HUWE1 mutations in Juberg-Marsidi and Brooks syndromes: the results of an X-chromosome exome sequencing study.

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HUWE1 mutations in Juberg-Marsidi and Brooks syndromes: the results of an X-chromosome exome sequencing study.

BMJ Open. 2016 Apr 29;6(4):e009537

Authors: Friez MJ, Brooks SS, Stevenson RE, Field M, Basehore MJ, Adès LC, Sebold C, McGee S, Saxon S, Skinner C, Craig ME, Murray L, Simensen RJ, Yap YY, Shaw MA, Gardner A, Corbett M, Kumar R, Bosshard M, van Loon B, Tarpey PS, Abidi F, Gecz J, Schwartz CE

Abstract
BACKGROUND: X linked intellectual disability (XLID) syndromes account for a substantial number of males with ID. Much progress has been made in identifying the genetic cause in many of the syndromes described 20-40 years ago. Next generation sequencing (NGS) has contributed to the rapid discovery of XLID genes and identifying novel mutations in known XLID genes for many of these syndromes.
METHODS: 2 NGS approaches were employed to identify mutations in X linked genes in families with XLID disorders. 1 involved exome sequencing of genes on the X chromosome using the Agilent SureSelect Human X Chromosome Kit. The second approach was to conduct targeted NGS sequencing of 90 known XLID genes.
RESULTS: We identified the same mutation, a c.12928 G>C transversion in the HUWE1 gene, which gives rise to a p.G4310R missense mutation in 2 XLID disorders: Juberg-Marsidi syndrome (JMS) and Brooks syndrome. Although the original families with these disorders were considered separate entities, they indeed overlap clinically. A third family was also found to have a novel HUWE1 mutation.
CONCLUSIONS: As we identified a HUWE1 mutation in an affected male from the original family reported by Juberg and Marsidi, it is evident the syndrome does not result from a mutation in ATRX as reported in the literature. Additionally, our data indicate that JMS and Brooks syndromes are allelic having the same HUWE1 mutation.

PMID: 27130160 [PubMed - indexed for MEDLINE]

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A narrative review of texting as a visually-dependent cognitive-motor secondary task during locomotion

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): T. Krasovsky, P.L. Weiss, R. Kizony
Typing while walking is an example of people’s ability to interact with technology while engaged in real life activities. Indeed, an increasing number of studies have investigated the typing of text messages (texting) as a dual task during locomotion. The objective of this review is to (1) describe the task requirements of texting-while-walking, (2) evaluate the measurement and psychometric properties of texting as a dual task, and (3) formulate methodological recommendations for researchers who use and report on texting-while-walking. Twenty studies which used texting as a dual task during gait were identified via a literature search. The majority of these studies examined texting among young healthy adults and showed that, like other dual tasks, texting-while-walking caused decrements in both gait and texting performance. The cause of these decrements was most likely related to increased visual task requirements, task-dependent cognitive requirements and fine motor skills. Texting-while-walking gait measures were repeatable, but texting performance showed poor reliability which further depended on skill. Preliminary results show that texting-while-walking performance may discriminate between populations (e.g., young vs. older adults) but no studies have yet examined its predictive validity (e.g., for fall risk). In conclusion, texting-while-walking is an ecologically-valid dual task for locomotion which has become much more commonly used in recent years. As opposed to other secondary tasks such as subtraction by 7 or generating words, texting may challenge various cognitive, visual and sensorimotor domains depending on its content. This imposes task-specific methodological challenges on future research, which are discussed.



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Dynamic plantar pressure distribution, strength capacity and postural control after Lisfranc fracture-dislocation

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Alexander T. Mehlhorn, Markus Walther, Tayfun Yilmaz, Lennart Gunst, Anja Hirschmüller, Norbert P. Südkamp, Hagen Schmal
Substantial progress has been made in the operative treatment of Lisfranc fractures, however, the prognosis remains poor. We hypothesized that Lisfranc injuries change the postural control and muscle strength of the lower limb. Both are suggested to correlate with the clinical outcome and quality of life.17 consecutive patients suffering from a Lisfranc fracture dislocation were registered, underwent open reduction and internal fixation and were followed-up for 50.5±25.7months (Mean±SDM). Biomechanical analysis of muscle strength capacities, postural control and plantar pressure distribution was assessed >6 month postoperatively. Results were correlated to clinical outcome (AOFAS, FFI, Pain, SF-36).The isokinetic assessment revealed a significant reduction in plantar flexor and dorsal extensor peak torque of the injured limb compared to the uninjured limb. The dorsal extensor peak torque thereby correlated well with clinical outcome. Altered postural control was evident by a significant reduction in unilateral stance time, from which we calculated a strong correlation between stance time and the isokinetic strength measurement. Plantar pressure measurements revealed a significant reduction in peak pressure under the midfoot and of Force-Time Integral beneath the second metatarsal.Sufficient rehabilitation is crucial to the clinical outcome following anatomical open reduction of Lisfranc fracture-dislocation. The present study supports a rehabilitation approach focussing on restoring proprioception and calf muscular strength including isometric exercises of the dorsal extensors.



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Hip mechanics underlie lower extremity power training-induced increase in old adults’ fast gait velocity: The Potsdam Gait Study (POGS)

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Chantal M.I. Beijersbergen, Urs Granacher, Martijn Gäbler, Paul DeVita, Tibor Hortobágyi
BackgroundAging is associated with slowed gait and old compared with young adults generally walk with greater positive hip work (H1) and reduced positive ankle work (A2). The role of exercise interventions on old adults’ gait mechanics that underlie training-induced improvements in gait velocity is unclear. We examined the effects of lower extremity power training and detraining on old adults’ gait kinetics.MethodsAs part of the Potsdam Gait Study (POGS), healthy old adults completed a no-intervention control period (69.1±4.4yrs, n=14) or a power training program followed by detraining (72.9±5.4yrs, n=15). We measured isokinetic knee extensor and plantarflexor power and measured hip, knee and ankle kinetics at habitual, fast and standardized walking speeds.ResultsPower training significantly increased isokinetic knee extensor power (25%), plantarflexor power (43%), and fast gait velocity (5.9%). Gait mechanics underlying the improved fast gait velocity included increases in hip angular impulse (29%) and H1 work (37%) and no changes in positive knee (K2) and A2 work. Detraining further improved fast gait velocity (4.7%) with reductions in H1 (−35%), and increases in K2 (36%) and A2 (7%).ConclusionPower training increased fast gait velocity in healthy old adults by increasing the reliance on hip muscle function and thus further strengthened the age-related distal-to-proximal shift in muscle function.



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A narrative review of texting as a visually-dependent cognitive-motor secondary task during locomotion

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): T. Krasovsky, P.L. Weiss, R. Kizony
Typing while walking is an example of people’s ability to interact with technology while engaged in real life activities. Indeed, an increasing number of studies have investigated the typing of text messages (texting) as a dual task during locomotion. The objective of this review is to (1) describe the task requirements of texting-while-walking, (2) evaluate the measurement and psychometric properties of texting as a dual task, and (3) formulate methodological recommendations for researchers who use and report on texting-while-walking. Twenty studies which used texting as a dual task during gait were identified via a literature search. The majority of these studies examined texting among young healthy adults and showed that, like other dual tasks, texting-while-walking caused decrements in both gait and texting performance. The cause of these decrements was most likely related to increased visual task requirements, task-dependent cognitive requirements and fine motor skills. Texting-while-walking gait measures were repeatable, but texting performance showed poor reliability which further depended on skill. Preliminary results show that texting-while-walking performance may discriminate between populations (e.g., young vs. older adults) but no studies have yet examined its predictive validity (e.g., for fall risk). In conclusion, texting-while-walking is an ecologically-valid dual task for locomotion which has become much more commonly used in recent years. As opposed to other secondary tasks such as subtraction by 7 or generating words, texting may challenge various cognitive, visual and sensorimotor domains depending on its content. This imposes task-specific methodological challenges on future research, which are discussed.



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Dynamic plantar pressure distribution, strength capacity and postural control after Lisfranc fracture-dislocation

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Alexander T. Mehlhorn, Markus Walther, Tayfun Yilmaz, Lennart Gunst, Anja Hirschmüller, Norbert P. Südkamp, Hagen Schmal
Substantial progress has been made in the operative treatment of Lisfranc fractures, however, the prognosis remains poor. We hypothesized that Lisfranc injuries change the postural control and muscle strength of the lower limb. Both are suggested to correlate with the clinical outcome and quality of life.17 consecutive patients suffering from a Lisfranc fracture dislocation were registered, underwent open reduction and internal fixation and were followed-up for 50.5±25.7months (Mean±SDM). Biomechanical analysis of muscle strength capacities, postural control and plantar pressure distribution was assessed >6 month postoperatively. Results were correlated to clinical outcome (AOFAS, FFI, Pain, SF-36).The isokinetic assessment revealed a significant reduction in plantar flexor and dorsal extensor peak torque of the injured limb compared to the uninjured limb. The dorsal extensor peak torque thereby correlated well with clinical outcome. Altered postural control was evident by a significant reduction in unilateral stance time, from which we calculated a strong correlation between stance time and the isokinetic strength measurement. Plantar pressure measurements revealed a significant reduction in peak pressure under the midfoot and of Force-Time Integral beneath the second metatarsal.Sufficient rehabilitation is crucial to the clinical outcome following anatomical open reduction of Lisfranc fracture-dislocation. The present study supports a rehabilitation approach focussing on restoring proprioception and calf muscular strength including isometric exercises of the dorsal extensors.



