showed a significant increase in upper body and lower body asymmetry of MS compared to CO. However, CO have a greater kinematic asymmetry compared to MS. CONCLUSION Temporal parameters are the most sensitive to body asymmetry evaluation. However, range of motion is completely inappropriate if it is calculated for one movement cycle.
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Affiliation(s)
- Kristina Daunoraviciene
- Department of Biomechanical Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Jurgita Ziziene
- Department of Biomechanical Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Agne Ovcinikova
- Republican Vilnius University Hospital, Vilnius University, Vilnius, Lithuania
| | - Rasa Kizlaitiene
- Centre for Neurology, Department of Neurology and Neurosurgery, Vilnius University, Vilnius, Lithuania
| | - Julius Griskevicius
- Department of Biomechanical Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
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Rotem Betito H, Himmelfarb M, Handzel O. Effects of Occlusion and Conductive Hearing Loss on Bone-Conducted cVEMP. Otolaryngol Head Neck Surg 2020; 164:407-413. [PMID: 32746733 DOI: 10.1177/0194599820944903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the effects of conductive hearing loss and occlusion on bone-conducted cervical vestibular evoked myogenic potentials (cVEMPs). STUDY DESIGN Prospective cohort study conducted in the year 2018. The right ear of each volunteer was evaluated under 3 conditions by using bone-conducted cVEMPs: normal (open external auditory canal), occluded (conductive hearing loss with occlusion effect), and closed (conductive hearing loss without the occlusion effect). SETTING Single academic center. SUBJECTS AND METHODS The study comprised 30 healthy volunteers aged 20 to 35 years (16 women, 14 men). All had normal hearing and no vestibular or auditory pathologies. The thresholds and amplitudes of cVEMP responses were recorded for the 3 conditions. The results of each condition for a particular participant were compared. RESULTS As compared with the open condition, the conductive condition increased thresholds by 2.8 dB (P = .01), and the occluded condition decreased thresholds by 3.8 dB (P = .008). The amplitude in the occluded condition was larger than the normal condition and the conductive condition (mean difference: 20.64 [P = .009] and 31.76 [P < .001], respectively). CONCLUSION The occlusion effect is present in cVEMP responses. The mechanism is not due to the conductive hearing loss induced. Clinical implications include potentially altering vestibular function with sealed hearing aids and in the surgically modified ears (ie, obliterated ears and open cavity mastoidectomy).
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Affiliation(s)
| | - Mordechai Himmelfarb
- Department of Communication Disorders, School of Medical Science, University of Ariel, Ariel, Israeli.,Department of Otolaryngology-Head, Neck, and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ophir Handzel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Department of Otolaryngology-Head, Neck, and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
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Cornwell T, Woodward J, Wu M, Jackson B, Souza P, Siegel J, Dhar S, Gordon KE. Walking With Ears: Altered Auditory Feedback Impacts Gait Step Length in Older Adults. Front Sports Act Living 2020; 2:38. [PMID: 33345030 PMCID: PMC7739652 DOI: 10.3389/fspor.2020.00038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/20/2020] [Indexed: 11/13/2022] Open
Abstract
Auditory feedback may provide the nervous system with valuable temporal (e. g., footstep sounds) and spatial (e.g., external reference sounds) information that can assist in the control of upright walking. As such, hearing loss may directly contribute to declines in mobility among older adults. Our purpose was to examine the impact of auditory feedback on the control of walking in older adults. Twenty older adults (65-86 years) with no diagnosed hearing loss walked on a treadmill for three sound conditions: Baseline, Ear Plugs, and White Noise. We hypothesized that in response to reduced temporal auditory feedback during the Ear Plugs and White Noise conditions, participants would adapt shorter and faster steps that are traditionally believed to increase mechanical stability. This hypothesis was not supported. Interestingly, we observed increases in step length (p = 0.047) and step time (p = 0.026) during the Ear Plugs condition vs. Baseline. Taking longer steps during the Ear Plugs condition may have increased ground reaction forces, thus allowing participants to sense footsteps via an occlusion effect. As a follow-up, we performed a Pearson's correlation relating the step length increase during the Ear Plugs condition to participants' scores on a clinical walking balance test, the Functional Gait Assessment. We found a moderate negative relationship (rho = -0.44, p = 0.055), indicating that participants with worse balance made the greatest increases in step length during the Ear Plugs condition. This trend suggests that participants may have actively sought auditory feedback with longer steps, sacrificing a more mechanically stable stepping pattern. We also hypothesized that reduced spatial localization feedback during the Ear Plugs and White Noise conditions would decrease control of center of mass (COM) dynamics, resulting in an increase in lateral COM excursion, lateral margin of stability, and maximum Lyapunov exponent. However, we found no main effects of auditory feedback on these metrics (p = 0.580, p = 0.896, and p = 0.056, respectively). Overall, these results suggest that during a steady-state walking task, healthy older adults can maintain walking control without auditory feedback. However, increases in step length observed during the Ear Plugs condition suggest that temporal auditory cues provide locomotor feedback that becomes increasingly valuable as balance deteriorates with age.
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Affiliation(s)
- Tara Cornwell
- Northwestern University, Biomedical Engineering, Evanston, IL, United States.,Northwestern University, Physical Therapy and Human Movement Sciences, Chicago, IL, United States
| | | | - Mengnan/Mary Wu
- Northwestern University, Physical Therapy and Human Movement Sciences, Chicago, IL, United States
| | - Brennan Jackson
- Northwestern University, Biomedical Engineering, Evanston, IL, United States
| | - Pamela Souza
- Northwestern University, Communication Sciences and Disorders, Evanston, IL, United States
| | - Jonathan Siegel
- Northwestern University, Communication Sciences and Disorders, Evanston, IL, United States
| | - Sumitrajit Dhar
- Northwestern University, Communication Sciences and Disorders, Evanston, IL, United States
| | - Keith E Gordon
- Northwestern University, Physical Therapy and Human Movement Sciences, Chicago, IL, United States.,Edward Hines Jr. VA Hospital, Research Service, Hines, IL, United States
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