10.1080/14992027.2016.1183826<br/>David M. Baguley
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Παρασκευή 27 Μαΐου 2016
Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study
10.1080/14992027.2016.1182651<br/>Ning-Chia Chang
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Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study
10.1080/14992027.2016.1182651<br/>Ning-Chia Chang
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Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Int J Audiol. 2016 May 24;:1-8
Authors: Chang NC, Dai CY, Lin WY, Chien CY, Hsieh MH, Ho KY
Abstract
OBJECTIVES: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan.
DESIGN: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed.
STUDY SAMPLE: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older.
RESULTS: The prevalence of HI >25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%).
CONCLUSIONS: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.
PMID: 27218891 [PubMed - as supplied by publisher]
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Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Int J Audiol. 2016 May 23;:1-11
Authors: Plant K, van Hoesel R, McDermott H, Dawson P, Cowan R
Abstract
OBJECTIVE: To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines.
DESIGN: Prospective, within-subject experimental design.
STUDY SAMPLE: Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%).
RESULTS: Post-implantation improvement of 2.4 dB and 4.0 dB was observed on a sentence in coincident babble test at presentation levels of 65 and 55 dB SPL respectively, and a 2.1 dB benefit in spatial release from masking (SRM) advantage observed when the noise location favoured the implanted side. Significant post-operative group mean change of between 2.1 and 3.0 was observed on the sub-scales of the speech, spatial, and qualities (SSQ) questionnaire. Degree of post-implantation speech reception threshold (SRT) benefit on the coincident babble test and on perception of soft speech and sounds in the environment was greater for subjects with less contralateral hearing. The degree of contralateral acoustic hearing did not affect time taken to acclimate to the device.
CONCLUSIONS: The findings from this study support cochlear implantation for candidates with substantial acoustic hearing in the contralateral ear, and provide guidance regarding post-implantation expectations.
PMID: 27216386 [PubMed - as supplied by publisher]
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Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Int J Audiol. 2016 May 24;:1-8
Authors: Chang NC, Dai CY, Lin WY, Chien CY, Hsieh MH, Ho KY
Abstract
OBJECTIVES: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan.
DESIGN: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed.
STUDY SAMPLE: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older.
RESULTS: The prevalence of HI >25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%).
CONCLUSIONS: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.
PMID: 27218891 [PubMed - as supplied by publisher]
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Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Int J Audiol. 2016 May 23;:1-11
Authors: Plant K, van Hoesel R, McDermott H, Dawson P, Cowan R
Abstract
OBJECTIVE: To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines.
DESIGN: Prospective, within-subject experimental design.
STUDY SAMPLE: Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%).
RESULTS: Post-implantation improvement of 2.4 dB and 4.0 dB was observed on a sentence in coincident babble test at presentation levels of 65 and 55 dB SPL respectively, and a 2.1 dB benefit in spatial release from masking (SRM) advantage observed when the noise location favoured the implanted side. Significant post-operative group mean change of between 2.1 and 3.0 was observed on the sub-scales of the speech, spatial, and qualities (SSQ) questionnaire. Degree of post-implantation speech reception threshold (SRT) benefit on the coincident babble test and on perception of soft speech and sounds in the environment was greater for subjects with less contralateral hearing. The degree of contralateral acoustic hearing did not affect time taken to acclimate to the device.
CONCLUSIONS: The findings from this study support cochlear implantation for candidates with substantial acoustic hearing in the contralateral ear, and provide guidance regarding post-implantation expectations.