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Hip mechanics underlie lower extremity power training-induced increase in old adults’ fast gait velocity: The Potsdam Gait Study (POGS)

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Chantal M.I. Beijersbergen, Urs Granacher, Martijn Gäbler, Paul DeVita, Tibor Hortobágyi
BackgroundAging is associated with slowed gait and old compared with young adults generally walk with greater positive hip work (H1) and reduced positive ankle work (A2). The role of exercise interventions on old adults’ gait mechanics that underlie training-induced improvements in gait velocity is unclear. We examined the effects of lower extremity power training and detraining on old adults’ gait kinetics.MethodsAs part of the Potsdam Gait Study (POGS), healthy old adults completed a no-intervention control period (69.1±4.4yrs, n=14) or a power training program followed by detraining (72.9±5.4yrs, n=15). We measured isokinetic knee extensor and plantarflexor power and measured hip, knee and ankle kinetics at habitual, fast and standardized walking speeds.ResultsPower training significantly increased isokinetic knee extensor power (25%), plantarflexor power (43%), and fast gait velocity (5.9%). Gait mechanics underlying the improved fast gait velocity included increases in hip angular impulse (29%) and H1 work (37%) and no changes in positive knee (K2) and A2 work. Detraining further improved fast gait velocity (4.7%) with reductions in H1 (−35%), and increases in K2 (36%) and A2 (7%).ConclusionPower training increased fast gait velocity in healthy old adults by increasing the reliance on hip muscle function and thus further strengthened the age-related distal-to-proximal shift in muscle function.



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Balance Performance of Deaf Children With and Without Cochlear Implants.

Related Articles

Balance Performance of Deaf Children With and Without Cochlear Implants.

Acta Med Iran. 2016 Nov;54(11):737-742

Authors: Ebrahimi AA, Movallali G, Jamshidi AA, Haghgoo HA, Rahgozar M

Abstract
 The aim of this study was to compare the static and dynamic balance performance of deaf children with and without cochlear implants. This is a cross-sectional study of 145 school children, aged between 7 and 12 years comprising 85 children with congenital or early acquired bilateral profound sensorineural hearing loss (the hearing loss group) and 60 normal hearing aged-matched control counterparts were assessed using the balance subtest of Bruininks-Oseretsky test of Motor Proficiency (BOTMP). The hearing loss group, 50 without cochlear implants (the non-implant group) and 35 of them with unilateral cochlear implants (the implant group) were recruited from schools for the deaf and normal hearing children (the control group) randomly selected from two randomly selected elementary schools of Tehran city. The scores were analyzed using one-way ANOVA. The total score of deaf children especially the implant group were significantly lower than the control group )P<0.001). The balance performance of the control group was better than the implant group in all of the items as well as the non-implant group except the fourth tested item (walking forward on a line) (P<0.05). The balance score of the implant group was significantly lower than the non-implant group except for the third tested item (standing on the preferred leg on a balance beam with eyes closed). The findings suggested that deaf children, specifically those with cochlear implants are at risk for motor and balance deficits. Thus, vestibular and motor evaluations, as well as interventions to improve balance and motor skills, should be prioritized for this population.

PMID: 28033698 [PubMed - in process]

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A narrative review of texting as a visually-dependent cognitive-motor secondary task during locomotion

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): T. Krasovsky, P.L. Weiss, R. Kizony
Typing while walking is an example of people’s ability to interact with technology while engaged in real life activities. Indeed, an increasing number of studies have investigated the typing of text messages (texting) as a dual task during locomotion. The objective of this review is to (1) describe the task requirements of texting-while-walking, (2) evaluate the measurement and psychometric properties of texting as a dual task, and (3) formulate methodological recommendations for researchers who use and report on texting-while-walking. Twenty studies which used texting as a dual task during gait were identified via a literature search. The majority of these studies examined texting among young healthy adults and showed that, like other dual tasks, texting-while-walking caused decrements in both gait and texting performance. The cause of these decrements was most likely related to increased visual task requirements, task-dependent cognitive requirements and fine motor skills. Texting-while-walking gait measures were repeatable, but texting performance showed poor reliability which further depended on skill. Preliminary results show that texting-while-walking performance may discriminate between populations (e.g., young vs. older adults) but no studies have yet examined its predictive validity (e.g., for fall risk). In conclusion, texting-while-walking is an ecologically-valid dual task for locomotion which has become much more commonly used in recent years. As opposed to other secondary tasks such as subtraction by 7 or generating words, texting may challenge various cognitive, visual and sensorimotor domains depending on its content. This imposes task-specific methodological challenges on future research, which are discussed.



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Dynamic plantar pressure distribution, strength capacity and postural control after Lisfranc fracture-dislocation

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Alexander T. Mehlhorn, Markus Walther, Tayfun Yilmaz, Lennart Gunst, Anja Hirschmüller, Norbert P. Südkamp, Hagen Schmal
Substantial progress has been made in the operative treatment of Lisfranc fractures, however, the prognosis remains poor. We hypothesized that Lisfranc injuries change the postural control and muscle strength of the lower limb. Both are suggested to correlate with the clinical outcome and quality of life.17 consecutive patients suffering from a Lisfranc fracture dislocation were registered, underwent open reduction and internal fixation and were followed-up for 50.5±25.7months (Mean±SDM). Biomechanical analysis of muscle strength capacities, postural control and plantar pressure distribution was assessed >6 month postoperatively. Results were correlated to clinical outcome (AOFAS, FFI, Pain, SF-36).The isokinetic assessment revealed a significant reduction in plantar flexor and dorsal extensor peak torque of the injured limb compared to the uninjured limb. The dorsal extensor peak torque thereby correlated well with clinical outcome. Altered postural control was evident by a significant reduction in unilateral stance time, from which we calculated a strong correlation between stance time and the isokinetic strength measurement. Plantar pressure measurements revealed a significant reduction in peak pressure under the midfoot and of Force-Time Integral beneath the second metatarsal.Sufficient rehabilitation is crucial to the clinical outcome following anatomical open reduction of Lisfranc fracture-dislocation. The present study supports a rehabilitation approach focussing on restoring proprioception and calf muscular strength including isometric exercises of the dorsal extensors.



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Hip mechanics underlie lower extremity power training-induced increase in old adults’ fast gait velocity: The Potsdam Gait Study (POGS)

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Chantal M.I. Beijersbergen, Urs Granacher, Martijn Gäbler, Paul DeVita, Tibor Hortobágyi
BackgroundAging is associated with slowed gait and old compared with young adults generally walk with greater positive hip work (H1) and reduced positive ankle work (A2). The role of exercise interventions on old adults’ gait mechanics that underlie training-induced improvements in gait velocity is unclear. We examined the effects of lower extremity power training and detraining on old adults’ gait kinetics.MethodsAs part of the Potsdam Gait Study (POGS), healthy old adults completed a no-intervention control period (69.1±4.4yrs, n=14) or a power training program followed by detraining (72.9±5.4yrs, n=15). We measured isokinetic knee extensor and plantarflexor power and measured hip, knee and ankle kinetics at habitual, fast and standardized walking speeds.ResultsPower training significantly increased isokinetic knee extensor power (25%), plantarflexor power (43%), and fast gait velocity (5.9%). Gait mechanics underlying the improved fast gait velocity included increases in hip angular impulse (29%) and H1 work (37%) and no changes in positive knee (K2) and A2 work. Detraining further improved fast gait velocity (4.7%) with reductions in H1 (−35%), and increases in K2 (36%) and A2 (7%).ConclusionPower training increased fast gait velocity in healthy old adults by increasing the reliance on hip muscle function and thus further strengthened the age-related distal-to-proximal shift in muscle function.



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Balance Performance of Deaf Children With and Without Cochlear Implants.

Related Articles

Balance Performance of Deaf Children With and Without Cochlear Implants.

Acta Med Iran. 2016 Nov;54(11):737-742

Authors: Ebrahimi AA, Movallali G, Jamshidi AA, Haghgoo HA, Rahgozar M

Abstract
 The aim of this study was to compare the static and dynamic balance performance of deaf children with and without cochlear implants. This is a cross-sectional study of 145 school children, aged between 7 and 12 years comprising 85 children with congenital or early acquired bilateral profound sensorineural hearing loss (the hearing loss group) and 60 normal hearing aged-matched control counterparts were assessed using the balance subtest of Bruininks-Oseretsky test of Motor Proficiency (BOTMP). The hearing loss group, 50 without cochlear implants (the non-implant group) and 35 of them with unilateral cochlear implants (the implant group) were recruited from schools for the deaf and normal hearing children (the control group) randomly selected from two randomly selected elementary schools of Tehran city. The scores were analyzed using one-way ANOVA. The total score of deaf children especially the implant group were significantly lower than the control group )P<0.001). The balance performance of the control group was better than the implant group in all of the items as well as the non-implant group except the fourth tested item (walking forward on a line) (P<0.05). The balance score of the implant group was significantly lower than the non-implant group except for the third tested item (standing on the preferred leg on a balance beam with eyes closed). The findings suggested that deaf children, specifically those with cochlear implants are at risk for motor and balance deficits. Thus, vestibular and motor evaluations, as well as interventions to improve balance and motor skills, should be prioritized for this population.

