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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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Jun C. IMPACTS OF SOCCER ON EXECUTIVE FUNCTION IN BOYS WITH ADHD. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
ABSTRACT Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder of genetic causes that appears in childhood. The main manifestations are inattention, hyperactivity, and emotional impulsivity. It is often accompanied by cognitive impairments and learning disabilities that seriously affect children's life, academic and social functions. Objective: Explore the impacts of soccer practice on executive function in boys with ADHD. Methods: Boys were selected from first and second graders in a public elementary school. They were randomly divided into an experimental group and a control group, and 8 boys in the control group were recruited according to the age difference of less than half a year. All children participated in various school sports activities, and the experimental group was added to soccer practice for 6 weeks. Results: There was no significant difference in cognitive subfunction between the soccer activity group, the conventional physical education teaching activity group, and the control group; however, the interaction between time and group factors proved to be significant P (4142) = 6.296, F< 0.01, it can be understood that the effect of the time factor on cognitive flexibility varies with different groups. Conclusion: The six-week soccer practice intervention can improve the executive function of 6-8-year-old boys with ADHD, especially inhibition control and cognitive flexibility, but does not represent a significant effect on memory. Level of evidence II; Therapeutic studies - investigating treatment outcomes.
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Affiliation(s)
- Chen Jun
- Jingchu University of Technology, China
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Duarte DSB, Cabral AMDL, Britto DBLDA. Vestibular assessment in children aged zero to twelve years: an integrative review. Braz J Otorhinolaryngol 2022; 88 Suppl 3:S212-S224. [PMID: 36347786 DOI: 10.1016/j.bjorl.2022.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/10/2022] [Accepted: 09/23/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To describe the main vestibular assessment tests performed in children aged zero to twelve years and the main causes of referral for vestibular assessment. METHODS The review was guided by the following question: What are the main vestibular assessment tests performed in children aged zero to twelve years and the main causes of referral for vestibular assessment? The PVO strategy was used, being defined as: Population (P) - newborns and children; study Variable (V) - causes of referral for vestibular assessment; study Outcome (O): the main vestibular assessment tests and the main findings. This study was carried out using the main available databases in the months of July, August and September 2021, with no restrictions regarding language and publication date, namely: PubMed, Web of Science, Scientific Electronic Library Online (SciELO), Latin-American and Caribbean Literature in Health Sciences (LILACS), ScienceDirect, Cochrane Library and Embase. The descriptors were obtained from the MeSH database: newborn, infant, child, children, vestibular screening, vestibular infant screening, vestibular newborn screening, test, vestibular function, vestibular function test. RESULTS A total of 7,078 studies were identified. After reading the titles and abstracts, 107 of them were selected, with 101 remaining after the exclusion of duplicates. After the full-text reading, 31 articles were included. It was observed that the most frequently used tests were: rotational tests, caloric stimulation and cervical vestibular evoked myogenic potential and the main causes of referral for vestibular evaluation were hearing loss and vestibular screening. CONCLUSION The main tests for vestibular screening and/or assessment of children aged zero to twelve years are the rotary chair testing, caloric stimulation and cervical-vestibular evoked myogenic potential. Consequently, performing these procedures is extremely important, since the presence of vestibular dysfunction is quite common in the studied population.
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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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A Systematic Review on the Association Between Vestibular Dysfunction and Balance Performance in Children With Hearing Loss. Ear Hear 2021; 43:712-721. [PMID: 34611117 PMCID: PMC8958172 DOI: 10.1097/aud.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to understand the functional impact of vestibular dysfunction on balance control in children with hearing loss. The vestibular system is an important contributor to maintaining balance. In adults, vestibular dysfunction is known to lead to unsteadiness and falls. Considerably less is known about the effects of vestibular dysfunction in children with hearing loss. DESIGN We conducted a systematic review in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included articles on children with hearing loss who underwent vestibular and balance testing. The Downs and Black checklist was used to assess the risk of bias. RESULTS A total of 20 articles were included in this systematic review, of which, 17 reported an association between vestibular dysfunction and balance abnormalities in children with hearing loss. Bias (as measured by the Downs and Black Checklist) was a concern, as most studies were nonblinded cohort studies or case series selected through convenience sampling. CONCLUSIONS Research to date has predominantly found that children with concomitant hearing loss and vestibular impairment tend to perform more poorly on balance measures than either children with hearing loss and normal vestibular function or children with both normal-hearing and normal vestibular function. A standardized approach to assessing both vestibular function and balance would better characterize the impact of vestibular dysfunction in children with hearing loss at the population level.