PMID: 27216386 [PubMed - as supplied by publisher]
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The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries
Publication date: Available online 24 May 2016
Source:Gait & Posture
Author(s): I. Hanzlíková, J. Richards, M. Tomsa, A. Chohan, K. May, D. Smékal, J. Selfe
IntroductionProprioceptive knee braces have been shown to improve knee mechanics, however much of the work to date has focused on tasks such as slow step down tasks rather than more dynamic sporting tasks.ObjectiveThis study aimed to explore if such improvements in stability may be seen during faster sports specific tasks as well as slower tasks.MethodTwelve subjects performed a slow step down, single leg drop jump and pivot turn jump with and without a silicone web brace. 3D kinematics of the knee were collected using a ten camera Qualisys motion analysis system. Reflective markers were placed on the foot, shank, thigh and pelvis using the Calibrated Anatomical Systems Technique. A two way ANOVA with repeated measures was performed with post-hoc pairwise comparison to explore the differences between the two conditions and three tasks.ResultsSignificant differences were seen in the knee joint angles and angular velocities in the sagittal, coronal and transverse planes between the tasks. The brace showed a reduction in knee valgum and internal rotation across all tasks, with the most notable effect during the single leg drop jump and pivot turn jump. The transverse plane also showed a significant reduction in the external rotation knee angular velocity when wearing the brace.DiscussionThe brace influenced the knee joint kinematics in coronal and transverse planes which confirms that such braces can have a significant effect on knee control during dynamic tasks. Further studies are required exploring the efficacy of proprioceptive braces in athletic patient cohort.
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Source:Gait & Posture
Author(s): I. Hanzlíková, J. Richards, M. Tomsa, A. Chohan, K. May, D. Smékal, J. Selfe
IntroductionProprioceptive knee braces have been shown to improve knee mechanics, however much of the work to date has focused on tasks such as slow step down tasks rather than more dynamic sporting tasks.ObjectiveThis study aimed to explore if such improvements in stability may be seen during faster sports specific tasks as well as slower tasks.MethodTwelve subjects performed a slow step down, single leg drop jump and pivot turn jump with and without a silicone web brace. 3D kinematics of the knee were collected using a ten camera Qualisys motion analysis system. Reflective markers were placed on the foot, shank, thigh and pelvis using the Calibrated Anatomical Systems Technique. A two way ANOVA with repeated measures was performed with post-hoc pairwise comparison to explore the differences between the two conditions and three tasks.ResultsSignificant differences were seen in the knee joint angles and angular velocities in the sagittal, coronal and transverse planes between the tasks. The brace showed a reduction in knee valgum and internal rotation across all tasks, with the most notable effect during the single leg drop jump and pivot turn jump. The transverse plane also showed a significant reduction in the external rotation knee angular velocity when wearing the brace.DiscussionThe brace influenced the knee joint kinematics in coronal and transverse planes which confirms that such braces can have a significant effect on knee control during dynamic tasks. Further studies are required exploring the efficacy of proprioceptive braces in athletic patient cohort.
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The effects of visual feedback during a rhythmic weight-shifting task in patients with Parkinson's disease
Publication date: Available online 24 May 2016
Source:Gait & Posture
Author(s): Maarten R.C. van den Heuvel, Andreas Daffertshofer, Peter J. Beek, Gert Kwakkel, Erwin E.H. van Wegen
Augmented visual feedback (VF) may offer benefits similar to those of rhythmic external cues in alleviating some mobility-related difficulties in individuals with Parkinson's disease (PD). However, due to an impaired ability to reweigh sensory information under changing circumstances, subjects with PD may be rather vulnerable to incongruity of visual information. In the present study, we investigated whether VF is indeed effective in improving motor functioning in a weight-shifting task during upright stance, and whether subjects with PD are affected more by incongruent VF than healthy controls. Participants performed sideways swaying motions based on tracking of real-time and delayed VF–the first providing congruent, and hence more accurate, visual information than the latter. We analyzed center-of-pressure signals patterns for 28 individuals with PD and 16 healthy, age- and gender-matched controls by estimating task accuracy, movement pattern variability, and normalized movement amplitude. For conditions without feedback and with real-time feedback, subjects with PD performed lateral swaying motions with greater error (F(1,42)=12.065, p=.001) and with more variable movement patterns than healthy controls (F(1, 24)=113.086, p<.001). Error change scores revealed that patients with PD were nevertheless still able to use VF to improve tracking performance (t(24)=-2.366, p=.026). However, whereas controls were able to adapt to a certain amount of visual incongruity, patients with PD were not. Instead, movement amplitude was significantly reduced in this group (F(1.448, 60.820)=17.639, p<.001). By reducing movement amplitude, subjects with PD appear to resort to a ‘conservative’ strategy to minimize performance breakdown.