PMID: 28033698 [PubMed - in process]

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Cold Thermal Irrigation Decreases the Ipsilateral Gain of the Vestibulo-Ocular Reflex.

Objectives: During head rotations, neuronal firing rates increase in ipsilateral and decrease in contralateral vestibular afferents. At low accelerations, this "push-pull mechanism" is linear. At high accelerations, however, the change of firing rates is nonlinear in that the ipsilateral increase of firing rate is larger than the contralateral decrease. This mechanism of stronger ipsilateral excitation than contralateral inhibition during high-acceleration head rotation, known as Ewald's second law, is implemented within the nonlinear pathways. The authors asked whether caloric stimulation could provide an acceleration signal high enough to influence the contribution of the nonlinear pathway to the rotational vestibulo-ocular reflex gain (rVOR gain) during head impulses. Design: Caloric warm (44[degrees]C) and cold (24, 27, and 30[degrees]C) water irrigations of the left ear were performed in 7 healthy human subjects with the lateral semicircular canals oriented approximately earth-vertical (head inclined 30[degrees] from supine) and earth-horizontal (head inclined 30[degrees] from upright). Results: With the lateral semicircular canal oriented earth-vertical, the strongest cold caloric stimulus (24[degrees]C) significantly decreased the rVOR gain during ipsilateral head impulses, while all other irrigations, irrespective of head position, had no significant effect on rVOR gains during head impulses to either side. Conclusions: Strong caloric irrigation, which can only be achieved with cold water, reduces the rVOR gain during ipsilateral head impulses and thus demonstrates Ewald's second law in healthy subjects. This unilateral gain reduction suggests that cold-water caloric irritation shifts the set point of the nonlinear relation between head acceleration and the vestibular firing rate toward a less acceleration-sensitive zone. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Three-Dimensional Force Profile During Cochlear Implantation Depends on Individual Geometry and Insertion Trauma.

Objectives: To preserve the acoustic hearing, cochlear implantation has to be as atraumatic as possible. Therefore, understanding the impact of the cochlear geometry on insertion forces and intracochlear trauma might help to adapt and improve the electrode insertion and reduce the probability of intracochlear trauma. Design: The study was conducted on 10 fresh-frozen human temporal bones. The inner ear was removed from the temporal bone. The bony capsule covering the scala vestibuli was removed and the dissected inner ear was mounted on the three-dimensional (3D) force measurement system (Agilent technologies, Nano UTM, Santa Clare, CA). A lateral wall electrode array was inserted, and the forces were recorded in three dimensions with a sensitivity of 2 [mu]N. Afterwards, the bones were scanned using a Skyscan 1173 micro-computed tomography (micro-CT). The obtained 3D force profiles were correlated with the videos of the insertions recorded through the microscope, and the micro-CT images. Results: A correlation was found between intracochlear force profiles measured in three different directions with intracochlear trauma detected with micro-CT imaging. The angle of insertion and the cochlear geometry had a significant impact on the electrode array insertion forces and possible insertion trauma. Intracochlear trauma occurred frequently within the first 180[degrees] from the round window, where buckling of the proximal part of the electrode carrier inside the cochlea, and rupturing of the spiral ligament was observed. Conclusions: The combination of the 3D force measurement system and micro-CT can be used to characterize the mechanical behavior of a CI electrode array and some forms of insertion trauma. Intracochlear trauma does not always correlate with higher force amplitudes, but rather with an abrupt change of force directions. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Some Neurocognitive Correlates of Noise-Vocoded Speech Perception in Children With Normal Hearing: A Replication and Extension of Eisenberg et al. (2002)

Objectives: Noise-vocoded speech is a valuable research tool for testing experimental hypotheses about the effects of spectral degradation on speech recognition in adults with normal hearing (NH). However, very little research has utilized noise-vocoded speech with children with NH. Earlier studies with children with NH focused primarily on the amount of spectral information needed for speech recognition without assessing the contribution of neurocognitive processes to speech perception and spoken word recognition. In this study, we first replicated the seminal findings reported by Eisenberg et al. (2002) who investigated effects of lexical density and word frequency on noise-vocoded speech perception in a small group of children with NH. We then extended the research to investigate relations between noise-vocoded speech recognition abilities and five neurocognitive measures: auditory attention (AA) and response set, talker discrimination, and verbal and nonverbal short-term working memory. Design: Thirty-one children with NH between 5 and 13 years of age were assessed on their ability to perceive lexically controlled words in isolation and in sentences that were noise-vocoded to four spectral channels. Children were also administered vocabulary assessments (Peabody Picture Vocabulary test-4th Edition and Expressive Vocabulary test-2nd Edition) and measures of AA (NEPSY AA and response set and a talker discrimination task) and short-term memory (visual digit and symbol spans). Results: Consistent with the findings reported in the original Eisenberg et al. (2002) study, we found that children perceived noise-vocoded lexically easy words better than lexically hard words. Words in sentences were also recognized better than the same words presented in isolation. No significant correlations were observed between noise-vocoded speech recognition scores and the Peabody Picture Vocabulary test-4th Edition using language quotients to control for age effects. However, children who scored higher on the Expressive Vocabulary test-2nd Edition recognized lexically easy words better than lexically hard words in sentences. Older children perceived noise-vocoded speech better than younger children. Finally, we found that measures of AA and short-term memory capacity were significantly correlated with a child's ability to perceive noise-vocoded isolated words and sentences. Conclusions: First, we successfully replicated the major findings from the Eisenberg et al. (2002) study. Because familiarity, phonological distinctiveness and lexical competition affect word recognition, these findings provide additional support for the proposal that several foundational elementary neurocognitive processes underlie the perception of spectrally degraded speech. Second, we found strong and significant correlations between performance on neurocognitive measures and children's ability to recognize words and sentences noise-vocoded to four spectral channels. These findings extend earlier research suggesting that perception of spectrally degraded speech reflects early peripheral auditory processes, as well as additional contributions of executive function, specifically, selective attention and short-term memory processes in spoken word recognition. The present findings suggest that AA and short-term memory support robust spoken word recognition in children with NH even under compromised and challenging listening conditions. These results are relevant to research carried out with listeners who have hearing loss, because they are routinely required to encode, process, and understand spectrally degraded acoustic signals. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Cold Thermal Irrigation Decreases the Ipsilateral Gain of the Vestibulo-Ocular Reflex.

Objectives: During head rotations, neuronal firing rates increase in ipsilateral and decrease in contralateral vestibular afferents. At low accelerations, this "push-pull mechanism" is linear. At high accelerations, however, the change of firing rates is nonlinear in that the ipsilateral increase of firing rate is larger than the contralateral decrease. This mechanism of stronger ipsilateral excitation than contralateral inhibition during high-acceleration head rotation, known as Ewald's second law, is implemented within the nonlinear pathways. The authors asked whether caloric stimulation could provide an acceleration signal high enough to influence the contribution of the nonlinear pathway to the rotational vestibulo-ocular reflex gain (rVOR gain) during head impulses. Design: Caloric warm (44[degrees]C) and cold (24, 27, and 30[degrees]C) water irrigations of the left ear were performed in 7 healthy human subjects with the lateral semicircular canals oriented approximately earth-vertical (head inclined 30[degrees] from supine) and earth-horizontal (head inclined 30[degrees] from upright). Results: With the lateral semicircular canal oriented earth-vertical, the strongest cold caloric stimulus (24[degrees]C) significantly decreased the rVOR gain during ipsilateral head impulses, while all other irrigations, irrespective of head position, had no significant effect on rVOR gains during head impulses to either side. Conclusions: Strong caloric irrigation, which can only be achieved with cold water, reduces the rVOR gain during ipsilateral head impulses and thus demonstrates Ewald's second law in healthy subjects. This unilateral gain reduction suggests that cold-water caloric irritation shifts the set point of the nonlinear relation between head acceleration and the vestibular firing rate toward a less acceleration-sensitive zone. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Three-Dimensional Force Profile During Cochlear Implantation Depends on Individual Geometry and Insertion Trauma.