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Cozma RS, Cristina MC, Cobzeanu MD, Olariu R, Bitere OR, Mârţu C, Dima-Cozma LC, Dascălu CG, Georgescu MG, Necula V, Rădulescu LM. Saccular function evolution related to cochlear implantation in hearing impaired children. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:113-119. [PMID: 32747901 PMCID: PMC7728102 DOI: 10.47162/rjme.61.1.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Vestibular sensorial input is essential for psychomotor development of the very small children. In consequence, possible vestibular impairment induced by cochlear implantation in deaf children could affect the balance and walking learning process. Some of cochlear implanted children can present congenital vestibular deficit. The anatomical and embryological relation between auditory and vestibular system explains why congenital neurosensorial hearing loss may associate vestibular impairment. The cochlear implant surgery presents a vestibular lesion risk. Bilateral vestibulopathy, as it appears in early childhood, has a poor prognosis for the psychomotor and cognitive development. Even probably rare, bilateral vestibulopathy induced by simultaneous bilateral cochlear implantation can delay the acquisition of motor skills. This pathology can be avoided by an appropriate surgical indication related to the vestibular preoperative status. This study reports the vestibular saccular functional modifications after the cochlear implantation in children. The cervical vestibular evoked myogenic potentials (cVEMPs) were performed in children before and after the cochlear implantation. Since previous studies report different vestibular impairment related to the portelectrode insertion approach, another objective of our study was to assess the saccular postoperative status depending of the insertion by cochleostomy (CO) or through the round window (RW). We performed cVEMPs for 80 patients (135 cochlear implanted ears) before and after cochlear implantation. We have detected preoperative saccular areflexia in 33 (24.4%) ears. In the group of 102 (75.6%) ears with preoperative normal saccular function, 72 (70.6%) ears preserved the cVEMP response after the surgery, while in 30 (29.4%) ears the cVEMP response was lost. Reporting our findings to the portelectrode insertion method, we found normal saccular function in 73.3% of the cochlear implanted ears by RW surgical approach and in 68.42% ears by CO approach. These results suggest that the RW portelectrode insertion is the recommended strategy in order to avoid the saccular vestibular impairment.
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Affiliation(s)
- Romică Sebastian Cozma
- Department of Otorhinolaryngology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania; ,
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Ertugrul G, Sennaroglu G, Sennaroglu L. Postural Control in Subjects with Incomplete Partition Inner Ear Malformations: A Comparison of Incomplete Partition Types. ORL J Otorhinolaryngol Relat Spec 2021; 84:47-54. [PMID: 34098563 DOI: 10.1159/000515873] [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] [Received: 01/05/2021] [Accepted: 03/13/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Children with inner ear malformation (IEM) are at risk of vestibular loss as well as hearing loss. Incomplete partition (IP) anomalies constitute about 41% of all IEMs. This study aimed to investigate the postural control in subjects with the same type of IP on both sides and to compare their results with cochlear implant (CI) users without IEM and healthy peers. METHODS The study group consists of 17 subjects with the same IP types on both sides and using auditory implants on at least one side, with the following 3 groups: 6 IP-I subjects (mean age 12.28 ± 6.25), 6 IP-II subjects (mean age 12.90 ± 3.23), and 5 IP-III subjects (mean age 6.98 ± 3.10). Six unilateral CI users (mean age 11.38 ± 3.57) with normal inner ear structures were included in the CI control group, and 6 healthy peers (10.20 ± 4.79) were included in the healthy control group. The postural control was measured using the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) balance subtest. All devices were turned off during the balance test. RESULTS The BOT-2 balance scale scores were observed to be significantly different between the IP-I and healthy control group (medians of balance scores being 3.00 and 16.00, respectively, p < 0.001) and the IP-III and healthy control group (medians of balance scores being 6.60 and 16.00, respectively, p = 0.04). The IP-II group had better balance scores (median = 8.00) than those of the other IP groups, although there were no significant differences between the IP-II and other groups (p > 0.05). CONCLUSION This study demonstrated that subjects with the same IP type on both sides and with early implantation may differ in terms of their postural control abilities depending on their IP type. Subjects with IP should be regularly followed up by the vestibular assessment and supported by their postural control ability by vestibular rehabilitation.