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Source:Gait & Posture
Author(s): Maarten R.C. van den Heuvel, Andreas Daffertshofer, Peter J. Beek, Gert Kwakkel, Erwin E.H. van Wegen
Augmented visual feedback (VF) may offer benefits similar to those of rhythmic external cues in alleviating some mobility-related difficulties in individuals with Parkinson's disease (PD). However, due to an impaired ability to reweigh sensory information under changing circumstances, subjects with PD may be rather vulnerable to incongruity of visual information. In the present study, we investigated whether VF is indeed effective in improving motor functioning in a weight-shifting task during upright stance, and whether subjects with PD are affected more by incongruent VF than healthy controls. Participants performed sideways swaying motions based on tracking of real-time and delayed VF–the first providing congruent, and hence more accurate, visual information than the latter. We analyzed center-of-pressure signals patterns for 28 individuals with PD and 16 healthy, age- and gender-matched controls by estimating task accuracy, movement pattern variability, and normalized movement amplitude. For conditions without feedback and with real-time feedback, subjects with PD performed lateral swaying motions with greater error (F(1,42)=12.065, p=.001) and with more variable movement patterns than healthy controls (F(1, 24)=113.086, p<.001). Error change scores revealed that patients with PD were nevertheless still able to use VF to improve tracking performance (t(24)=-2.366, p=.026). However, whereas controls were able to adapt to a certain amount of visual incongruity, patients with PD were not. Instead, movement amplitude was significantly reduced in this group (F(1.448, 60.820)=17.639, p<.001). By reducing movement amplitude, subjects with PD appear to resort to a ‘conservative’ strategy to minimize performance breakdown.
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Acquired Hearing Loss and Brain Plasticity
Source:Hearing Research
Author(s): Jos J. Eggermont
Acquired hearing loss results in an imbalance of the cochlear output across frequency. Central auditory system homeostatic processes responding to this result in frequency specific gain changes consequent to the emerging imbalance between excitation and inhibition. Several consequences thereof are increased spontaneous firing rates, increased neural synchrony, and (in adults) potentially restricted to the auditory thalamus and cortex a reorganization of tonotopic areas. It does not seem to matter much whether the hearing loss is acquired neonatally or in adulthood. In humans, no clear evidence of tonotopic map changes with hearing loss has so far been provided, but frequency specific gain changes are well documented. Unilateral hearing loss in addition makes brain activity across hemispheres more symmetrical and more synchronous. Molecular studies indicate that in the brainstem, after 2-5 days post trauma, the glutamatergic activity is reduced, whereas glycinergic and GABAergic activity is largely unchanged. At 2 months post trauma, excitatory activity remains decreased but the inhibitory one is significantly increased. In contrast protein assays related to inhibitory transmission are all decreased or unchanged in the brainstem, midbrain and auditory cortex. Comparison of neurophysiological data with the molecular findings during a time-line of changes following noise trauma suggests that increases in spontaneous firing rates are related to decreases in inhibition, and not to increases in excitation. Because noise-induced hearing loss in cats resulted in a loss of cortical temporal processing capabilities, this may also underlie speech understanding in humans.