Objectives: To preserve the acoustic hearing, cochlear implantation has to be as atraumatic as possible. Therefore, understanding the impact of the cochlear geometry on insertion forces and intracochlear trauma might help to adapt and improve the electrode insertion and reduce the probability of intracochlear trauma. Design: The study was conducted on 10 fresh-frozen human temporal bones. The inner ear was removed from the temporal bone. The bony capsule covering the scala vestibuli was removed and the dissected inner ear was mounted on the three-dimensional (3D) force measurement system (Agilent technologies, Nano UTM, Santa Clare, CA). A lateral wall electrode array was inserted, and the forces were recorded in three dimensions with a sensitivity of 2 [mu]N. Afterwards, the bones were scanned using a Skyscan 1173 micro-computed tomography (micro-CT). The obtained 3D force profiles were correlated with the videos of the insertions recorded through the microscope, and the micro-CT images. Results: A correlation was found between intracochlear force profiles measured in three different directions with intracochlear trauma detected with micro-CT imaging. The angle of insertion and the cochlear geometry had a significant impact on the electrode array insertion forces and possible insertion trauma. Intracochlear trauma occurred frequently within the first 180[degrees] from the round window, where buckling of the proximal part of the electrode carrier inside the cochlea, and rupturing of the spiral ligament was observed. Conclusions: The combination of the 3D force measurement system and micro-CT can be used to characterize the mechanical behavior of a CI electrode array and some forms of insertion trauma. Intracochlear trauma does not always correlate with higher force amplitudes, but rather with an abrupt change of force directions. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Some Neurocognitive Correlates of Noise-Vocoded Speech Perception in Children With Normal Hearing: A Replication and Extension of Eisenberg et al. (2002)

Objectives: Noise-vocoded speech is a valuable research tool for testing experimental hypotheses about the effects of spectral degradation on speech recognition in adults with normal hearing (NH). However, very little research has utilized noise-vocoded speech with children with NH. Earlier studies with children with NH focused primarily on the amount of spectral information needed for speech recognition without assessing the contribution of neurocognitive processes to speech perception and spoken word recognition. In this study, we first replicated the seminal findings reported by Eisenberg et al. (2002) who investigated effects of lexical density and word frequency on noise-vocoded speech perception in a small group of children with NH. We then extended the research to investigate relations between noise-vocoded speech recognition abilities and five neurocognitive measures: auditory attention (AA) and response set, talker discrimination, and verbal and nonverbal short-term working memory. Design: Thirty-one children with NH between 5 and 13 years of age were assessed on their ability to perceive lexically controlled words in isolation and in sentences that were noise-vocoded to four spectral channels. Children were also administered vocabulary assessments (Peabody Picture Vocabulary test-4th Edition and Expressive Vocabulary test-2nd Edition) and measures of AA (NEPSY AA and response set and a talker discrimination task) and short-term memory (visual digit and symbol spans). Results: Consistent with the findings reported in the original Eisenberg et al. (2002) study, we found that children perceived noise-vocoded lexically easy words better than lexically hard words. Words in sentences were also recognized better than the same words presented in isolation. No significant correlations were observed between noise-vocoded speech recognition scores and the Peabody Picture Vocabulary test-4th Edition using language quotients to control for age effects. However, children who scored higher on the Expressive Vocabulary test-2nd Edition recognized lexically easy words better than lexically hard words in sentences. Older children perceived noise-vocoded speech better than younger children. Finally, we found that measures of AA and short-term memory capacity were significantly correlated with a child's ability to perceive noise-vocoded isolated words and sentences. Conclusions: First, we successfully replicated the major findings from the Eisenberg et al. (2002) study. Because familiarity, phonological distinctiveness and lexical competition affect word recognition, these findings provide additional support for the proposal that several foundational elementary neurocognitive processes underlie the perception of spectrally degraded speech. Second, we found strong and significant correlations between performance on neurocognitive measures and children's ability to recognize words and sentences noise-vocoded to four spectral channels. These findings extend earlier research suggesting that perception of spectrally degraded speech reflects early peripheral auditory processes, as well as additional contributions of executive function, specifically, selective attention and short-term memory processes in spoken word recognition. The present findings suggest that AA and short-term memory support robust spoken word recognition in children with NH even under compromised and challenging listening conditions. These results are relevant to research carried out with listeners who have hearing loss, because they are routinely required to encode, process, and understand spectrally degraded acoustic signals. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Cold Thermal Irrigation Decreases the Ipsilateral Gain of the Vestibulo-Ocular Reflex.

Objectives: During head rotations, neuronal firing rates increase in ipsilateral and decrease in contralateral vestibular afferents. At low accelerations, this "push-pull mechanism" is linear. At high accelerations, however, the change of firing rates is nonlinear in that the ipsilateral increase of firing rate is larger than the contralateral decrease. This mechanism of stronger ipsilateral excitation than contralateral inhibition during high-acceleration head rotation, known as Ewald's second law, is implemented within the nonlinear pathways. The authors asked whether caloric stimulation could provide an acceleration signal high enough to influence the contribution of the nonlinear pathway to the rotational vestibulo-ocular reflex gain (rVOR gain) during head impulses. Design: Caloric warm (44[degrees]C) and cold (24, 27, and 30[degrees]C) water irrigations of the left ear were performed in 7 healthy human subjects with the lateral semicircular canals oriented approximately earth-vertical (head inclined 30[degrees] from supine) and earth-horizontal (head inclined 30[degrees] from upright). Results: With the lateral semicircular canal oriented earth-vertical, the strongest cold caloric stimulus (24[degrees]C) significantly decreased the rVOR gain during ipsilateral head impulses, while all other irrigations, irrespective of head position, had no significant effect on rVOR gains during head impulses to either side. Conclusions: Strong caloric irrigation, which can only be achieved with cold water, reduces the rVOR gain during ipsilateral head impulses and thus demonstrates Ewald's second law in healthy subjects. This unilateral gain reduction suggests that cold-water caloric irritation shifts the set point of the nonlinear relation between head acceleration and the vestibular firing rate toward a less acceleration-sensitive zone. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Three-Dimensional Force Profile During Cochlear Implantation Depends on Individual Geometry and Insertion Trauma.

Objectives: To preserve the acoustic hearing, cochlear implantation has to be as atraumatic as possible. Therefore, understanding the impact of the cochlear geometry on insertion forces and intracochlear trauma might help to adapt and improve the electrode insertion and reduce the probability of intracochlear trauma. Design: The study was conducted on 10 fresh-frozen human temporal bones. The inner ear was removed from the temporal bone. The bony capsule covering the scala vestibuli was removed and the dissected inner ear was mounted on the three-dimensional (3D) force measurement system (Agilent technologies, Nano UTM, Santa Clare, CA). A lateral wall electrode array was inserted, and the forces were recorded in three dimensions with a sensitivity of 2 [mu]N. Afterwards, the bones were scanned using a Skyscan 1173 micro-computed tomography (micro-CT). The obtained 3D force profiles were correlated with the videos of the insertions recorded through the microscope, and the micro-CT images. Results: A correlation was found between intracochlear force profiles measured in three different directions with intracochlear trauma detected with micro-CT imaging. The angle of insertion and the cochlear geometry had a significant impact on the electrode array insertion forces and possible insertion trauma. Intracochlear trauma occurred frequently within the first 180[degrees] from the round window, where buckling of the proximal part of the electrode carrier inside the cochlea, and rupturing of the spiral ligament was observed. Conclusions: The combination of the 3D force measurement system and micro-CT can be used to characterize the mechanical behavior of a CI electrode array and some forms of insertion trauma. Intracochlear trauma does not always correlate with higher force amplitudes, but rather with an abrupt change of force directions. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Some Neurocognitive Correlates of Noise-Vocoded Speech Perception in Children With Normal Hearing: A Replication and Extension of Eisenberg et al. (2002)

Objectives: Noise-vocoded speech is a valuable research tool for testing experimental hypotheses about the effects of spectral degradation on speech recognition in adults with normal hearing (NH). However, very little research has utilized noise-vocoded speech with children with NH. Earlier studies with children with NH focused primarily on the amount of spectral information needed for speech recognition without assessing the contribution of neurocognitive processes to speech perception and spoken word recognition. In this study, we first replicated the seminal findings reported by Eisenberg et al. (2002) who investigated effects of lexical density and word frequency on noise-vocoded speech perception in a small group of children with NH. We then extended the research to investigate relations between noise-vocoded speech recognition abilities and five neurocognitive measures: auditory attention (AA) and response set, talker discrimination, and verbal and nonverbal short-term working memory. Design: Thirty-one children with NH between 5 and 13 years of age were assessed on their ability to perceive lexically controlled words in isolation and in sentences that were noise-vocoded to four spectral channels. Children were also administered vocabulary assessments (Peabody Picture Vocabulary test-4th Edition and Expressive Vocabulary test-2nd Edition) and measures of AA (NEPSY AA and response set and a talker discrimination task) and short-term memory (visual digit and symbol spans). Results: Consistent with the findings reported in the original Eisenberg et al. (2002) study, we found that children perceived noise-vocoded lexically easy words better than lexically hard words. Words in sentences were also recognized better than the same words presented in isolation. No significant correlations were observed between noise-vocoded speech recognition scores and the Peabody Picture Vocabulary test-4th Edition using language quotients to control for age effects. However, children who scored higher on the Expressive Vocabulary test-2nd Edition recognized lexically easy words better than lexically hard words in sentences. Older children perceived noise-vocoded speech better than younger children. Finally, we found that measures of AA and short-term memory capacity were significantly correlated with a child's ability to perceive noise-vocoded isolated words and sentences. Conclusions: First, we successfully replicated the major findings from the Eisenberg et al. (2002) study. Because familiarity, phonological distinctiveness and lexical competition affect word recognition, these findings provide additional support for the proposal that several foundational elementary neurocognitive processes underlie the perception of spectrally degraded speech. Second, we found strong and significant correlations between performance on neurocognitive measures and children's ability to recognize words and sentences noise-vocoded to four spectral channels. These findings extend earlier research suggesting that perception of spectrally degraded speech reflects early peripheral auditory processes, as well as additional contributions of executive function, specifically, selective attention and short-term memory processes in spoken word recognition. The present findings suggest that AA and short-term memory support robust spoken word recognition in children with NH even under compromised and challenging listening conditions. These results are relevant to research carried out with listeners who have hearing loss, because they are routinely required to encode, process, and understand spectrally degraded acoustic signals. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying an Adequate Intensity and Variation in Treatment Response

Purpose

This study sought to identify an adequate intensity of interactive book reading for new word learning by children with specific language impairment (SLI) and to examine variability in treatment response.