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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
| | - Levent Sennaroglu
- Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Li Y, Yang Y, Zhang W, Sun J, Liu B, Chen M, Liu W, Liu S, Wang X, Li S, Zhang J, Ni X. Developmental performance between pediatric cochlear implantation candidates with and without large vestibular aqueduct syndrome. Acta Otolaryngol 2021; 141:250-255. [PMID: 33502272 DOI: 10.1080/00016489.2020.1862909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND We are inclined to pay special care and attention to children with large vestibular aqueduct syndrome (LVAS). However, it is not clear whether children with LVAS have more developmental delays than children without LVAS. OBJECTIVES To compare the developmental performance between pediatric cochlear implantation (CI) candidates with and without LVAS. MATERIALS AND METHODS Medical records of pediatric CI candidates were reviewed. Through propensity score matching analysis, 70 children with LVAS and 70 gender-, age-, and auditory-matched children were recruited as the LVAS and non-LVAS group, respectively. Developmental performances were compared between the two groups. RESULTS Compared with normal developmental metrics, both LVAS and non-LVAS groups had developmental delay in multiple domains (both p < .001). Although some differences in motor developments between children with LVAS and without LVAS, they demonstrated overall equal developmental levels in both verbal and nonverbal aspects (all p > .05). Age of intervention was the primary risk factor for developmental performance of LVAS children (β < 0, p < .05) with an obvious delay starting at 1 year of age. CONCLUSION Pediatric CI candidates with LVAS had both verbal and nonverbal developmental delays. However, they exhibited similar overall developmental performances to those without LVAS.
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Affiliation(s)
- Yanhong Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Yang Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Wanxia Zhang
- Department of Health Care, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
| | - Jihang Sun
- Department of Radiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Bing Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Min Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Wei Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Shanshan Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Xiaoxu Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Shilan Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Jie Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
| | - Xin Ni
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children′s Hospital, National Center for Children′s Health, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing, China
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Singh A, Raynor EM, Lee JW, Smith SL, Heet H, Garrison D, Wrigley J, Kaylie DM, Riska KM. Vestibular Dysfunction and Gross Motor Milestone Acquisition in Children With Hearing Loss: A Systematic Review. Otolaryngol Head Neck Surg 2021; 165:493-506. [PMID: 33430703 DOI: 10.1177/0194599820983726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe the impact of vestibular dysfunction on gross motor development in children with hearing loss. DATA SOURCES MEDLINE (PubMed), Embase (Elsevier), Web of Science (Clarivate), and the Cumulative Index of Nursing and Allied Health Literature (EBSCO). REVIEW METHODS A systematic review was reported in concordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Articles on children with hearing loss who underwent at least 1 instrumented measure of vestibular function and had gross motor milestones assessed were included. The Downs and Black checklist was used to assess risk of bias and methodological quality. RESULTS Eleven articles were included in the systematic review. Three articles stratified quantitative results of gross motor milestone acquisition by severity of vestibular impairment. Over half of studies were case series published within the last 5 years. This systematic review showed that children with hearing loss and severe, bilateral vestibular dysfunction demonstrate delayed gross motor milestones. However, it was difficult to draw conclusions on whether milder forms of vestibular dysfunction significantly affect gross motor milestone acquisition in children with hearing loss. The reason is that most studies were of low to moderate quality, used different assessment methods, and contained results that were descriptive in nature. CONCLUSIONS This emerging area would benefit from future research, such as higher-quality studies to assess vestibular function and gross motor milestones. This would allow for better characterization of the impacts of vestibular impairment, especially milder forms, in children with hearing loss.