Method

An escalation design adapted from nontoxic drug trials (Hunsberger, Rubinstein, Dancey, & Korn, 2005) was used in this Phase I/II preliminary clinical trial. A total of 27 kindergarten children with SLI were randomized to 1 of 4 intensities of interactive book reading: 12, 24, 36, or 48 exposures. Word learning was monitored through a definition task and a naming task. An intensity response curve was examined to identify the adequate intensity. Correlations and classification accuracy were used to examine variation in response to treatment relative to pretreatment and early treatment measures.

Results

Response to treatment improved as intensity increased from 12 to 24 to 36 exposures, and then no further improvements were observed as intensity increased to 48 exposures. There was variability in treatment response: Children with poor phonological awareness, low vocabulary, and/or poor nonword repetition were less likely to respond to treatment.

Conclusion

The adequate intensity for this version of interactive book reading was 36 exposures, but further development of the treatment is needed to increase the benefit for children with SLI.

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Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying an Adequate Intensity and Variation in Treatment Response

Purpose

This study sought to identify an adequate intensity of interactive book reading for new word learning by children with specific language impairment (SLI) and to examine variability in treatment response.

Method

An escalation design adapted from nontoxic drug trials (Hunsberger, Rubinstein, Dancey, & Korn, 2005) was used in this Phase I/II preliminary clinical trial. A total of 27 kindergarten children with SLI were randomized to 1 of 4 intensities of interactive book reading: 12, 24, 36, or 48 exposures. Word learning was monitored through a definition task and a naming task. An intensity response curve was examined to identify the adequate intensity. Correlations and classification accuracy were used to examine variation in response to treatment relative to pretreatment and early treatment measures.

Results

Response to treatment improved as intensity increased from 12 to 24 to 36 exposures, and then no further improvements were observed as intensity increased to 48 exposures. There was variability in treatment response: Children with poor phonological awareness, low vocabulary, and/or poor nonword repetition were less likely to respond to treatment.

Conclusion

The adequate intensity for this version of interactive book reading was 36 exposures, but further development of the treatment is needed to increase the benefit for children with SLI.

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Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying an Adequate Intensity and Variation in Treatment Response

Purpose

This study sought to identify an adequate intensity of interactive book reading for new word learning by children with specific language impairment (SLI) and to examine variability in treatment response.

Method

An escalation design adapted from nontoxic drug trials (Hunsberger, Rubinstein, Dancey, & Korn, 2005) was used in this Phase I/II preliminary clinical trial. A total of 27 kindergarten children with SLI were randomized to 1 of 4 intensities of interactive book reading: 12, 24, 36, or 48 exposures. Word learning was monitored through a definition task and a naming task. An intensity response curve was examined to identify the adequate intensity. Correlations and classification accuracy were used to examine variation in response to treatment relative to pretreatment and early treatment measures.

Results

Response to treatment improved as intensity increased from 12 to 24 to 36 exposures, and then no further improvements were observed as intensity increased to 48 exposures. There was variability in treatment response: Children with poor phonological awareness, low vocabulary, and/or poor nonword repetition were less likely to respond to treatment.

Conclusion

The adequate intensity for this version of interactive book reading was 36 exposures, but further development of the treatment is needed to increase the benefit for children with SLI.

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The Acceptable Noise Level and the Pure-Tone Audiogram

Purpose

The vast majority of previous studies suggest that there is no relationship between the acceptable noise level (ANL) and pure-tone hearing thresholds reported as the average pure-tone hearing thresholds (pure-tone average). This study aims to explore (a) the relationship between hearing thresholds at individual frequencies and the ANL and (b) a measure of the slope of the audiogram and ANL.

Method

Sixty-three Danish adult hearing aid users participated. Assessments were pure-tone audiogram and 3 different versions of the ANL test made monaurally at 2 different sessions.

Results

The findings show that low-frequency hearing thresholds and the slope of the audiogram are significantly related to all versions of the ANL.

Conclusion

It is possible that previous studies have failed to discover a relationship between ANL and hearing thresholds due to the use of the broad 4-frequency pure-tone average. This has implications for our understanding of the ANL test.

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The Acceptable Noise Level and the Pure-Tone Audiogram

Purpose

The vast majority of previous studies suggest that there is no relationship between the acceptable noise level (ANL) and pure-tone hearing thresholds reported as the average pure-tone hearing thresholds (pure-tone average). This study aims to explore (a) the relationship between hearing thresholds at individual frequencies and the ANL and (b) a measure of the slope of the audiogram and ANL.

Method

Sixty-three Danish adult hearing aid users participated. Assessments were pure-tone audiogram and 3 different versions of the ANL test made monaurally at 2 different sessions.

Results

The findings show that low-frequency hearing thresholds and the slope of the audiogram are significantly related to all versions of the ANL.

Conclusion

It is possible that previous studies have failed to discover a relationship between ANL and hearing thresholds due to the use of the broad 4-frequency pure-tone average. This has implications for our understanding of the ANL test.

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The Acceptable Noise Level and the Pure-Tone Audiogram

Purpose

The vast majority of previous studies suggest that there is no relationship between the acceptable noise level (ANL) and pure-tone hearing thresholds reported as the average pure-tone hearing thresholds (pure-tone average). This study aims to explore (a) the relationship between hearing thresholds at individual frequencies and the ANL and (b) a measure of the slope of the audiogram and ANL.

Method

Sixty-three Danish adult hearing aid users participated. Assessments were pure-tone audiogram and 3 different versions of the ANL test made monaurally at 2 different sessions.

Results

The findings show that low-frequency hearing thresholds and the slope of the audiogram are significantly related to all versions of the ANL.

Conclusion

It is possible that previous studies have failed to discover a relationship between ANL and hearing thresholds due to the use of the broad 4-frequency pure-tone average. This has implications for our understanding of the ANL test.

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Recurrent missense mutation of GDF5 (p.R438L) causes proximal symphalangism in a British family.

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Recurrent missense mutation of GDF5 (p.R438L) causes proximal symphalangism in a British family.

World J Orthop. 2016 Dec 18;7(12):839-842

Authors: Leonidou A, Irving M, Holden S, Katchburian M

Abstract
Proximal symphalangism (SYM1B) (OMIM 615298) is an autosomal dominant developmental disorder affecting joint fusion. It is characterized by variable fusions of the proximal interphalangeal joints of the hands, typically of the ring and little finger, with the thumb typically being spared. SYM1 is frequently associated with coalition of tarsal bones and conductive hearing loss. Molecular studies have identified two possible genetic aetiologies for this syndrome, NOG and GDF5. We herein present a British caucasian family with SYM1B caused by a mutation of the GDF5 gene. A mother and her three children presented to the orthopaedic outpatient department predominantly for feet related problems. All patients had multiple tarsal coalitions and hand involvement in the form of either brachydactyly or symphalangism of the proximal and middle phalanx of the little fingers. Genetic testing in the eldest child and his mother identified a heterozygous missense mutation in GDF5 c.1313G>T (p.R438L), thereby establishing SYM1B as the cause of the orthopaedic problems in this family. There were no mutations identified in the NOG gene. This report highlights the importance of thorough history taking, including a three generation family history, and detailed clinical examination of children with fixed planovalgus feet and other family members to detect rare skeletal dysplasia conditions causing pain and deformity, and provides details of the spectrum of problems associated with SYM1B.

PMID: 28032038 [PubMed]

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Vici syndrome in siblings born to consanguineous parents.

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Vici syndrome in siblings born to consanguineous parents.

Am J Med Genet A. 2016 Jan;170A(1):220-5

Authors: Tasdemir S, Sahin I, Cayır A, Yuce I, Ceylaner S, Tatar A

Abstract
Vici syndrome (OMIM 242840) is a rare syndrome and since its initial description by Vici et al. [1988], only 29 cases have been reported. We describe two brothers from healthy consanguineous Turkish parents with psychomotor delay, congenital bilateral cataracts, high palate, long philtrum, micrognathia, fair hair, and skin. They both had general hypotonia and elevated muscle enzymes. Magnetic resonance imaging (MRI) of the brain confirmed agenesis of corpus callosum in both patients. Secundum type atrial septal defect (in Patient 1) and mild mitral, tricuspid, and pulmonary insufficiency (in Patient 2) were detected by echocardiographic examination. Immunological studies were normal, as were chromosome karyotype analyses (46, XY). Both children had bilateral cutaneous syndactyly between second and third toes and also bilateral sensorineural hearing loss. Patient 1 had poor feeding and regurgitation necessitating a feeding tube; mild laryngomalacia was subsequently detected by bronchoscopy. Mutation analysis in patient 2 showed a homozygous p.R2483* (c.7447C > T) mutation in EPG5 gene. We report a summary of the clinical findings in our patients and 29 cases from the literature.

PMID: 26395118 [PubMed - indexed for MEDLINE]

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A Comparative Study of the VHI-10 and the V-RQOL for Quality of Life Among Chinese Teachers With and Without Voice Disorders

Publication date: Available online 29 December 2016
Source:Journal of Voice
Author(s): Dan Lu, Bei Wen, Hui Yang, Fei Chen, Jun Liu, Yanan Xu, Yitao Zheng, Yu Zhao, Jian Zou, Haiyang Wang
ObjectivesTo investigate the differences and correlation between the Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (V-RQOL) in teachers in China with and without voice disorders.Study DesignThis is a cross-sectional descriptive analytical study.MethodsThe participants were 864 teachers (569 women, 295 men) whose vocal cords were examined using a flexible nasofibrolaryngoscope. Questionnaire results were obtained for both the VHI-10 and the V-RQOL.ResultsOf the 864 participants, 409 teachers had no voice disorders and 455 teachers had voice disorders. The most common voice complaint was hoarseness (n = 298) and the most common throat complaint was globus pharyngis (n = 79) in teachers with voice disorders. Chronic laryngitis (n = 218) and polyps and nodules (n = 182) were the most frequent diagnoses in teachers with voice disorders. Significant differences were seen on the VHI-10 between teachers with and those without voice disorders (P < 0.05) and in function between female and male teachers with voice disorders (P < 0.05) and between those with different voice disorders (P < 0.05). Moderate to strong correlations were observed between VHI-10 total score and those for the three domains of the VHI-10 and the V-RQOL (P < 0.0001).ConclusionsThere is a high prevalence of voice disorders in teachers. Teachers with voice disorders have poor voice-related quality of life, with more impairment seen among female than male teachers. Different groups of voice disorders have different effects on voice-related quality of life. A moderate correlation was found between the results of the VHI-10 and the V-RQOL.



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AHNS Series--Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors.

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AHNS Series--Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors.

Head Neck. 2016 Feb;38(2):168-74

Authors: Roman BR, Goldenberg D, Givi B, Education Committee of American Head and Neck Society (AHNS)

Abstract
In this first article of the "Do You Know Your Guidelines" series, we review National Comprehensive Cancer Network (NCCN) recommendations and underlying evidence for the follow-up and surveillance of head and neck cancer survivors. The goals of follow-up and surveillance care are (1) to maximize long-term oncologic outcomes of therapy with appropriate evaluation for recurrence, (2) to maximize functional and quality of life outcomes, and (3) minimizing unnecessary and harmful low-value care. Finding the right balance of testing and surveillance is a challenge for providers and patients. Herein, we review all NCCN recommendations for head and neck cancer survivors. We pay particular attention to an area of controversy: the use of ongoing surveillance imaging, in particular, PET/CT scans.

PMID: 25916656 [PubMed - indexed for MEDLINE]

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AHNS Series--Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors.

Related Articles

AHNS Series--Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors.

Head Neck. 2016 Feb;38(2):168-74

Authors: Roman BR, Goldenberg D, Givi B, Education Committee of American Head and Neck Society (AHNS)

Abstract
In this first article of the "Do You Know Your Guidelines" series, we review National Comprehensive Cancer Network (NCCN) recommendations and underlying evidence for the follow-up and surveillance of head and neck cancer survivors. The goals of follow-up and surveillance care are (1) to maximize long-term oncologic outcomes of therapy with appropriate evaluation for recurrence, (2) to maximize functional and quality of life outcomes, and (3) minimizing unnecessary and harmful low-value care. Finding the right balance of testing and surveillance is a challenge for providers and patients. Herein, we review all NCCN recommendations for head and neck cancer survivors. We pay particular attention to an area of controversy: the use of ongoing surveillance imaging, in particular, PET/CT scans.

PMID: 25916656 [PubMed - indexed for MEDLINE]

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Symptoms Associated with Vestibular Impairment in Veterans with Posttraumatic Stress Disorder

by Yaa O. Haber, Helena K. Chandler, Jorge M. Serrador

Posttraumatic stress disorder (PTSD) is a chronic and disabling, anxiety disorder resulting from exposure to life threatening events such as a serious accident, abuse or combat (DSM IV definition). Among veterans with PTSD, a common complaint is dizziness, disorientation and/or postural imbalance in environments such as grocery stores and shopping malls. The etiology of these symptoms in PTSD is poorly understood and some attribute them to anxiety or traumatic brain injury. There is a possibility that an impaired vestibular system may contribute to these symptoms since, symptoms of an impaired vestibular system include dizziness, disorientation and postural imbalance. To our knowledge, this is the first report to describe the nature of vestibular related symptoms in veterans with and without PTSD. We measured PTSD symptoms using the Posttraumatic Stress Disorder Checklist (PCL-C) and compared it to responses on vestibular function scales including the Dizziness Handicap Inventory (DHI), the Vertigo Symptom Scale Short Form (VSS-SF), the Chambless Mobility Inventory (CMI), and the Neurobehavioral Scale Inventory (NSI) in order to identify vestibular-related symptoms. Our findings indicate that veterans with worse PTSD symptoms report increased vestibular related symptoms. Additionally veterans with PTSD reported 3 times more dizziness related handicap than veterans without PTSD. Veterans with increased avoidance reported more vertigo and dizziness related handicap than those with PTSD and reduced avoidance. We describe possible contributing factors to increased reports of vestibular symptoms in PTSD, namely, anxiety, a vestibular component as well as an interactive effect of anxiety and vestibular impairment. We also present some preliminary analyses regarding the contribution of TBI. This data suggests possible evidence for vestibular symptom reporting in veterans with PTSD, which may be explained by possible underlying vestibular impairment, worthy of further exploration.

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Muckle-Wells syndrome in Chinese patients: a single center case series.

Related Articles

Muckle-Wells syndrome in Chinese patients: a single center case series.

Clin Rheumatol. 2016 Dec 27;:

Authors: Wu D, Shen M

Abstract
Muckle-Wells syndrome (MWS) is a rare autoinflammatory disease. This study aimed to report the clinical features and gene variations of the first case series of MWS patients in Chinese population. Four Han Chinese patients were diagnosed with MWS and followed up at our adult clinic for autoinflammatory diseases. All relevant phenotypes and genotypes were collected. All patients were adult male. The median age of disease onset was 4.5 years, and one patient had adult-onset disease. No positive family history was observed. All patients had a remittent disease course. The duration of fever attacks ranged from 0.5 to 7 days. Skin rashes were present in all patients. The other manifestations included polyarthralgia/arthritis (n = 3), oral ulcers (n = 2), conjunctivitis (n = 2), myalgia (n = 2), headache (n = 2), pharyngitis (n = 1), abdominal pain (n = 1), severe sensorineural hearing loss (n = 1), and chronic meningitis with communicating hydrocephalus (n = 1). None of the patients showed evidence of renal amyloidosis. Each patient carried a heterozygous mutation in an NLRP3 gene, including D29V, V70M, T348M, and Q703K, respectively. D29V and V70M variants were novel mutations in exon 1 of NLRP3. All patients had good response to corticosteroids. Our study suggests that MWS could be identified in Chinese population. Our finding of novel mutations in NLRP3 may expand the diversity of MWS.

PMID: 28028683 [PubMed - as supplied by publisher]

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Voice-Vibratory Assessment With Laryngeal Imaging (VALI) Form: Reliability of Rating Stroboscopy and High-speed Videoendoscopy

Publication date: Available online 28 December 2016
Source:Journal of Voice
Author(s): Bruce J. Poburka, Rita R. Patel, Diane M. Bless
ObjectiveThe purpose of the study was to evaluate the inter-judge and intra-judge reliability of raters using the Voice-Vibratory Assessment with Laryngeal Imaging (VALI) rating form that was developed for assessing videostroboscopy and high-speed videoendoscopic (HSV) recordings.Subjects and MethodsNine speech-language pathologists with an average of 12.8 years of experience with laryngeal imaging were trained to use the VALI form for rating 66 de-identified and randomized samples with voice disorders. Inter-judge reliability for parameters with scale data (amplitude, mucosal wave, nonvibratory portion, supraglottic activity, phase closure, symmetry, and regularity or periodicity) was assessed with intraclass correlations, and parameters with nominal data (glottal closure, vertical level, and free edge contour) were assessed with Fleiss' kappa. Intra-judge reliability was assessed using the Spearman rho statistic for scale data and percentage of concordant pairs for nominal data.ResultsInter-judge reliability for parameters with scale data ranged from 0.57 to 0.96 for stroboscopy and from 0.81 to 0.94 for HSV. For nominal parameters, correlations ranged from 0.18 to 0.35 for stroboscopy and from 0.13 to 0.33 for HSV. Intra-judge reliability correlations for parameters with scale data ranged from 0.19 to 0.87 for stroboscopy and from 0.28 to 0.85 for HSV. For parameters with nominal data, percentage of concordance ranged from 44% to 78% for stroboscopy and from 52% to 89% for HSV.ConclusionsThe VALI rating form and the training protocol is a first, a priori developed rating form that includes visual-perceptual ratings of both stroboscopy and HSV. The current form can be used to make reliable visual-perceptual judgments for selected features of vibratory motion from stroboscopy and HSV.