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Affiliation(s)
- Anisha Singh
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Eileen M Raynor
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Janet W Lee
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Sherri L Smith
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA.,Center for the Study of Aging and Human Development, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Hannah Heet
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Doug Garrison
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Jordan Wrigley
- Medical Center Library and Archives, Duke University, Durham, North Carolina, USA
| | - David M Kaylie
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Kristal M Riska
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA.,Center for the Study of Aging and Human Development, School of Medicine, Duke University, Durham, North Carolina, USA
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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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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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Balance performance of children and adolescents with sensorineural hearing loss: Repercussions of hearing loss degrees and etiological factors. Int J Pediatr Otorhinolaryngol 2018; 110:16-21. [PMID: 29859579 DOI: 10.1016/j.ijporl.2018.04.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Some studies have demonstrated a parallelism between the extent of hearing loss and the frequency of vestibular dysfunction in children with sensorineural hearing loss (SNHL). Despite this, little is known about the repercussion of degrees of hearing loss and etiological factors on the balance performance in this children. OBJECTIVE Compare the balance performance between normal hearing (NH) children and those with SNHL, considering the sex and age range of the sample, and analyze balance performance according to the degrees of hearing loss and etiological factors in the latter group. METHODS Cross-sectional study that assessed 96 children (48 NH and 48 with SNHL), aged between 7 and 18 years old. The balance performance was assessed by the Brazilian version of the Pediatric Balance Scale, validated for Brazilian child population and the Mann-Whitney test used for statistical analysis. RESULTS The group with SNHL showed lower average balance performance compared to NH (p = 0.000). This was also observed when the children were grouped by sex: female and male (p = 0.001). The same difference occurred when the children were stratified by age group: 7-14 years old (p = 0.000). There were no differences between the balance performance of the groups according to the degrees of hearing loss (p = 0.236) and the children with prematurity or post-natal meningitis as an etiological factor demonstrated the worst balance performance. CONCLUSION The children with SNHL showed worse balance performance compared to NH of the same sex and age range between seven to fourteen years. There were no differences between balance performance and hearing loss degrees, and those children with prematurity or post-natal meningitis as an etiological factor demonstrated the worst balance performances.
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Janky KL, Thomas MLA, High RR, Schmid KK, Ogun OA. Predictive Factors for Vestibular Loss in Children With Hearing Loss. Am J Audiol 2018; 27:137-146. [PMID: 29482202 DOI: 10.1044/2017_aja-17-0058] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 11/05/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The aim of this study was to determine if there are factors that can predict whether a child with hearing loss will also have vestibular loss. METHOD A retrospective chart review was completed on 186 children with hearing loss seen at Boys Town National Research Hospital for vestibular testing from 1999 to 2015 through neurosensory genetics clinic or cochlear implant candidacy. Each child's medical chart was reviewed to obtain the following data: vestibular loss severity (classified as normal, bilateral, or mild to moderate), degree of hearing loss (bilateral pure-tone average [PTA]), imaging abnormalities (classified as "normal" or "abnormal"), parental concerns for gross motor delay (classified as "yes, there is concern" or "no, there is not a concern"), parent report of age when their child sat (months) and walked independently (months), comorbidities (classified as "yes" if there were 1 or more comorbidities or "no" if there were no comorbidities), and score on the Developmental Profile-3. RESULTS Children were grouped according to vestibular loss severity; 115 children had normal vestibular function, 31 had bilateral vestibular loss, and 40 had mild-to-moderate vestibular loss. As severity of vestibular loss increased, children (a) sat and walked later, (b) scored more poorly on the Developmental Profile-3 physical subscale, (c) had more severe hearing loss, (d) had parents who more frequently reported concern for gross motor delay, and (e) were more likely to have other comorbidities. Of these factors, age-to-sit, age-to-walk, PTA, and parental concerns for gross motor developmental delay had the greatest ability to differentiate children with vestibular loss from children with normal vestibular function. For age-to-sit, using a cutoff value of 7.25 months yielded a sensitivity of 62% and a specificity of 81%. For age-to-walk, a cutoff value of 14.5 months yielded a sensitivity of 78% and a specificity of 77%. For PTA for the neurosensory genetics group, a cutoff value of 40 dB yielded a sensitivity of 80% and a specificity of 55%; however, a cutoff value of 66 dB yielded a sensitivity of 33% and an improved specificity of 91%. CONCLUSIONS A referral for vestibular evaluation should be considered for children whose hearing loss is greater than 66 dB and particularly those who sit later than 7.25 months or walk later than 14.5 months or whose parents report concerns for gross motor development. Collectively, these factors appear to be more sensitive for identifying children with bilateral vestibular loss compared with children with mild-to-moderate vestibular loss. Because of the benefit of physical therapy, children identified with vestibular loss should then be referred to physical therapy for further evaluation and treatment.