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The Influence of Vowels on Vocal Fold Dynamics in the Tenor's Passaggio

Publication date: Available online 28 December 2016
Source:Journal of Voice
Author(s): Matthias Echternach, Fabian Burk, Marie Köberlein, Michael Burdumy, Michael Döllinger, Bernhard Richter
IntroductionThe influence of vowels on the frequency region where registration events in male voices usually occur (passaggio) has not yet been clarified. Particularly, for tenors who frequently have to sing across the passaggio, it might be assumed that the vowel quality has an influence on the stability of phonation.MethodsIn this investigation, six professionally trained Western classical tenors performed a glide from A3 (220 Hz) to A4 (440 Hz) and were recorded using high-speed videoendoscopy at 20,000 fps via transnasal flexible endoscopy. The participants produced transitions (1) from modal register to falsetto and (2) from modal register to stage voice above the passaggio on the vowels [aː], [iː], and [uː]. Simultaneously, acoustic and electroglottographic (EGG) signals were recorded. The glottal area waveform (GAW) open quotient (OQ), the EGG OQ, and the sample entropy derived from the EGG were calculated and phonovibrograms were established.ResultsIn comparison to [iː] and [uː], vowel [aː] showed lower values regarding the sample entropy and greater periodicity in the phonovibrograms during the passaggio. For [iː] and [uː], the falsetto showed greater GAW OQ than the stage voice above the passaggio but no great difference for vowel [aː]. There was a good agreement between GAW OQ and EGG OQ for GAW OQ values below .65. However, for values greater than .65, the EGG OQ showed greater disagreement.ConclusionsThe data support the hypothesis that the vowel condition influences the phonatory stability concerning the passaggio, suggesting that vowel [aː] is associated with greater phonation stability.



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Patient Satisfaction by Design.

Related Articles

Patient Satisfaction by Design.

Semin Hear. 2016 Nov;37(4):316-324

Authors: Jacobs K

Abstract
The concept of the patient experience as it relates to patient satisfaction is a complex dynamic. It is a dynamic that is becoming increasingly more important as patients are faced with multiple choices for their hearing and balance care. As reimbursement and performance policies have become more normative within health care, patient satisfaction has become a metric to measure quality. Patient satisfaction is no longer contained to just the interaction with the audiologist. It extends to the entire experience-the staff, the service, the product, and other factors. Many practices fail to capitalize on one of the primary components of the patient experience-office design. This article discusses the role of evidence-based design in facility planning as it relates to patient satisfaction. It will illustrate how design principles and ideal attributes may be used to send conscious and subconscious cues that will motivate staff, facilitate patient-centered care, and ultimately increase patient satisfaction.

PMID: 28028324 [PubMed]

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Patient Satisfaction by Design.

Related Articles

Patient Satisfaction by Design.

Semin Hear. 2016 Nov;37(4):316-324

Authors: Jacobs K

Abstract
The concept of the patient experience as it relates to patient satisfaction is a complex dynamic. It is a dynamic that is becoming increasingly more important as patients are faced with multiple choices for their hearing and balance care. As reimbursement and performance policies have become more normative within health care, patient satisfaction has become a metric to measure quality. Patient satisfaction is no longer contained to just the interaction with the audiologist. It extends to the entire experience-the staff, the service, the product, and other factors. Many practices fail to capitalize on one of the primary components of the patient experience-office design. This article discusses the role of evidence-based design in facility planning as it relates to patient satisfaction. It will illustrate how design principles and ideal attributes may be used to send conscious and subconscious cues that will motivate staff, facilitate patient-centered care, and ultimately increase patient satisfaction.

PMID: 28028324 [PubMed]

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Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation

Purpose

The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties.

Method

MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument databases were searched using relevant vocabulary terms and key terms related to PRO measures and voice. Inclusion and exclusion criteria were developed in consultation with an expert panel. Three independent investigators assessed study methodology using criteria developed a priori. Measurement properties were examined and entered into evidence tables.

Results

A total of 3,744 studies assessing voice-related constructs were identified. This list was narrowed to 32 PRO measures on the basis of predetermined inclusion and exclusion criteria. Questionnaire measurement properties varied widely. Important thematic deficiencies were apparent: (a) lack of patient involvement in the item development process, (b) lack of robust construct validity, and (c) lack of clear interpretability and scaling.

Conclusions

PRO measures are a principal means of evaluating treatment effectiveness in voice-related conditions. Despite their prominence, available PRO measures have disparate methodological rigor. Care must be taken to understand the psychometric and measurement properties and the applicability of PRO measures before advocating for their use in clinical or research applications.

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Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation

Purpose

The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties.

Method

MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument databases were searched using relevant vocabulary terms and key terms related to PRO measures and voice. Inclusion and exclusion criteria were developed in consultation with an expert panel. Three independent investigators assessed study methodology using criteria developed a priori. Measurement properties were examined and entered into evidence tables.

Results

A total of 3,744 studies assessing voice-related constructs were identified. This list was narrowed to 32 PRO measures on the basis of predetermined inclusion and exclusion criteria. Questionnaire measurement properties varied widely. Important thematic deficiencies were apparent: (a) lack of patient involvement in the item development process, (b) lack of robust construct validity, and (c) lack of clear interpretability and scaling.

Conclusions

PRO measures are a principal means of evaluating treatment effectiveness in voice-related conditions. Despite their prominence, available PRO measures have disparate methodological rigor. Care must be taken to understand the psychometric and measurement properties and the applicability of PRO measures before advocating for their use in clinical or research applications.

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Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation

Purpose

The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties.

Method

MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument databases were searched using relevant vocabulary terms and key terms related to PRO measures and voice. Inclusion and exclusion criteria were developed in consultation with an expert panel. Three independent investigators assessed study methodology using criteria developed a priori. Measurement properties were examined and entered into evidence tables.

Results

A total of 3,744 studies assessing voice-related constructs were identified. This list was narrowed to 32 PRO measures on the basis of predetermined inclusion and exclusion criteria. Questionnaire measurement properties varied widely. Important thematic deficiencies were apparent: (a) lack of patient involvement in the item development process, (b) lack of robust construct validity, and (c) lack of clear interpretability and scaling.

Conclusions

PRO measures are a principal means of evaluating treatment effectiveness in voice-related conditions. Despite their prominence, available PRO measures have disparate methodological rigor. Care must be taken to understand the psychometric and measurement properties and the applicability of PRO measures before advocating for their use in clinical or research applications.

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The Effects of Earphone Use and Environmental Lead Exposure on Hearing Loss in the Korean Population: Data Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), 2010–2013

by Da-An Huh, Yun-Hee Choi, Kyong Whan Moon

Background

Although previous studies have reported that frequent earphone use and lead exposure are risk factors for hearing loss, most of these studies were limited to small populations or animal experiments. Several studies that presented the joint effect of combined exposure of noise and heavy metal on hearing loss were also mainly conducted on occupational workers exposed to high concentration.

Objectives

We investigated both the individual and joint effects of earphone use and environmental lead exposure on hearing loss in the Korean general population.

Methods

We analyzed data from 7,596 Koreans provided by the Korea National Health and Nutrition Examination Survey (KNHANES) during the period 2010–2013. The pure-tone average (PTA) of hearing thresholds at 2, 3, and 4 kHz frequencies was computed, and hearing loss was defined as a PTA ≥ 25 dB in one or both ears.

Results

A dose-response relationship in hearing loss with earphone use time and blood lead level is observed after adjustment for confounding factors. With a 1-hour increase in earphone use time and 1 μg/dL increase in blood lead concentration, the odds of hearing loss increased by 1.19 and 1.43 times, respectively. For hearing loss, the additive and multiplicative effect of earphone use and blood lead level were not statistically significant.

Conclusions

Earphone use and environmental lead exposure have an individual effect on hearing loss in the general population. However, the estimated joint effect of earphone use and lead exposure was not statistically significant.

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Organ of Corti and Stria Vascularis: Is there an Interdependence for Survival?

by Huizhan Liu, Yi Li, Lei Chen, Qian Zhang, Ning Pan, David H. Nichols, Weiping J. Zhang, Bernd Fritzsch, David Z. Z. He

Cochlear hair cells and the stria vascularis are critical for normal hearing. Hair cells transduce mechanical stimuli into electrical signals, whereas the stria is responsible for generating the endocochlear potential (EP), which is the driving force for hair cell mechanotransduction. We questioned whether hair cells and the stria interdepend for survival by using two mouse models. Atoh1 conditional knockout mice, which lose all hair cells within four weeks after birth, were used to determine whether the absence of hair cells would affect function and survival of stria. We showed that stria morphology and EP remained normal for long time despite a complete loss of all hair cells. We then used a mouse model that has an abnormal stria morphology and function due to mutation of the Mitf gene to determine whether hair cells are able to survive and transduce sound signals without a normal electrochemical environment in the endolymph. A strial defect, reflected by missing intermediate cells in the stria and by reduction of EP, led to systematic outer hair cell death from the base to the apex after postnatal day 18. However, an 18-mV EP was sufficient for outer hair cell survival. Surprisingly, inner hair cell survival was less vulnerable to reduction of the EP. Our studies show that normal function of the stria is essential for adult outer hair cell survival, while the survival and normal function of the stria vascularis do not depend on functional hair cells.