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Affiliation(s)
- Kristen L. Janky
- Department of Audiology, Boys Town National Research Hospital, Omaha, NE
| | - Megan L. A. Thomas
- Department of Audiology, Boys Town National Research Hospital, Omaha, NE
| | - Robin R. High
- Department of Biostatistics, University of Nebraska Medical Center, Omaha
| | - Kendra K. Schmid
- Department of Biostatistics, University of Nebraska Medical Center, Omaha
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Melo RDS. Gait performance of children and adolescents with sensorineural hearing loss. Gait Posture 2017; 57:109-114. [PMID: 28600974 DOI: 10.1016/j.gaitpost.2017.05.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/24/2017] [Accepted: 05/29/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Several studies have demonstrated that children with sensorineural hearing loss (SNHL) may exhibit balance disorders, which can compromise the gait performance of this population. OBJECTIVE Compare the gait performance of normal hearing (NH) children and those with SNHL, considering the sex and age range of the sample, and analyze gait performance according to degrees of hearing loss and etiological factors in the latter group. METHOD This is a cross-sectional study that assessed 96 students, 48 NH and 48 with SNHL, aged between 7 and 18 years. The Brazilian version of the Dynamic Gait Index (DGI) was used to analyze gait and the Mann-Whitney test for statistical analysis. RESULTS The group with SNHL obtained lower average gait performance compared to NH subjects (p=0.000). This was also observed when the children were grouped by sex female and male (p=0.000). The same difference occurred when the children were stratified by age group: 7-18 years (p=0.000). The group with severe and profound hearing loss exhibited worse gait performance than those with mild and moderate loss (p=0.048) and children with prematurity as an etiological factor demonstrated the worst gait performance. CONCLUSION The children with SNHL showed worse gait performance compared to NH of the same sex and age group. Those with severe and profound hearing loss and prematurity as an etiological factor demonstrated the worst gait performances.
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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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Kimura Y, Masuda T, Tomizawa A, Sakata H, Kaga K. A child with severe inner ear malformations with favorable hearing utilization and balance functions after wearing hearing aids. J Otol 2017; 12:41-46. [PMID: 29937836 PMCID: PMC6011802 DOI: 10.1016/j.joto.2017.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/03/2017] [Accepted: 03/08/2017] [Indexed: 11/07/2022] Open
Abstract
Infants with congenital deafness caused by severe bilateral inner ear malformations frequently suffer from severe hearing loss and poor balance. Unfortunately, the use of hearing aids is usually ineffective in recovering hearing, necessitating cochlear implants. We report a case of a 6-year-old boy with congenital deafness and bilateral inner ear malformations (right side, incomplete partition type I [IP-I]; left side, common cavity deformity). Hearing aids had a remarkable effect in this patient, enabling sufficient and favorable hearing recovery such as to allow the patient to engage in daily conversations. Per-rotatory nystagmus was recorded on an electronystagmogram for both right and left rotations in a damped rotational chair test. It is rare for deaf children with severe bilateral inner ear malformation to demonstrate favorable development in hearing and good equilibrium function. Our findings suggest that auditory–vestibular hair cells in this patient may have been partially preserved despite IP-I in the right ear and common cavity deformity of the left ear.
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Affiliation(s)
- Yusuke Kimura
- National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan.,Department of Otolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Takeshi Masuda
- National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan.,Department of Otolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Akifumi Tomizawa
- Department of Speech, Language and Hearing Therapy, Mejiro University, Saitama, Japan
| | - Hideaki Sakata
- Department of Speech, Language and Hearing Therapy, Mejiro University, Saitama, Japan.,Kawagoe Otology Institute, Saitama, Japan
| | - Kimitaka Kaga
- National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan
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Letter to the Editor Regarding Oyewumi M, Wolter NE, Heon E, Gordon KA, Papsin BC, Cushing SL. "Using Balance Function to Screen for Vestibular Impairment in Children with Sensorineural Hearing Loss and Cochlear Implants". Otol Neurotol 2017; 38:611-612. [PMID: 28207627 DOI: 10.1097/mao.0000000000001345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Verbecque E, Marijnissen T, De Belder N, Van Rompaey V, Boudewyns A, Van de Heyning P, Vereeck L, Hallemans A. Vestibular (dys)function in children with sensorineural hearing loss: a systematic review. Int J Audiol 2017; 56:361-381. [DOI: 10.1080/14992027.2017.1281444] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Evi Verbecque
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
| | - Tessa Marijnissen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
| | - Niels De Belder
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
| | - Vincent Van Rompaey
- Department of Otorhinolargynology and Neck & Head Surgery, Antwerp University Hospital, Antwerp, Belgium,
| | - An Boudewyns
- Department of Otorhinolargynology and Neck & Head Surgery, Antwerp University Hospital, Antwerp, Belgium,
| | - Paul Van de Heyning
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
- Department of Otorhinolargynology and Neck & Head Surgery, Antwerp University Hospital, Antwerp, Belgium,
- Department of Translational Neurosciences, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium, and
| | - Luc Vereeck
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,
- Multidisciplinary Motor Centre Antwerp, University of Antwerp, Wilrijk, Belgium,
- Department of Functional Morphology, Faculty of Sciences, University of Antwerp, Antwerp, Belgium
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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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Suarez H, Ferreira E, Alonso R, Arocena S, San Roman C, Herrera T, Lapilover V. Postural responses applied in a control model in cochlear implant users with pre-lingual hearing loss. Acta Otolaryngol 2016; 136:344-50. [PMID: 26824633 DOI: 10.3109/00016489.2015.1113558] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Conclusions The assessment of postural responses (PR) based in a feedback control system model shows selective gains in different bands of frequencies adaptable with child development. Objective PR characterization of pre-lingual cochlear implant users (CIU) in different sensory conditions. Methods Total energy consumption of the body's center of pressure signal (ECCOP) and its distribution in three bands of frequencies: band 1 (0-0.1 Hz), band 2 (0.1-0.7 Hz), and band 3 (0.7-20 Hz) was measured in a sample of 18 CIU (8-16 years old) and in a control group (CG) (8-15 years old). They were assessed in a standing position on a force platform in two sensory conditions: 1 = Eyes open. 2 = Eyes closed and standing on foam. Results In condition 1, total ECCOP of PR and its proportion of energy consumption in the three bands of frequencies were similar between CIU and CG (p > 0.05). In condition 2, CIU have significantly higher ECCOP, mainly in high frequencies (bands 2 and 3) (p < 0.05). ECCOP values decreased with age also, mainly in bands 2 and 3. This behavior is interpreted in the control system model proposed as an adaptation process related with child development.
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Affiliation(s)
- Hamlet Suarez
- a Laboratory of Otoneurology , British Hospital , Montevideo , Uruguay
| | - Enrique Ferreira
- b Department of Electrical Engineering , Universidad Catolica Del Uruguay , Montevideo , Uruguay
| | - Rafael Alonso
- c Department of Quantitative Methods, Facultad De Medicina UDELAR , Montevideo , Uruguay
| | - Sofia Arocena
- a Laboratory of Otoneurology , British Hospital , Montevideo , Uruguay
| | - Cecilia San Roman
- a Laboratory of Otoneurology , British Hospital , Montevideo , Uruguay
| | - Tamara Herrera
- a Laboratory of Otoneurology , British Hospital , Montevideo , Uruguay
| | - Valeria Lapilover
- a Laboratory of Otoneurology , British Hospital , Montevideo , Uruguay
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