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Professor Peter Torre III Featured on KPBS!

“Hearing loss from loud music can be permanent, according to San Diego State University audiology professor Peter Torre. He heads up SDSU’s Recreational Noise Exposure and Auditory Function Lab. The 85 decibel limit is a good start, he said, but because it was set decades ago for adults over an eight-hour workday, there’s still a risk of hearing loss for children even at that level.”

• See the full article on KPBS.org! >>

 

 

 

 

 

 

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Professor Peter Torre III Featured on KPBS!

“Hearing loss from loud music can be permanent, according to San Diego State University audiology professor Peter Torre. He heads up SDSU’s Recreational Noise Exposure and Auditory Function Lab. The 85 decibel limit is a good start, he said, but because it was set decades ago for adults over an eight-hour workday, there’s still a risk of hearing loss for children even at that level.”

• See the full article on KPBS.org! >>

 

 

 

 

 

 

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Professor Peter Torre III Featured on KPBS!

“Hearing loss from loud music can be permanent, according to San Diego State University audiology professor Peter Torre. He heads up SDSU’s Recreational Noise Exposure and Auditory Function Lab. The 85 decibel limit is a good start, he said, but because it was set decades ago for adults over an eight-hour workday, there’s still a risk of hearing loss for children even at that level.”

• See the full article on KPBS.org! >>

 

 

 

 

 

 

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Standing balance and inter-limb balance asymmetry at one year post primary anterior cruciate ligament reconstruction: Sex differences in a cohort study of 414 patients

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Ross A. Clark, Stuart W. Bell, Julian A. Feller, Timothy S. Whitehead, Kate E. Webster
BackgroundStatic standing balance can be safely assessed early following anterior cruciate ligament reconstruction (ACLR), and deficits may have important implications for long-term outcomes. This study includes a large cohort of people post-ACLR and has the primary aim of establishing whether inter-limb and sex differences exist, with a secondary aim of assessing the association between static balance variables and other outcome measures.MethodsA total of 414 patients with a primary ACLR performed a 30-s static single leg balance test. Centre of pressure (COP) path length, antero-posterior (AP) and medio-lateral (ML) sway range and slow and fast speed COP path-length were examined. Additional measures included single and triple hop distance and symmetry, knee flexion range of motion, ligament laxity and the International Knee Documentation Committee (IKDC) subjective knee evaluation form.ResultsNo significant inter-limb balance differences were present in females. Significant, yet small to negligible effect size (ES) differences were present in males for ML range (ES=0.19), and AP and ML axis slow speed path length (ES=0.11 and 0.23 respectively). Significant, negligible to moderate effect size (ES range=<0.01 to 0.60) sex differences were observed, with females showing reduced sway compared to males. No balance variables had associations with any other variable that were greater than weak.DiscussionOur findings provide evidence that primary ACLR does not appear to negatively impact single leg standing balance on the operated limb more than the non-operated side. The lack of association with other outcome measures warrants further longitudinal examination into the utility of static standing balance assessment.



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Spatio-temporal and kinematic gait analysis in patients with Frontotemporal dementia and Alzheimer’s disease through 3D motion capture

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Rosaria Rucco, Valeria Agosti, Francesca Jacini, Pierpaolo Sorrentino, Pasquale Varriale, Manuela De Stefano, Graziella Milan, Patrizia Montella, Giuseppe Sorrentino
Alzheimer’s disease (AD) and behavioral variant of Frontotemporal Dementia (bvFTD) are characterized respectively by atrophy in the medial temporal lobe with memory loss and prefrontal and anterior temporal degeneration with dysexecutive syndrome. In this study, we hypothesized that specific gait patterns are induced by either frontal or temporal degeneration. To test this hypothesis, we studied the gait pattern in bvFTD (23) and AD (22) patients in single and dual task (“motor” and “cognitive”) conditions. To detect subtle alterations, we performed motion analysis estimating both spatio-temporal parameters and joint excursions. In the single task condition, the bvFTD group was more unstable and slower compared to healthy subjects, while only two stability parameters were compromised in the AD group. During the motor dual task, both velocity and stability parameters worsened further in the bvFTD group. In the same experimental conditions, AD patients showed a significantly lower speed and stride length than healthy subjects. During the cognitive dual task, a further impairment of velocity and stability parameters was observed in the bvFTD group. Interestingly, during the cognitive dual task, the gait performance of the AD group markedly deteriorated, as documented by the impairment of more indices of velocity and stability. Finally, the kinematic data of thigh, knee, and ankle were more helpful in revealing gait impairment than the spatio-temporal parameters alone. In conclusion, our data showed that the dysexecutive syndrome induces specific gait alterations. Furthermore, our results suggest that the gait worsens in the AD patients when the cognitive resources are stressed.



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Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Roshanth Rajachandrakumar, Julia E. Fraser, Alison Schinkel-Ivy, Elizabeth L. Inness, Lou Biasin, Karen Brunton, William E. McIlroy, Avril Mansfield
Anticipatory postural adjustments, executed prior to gait initiation, help preserve lateral stability when stepping. Atypical patterns of anticipatory activity prior to gait initiation may occur in individuals with unilateral impairment (e.g., stroke). This study aimed to determine the prevalence, correlates, and consequences of atypical anticipatory postural adjustment patterns prior to gait initiation in a sub-acute stroke population. Forty independently-ambulatory individuals with sub-acute stroke stood on two force plates and initiated gait at a self-selected speed. Medio-lateral centre of pressure displacement was calculated and used to define anticipatory postural adjustments (shift in medio-lateral centre of pressure >10mm from baseline). Stroke severity, motor recovery, and functional balance and mobility status were also obtained. Three patterns were identified: single (typical), absent (atypical), and multiple (atypical) anticipatory postural adjustments. Thirty-five percent of trials had atypical anticipatory postural adjustments (absent and multiple). Frequency of absent anticipatory postural adjustments was negatively correlated with walking speed. Multiple anticipatory postural adjustments were more prevalent when leading with the non-paretic than the paretic limb. Trials with multiple anticipatory postural adjustments had longer duration of anticipatory postural adjustment and time to foot-off, and shorter unloading time than trials with single anticipatory postural adjustments. A high prevalence of atypical anticipatory control prior to gait initiation was found in individuals with stroke. Temporal differences were identified with multiple anticipatory postural adjustments, indicating altered gait initiation. These findings provide insight into postural control during gait initiation in individuals with sub-acute stroke, and may inform interventions to improve ambulation in this population.



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Enjoy a Concert Safely When You Have Hearing Loss

No abstract available

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Hidden Hearing Loss: An Audiologist's Perspective

No abstract available

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m-Health Self-Management Program for the Smartphone Generation

No abstract available

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Amplification, Auditory Training for Hearing Aid, Cochlear Implant Users

No abstract available

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Recognizing Emotional Challenges of Hearing Loss

No abstract available

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Revisiting Age-Related Hearing Loss Screening - Part 2

No abstract available

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Will 2017 Produce a Hearing Breakthrough?

No abstract available

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Symptom: Left-Sided Ear Pain

No abstract available

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Tinnitus: An Evolutionary Phenomenon?

No abstract available

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Smartphone-based National Hearing Test Launched in South Africa

No abstract available

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The Challenges of Adapting to a New Power Hearing Aid

No abstract available

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The Bilingualism Paradox

No abstract available

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Manufacturers News

No abstract available

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The effects of various visual conditions on trunk control during ambulation in chronic post stroke patients

Publication date: February 2017
Source:Gait & Posture, Volume 52
Author(s): Osamu Aoki, Yoshitaka Otani, Shinichiro Morishita, Kazuhisa Domen
Downward gazing is commonly observed among patients after a stroke during standing or walking as they struggle to maintain equilibrium. In this study, we aimed to evaluate the effects of fixed gazing and downward gazing on trunk control ability during gait. Sixteen subjects after a stroke (age: 51.3±4.9years) and seven healthy subjects (age: 65.1±3.4years) participated in this study. Participants walked 10m at a comfortable speed while they faced forward (no gaze point), gazed forward (with a fixed gaze point), gazed downward, and gazed downward while concealing their legs. Trunk acceleration was measured using tri-axial accelerometers attached to the back of the upper (C7 spinous process) and lower (L3 spinous process) trunk. The coefficient of attenuation (CoA) of acceleration at the trunk was computed to assess trunk control ability. Results in the stroke group showed that the CoA during fixed-point and downward gazing was better than that while facing forward with no gaze point (p<0.001). In the stroke group, the CoA during gazing downward with their legs concealed was worse than that during downward gazing. Our findings indicate that patients after a stroke might use visual information for reducing their neck oscillation (C7) during fixed-point and downward gazing. Our results indicate that the visual information during downward gazing might work the same as during fixed-point gazing.



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