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Dexamethasone Is One of the Factors Minimizing the Inner Ear Damage from Electrode Insertion in Cochlear Implantation
The aim of this study was to investigate the efficacy of preoperative and intraoperative steroid administration for inner ear protection in cochlear implantation (CI). Nineteen subjects who underwent CI were included in the study, and 10 subjects were enrolled as controls (steroid-administered group, n = 19; control group, n = 10). Dexamethasone (dexamethasone sodium phosphate, 5 mg/ml) was systemically administered preoperatively (1 ml) and topically applied during CI (0.5 ml). The extent of hearing preservation (HP) after CI and the change in the bithermal caloric response were evaluated. Hearing level was calculated using mean thresholds [(250 Hz + 500 Hz + 1,000 Hz + 2,000 Hz)/4]. Preoperative hearing thresholds were similar in the steroid-administered and control groups (100.92 ± 12.60 vs. 103.29 ± 14.39 dB, p = 0.650). The mean thresholds significantly increased in both groups after surgery (108.46 ± 14.08 dB, p = 0.006, for the steroid-administered group; 117.50 ± 6.34 dB, p = 0.027, for the control group), and the difference between the groups was also significant (p = 0.027). The postoperative shift in the hearing thresholds at frequencies of 500 and 1,000 Hz was significant in the steroid-administered group and that at the frequencies of 500, 1,000 and 2,000 Hz was significant in the control group. However, the extent of the shift in hearing threshold levels at each frequency was not significantly different between the groups. Preservation of hearing thresholds was compared between the groups, and there were significantly more subjects with complete and partial HP in the steroid-administered group than in the control group (p = 0.008). The preoperative caloric response was maintained after CI in the steroid-administered group. This study suggests that the perioperative use of a steroid could minimize the inner ear damage after CI.
Audiol Neurotol 2016;21:178-186
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Audiol Neurotol 2016;21:178-186
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Comparing Distortion Product Otoacoustic Emissions to Intracochlear Distortion Products Inferred from a Noninvasive Assay
Abstract
The behavior of intracochlear distortion products (iDPs) was inferred by interacting a probe tone (f3) with the iDP of interest to produce a “secondary” distortion product otoacoustic emission termed DPOAE2ry. Measures of the DPOAE2ry were then used to deduce the properties of the iDP. This approach was used in alert rabbits and anesthetized gerbils to compare ear-canal 2f1-f2 and 2f2-f1 DPOAE f2/f1 ratio functions, level/phase (L/P) maps, and interference-response areas (IRAs) to their simultaneously collected DPOAE2ry counterparts. These same measures were also collected in a human volunteer to demonstrate similarities with their laboratory animal counterparts and their potential applicability to humans. Results showed that DPOAEs and inferred iDPs evidenced distinct behaviors and properties. That is, DPOAE ratio functions elicited by low-level primaries peaked around an f2/f1 = 1.21 or 1.25, depending on species, while the corresponding inferred iDP ratio functions peaked at f2/f1 ratios of ~1. Additionally, L/P maps showed rapid phase variation with DPOAE frequency (fdp) for the narrow-ratio 2f1-f2 and all 2f2-f1 DPOAEs, while the corresponding DPOAE2ry measures evidenced relatively constant phases. Common features of narrow-ratio DPOAE IRAs, such as large enhancements for interference tones (ITs) presented above f2, were not present in DPOAE2ry IRAs. Finally, based on prior experiments in gerbils, the behavior of the iDP directly measured in intracochlear pressure was compared to the iDP inferred from the DPOAE2ry and found to be similar. Together, these findings are consistent with the notion that under certain conditions, ear-canal DPOAEs provide poor representations of iDPs and thus support a “beamforming” hypothesis. According to this concept, distributed emission components directed toward the ear canal from the f2 and basal to f2 regions can be of differing phases and thus cancel, while these same components directed toward fdp add in phase.
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Clinical Verification of Ear Level FM Systems: Classroom & Personal Use Applications
Dave Smriga: In today’s course, we’ll explore how Audioscan equipment easily facilitates the execution of the most current recommended FM verification procedures. In addition, we’ll discuss how you can use these procedures for both FM system verification and verification of remote microphone technology. Although we will be depicting the various test procedures included in today's webinar with images created using the Verifit2 hearing instrument fitting system, the same tests can be performed with the original Verifit system. 
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The Ponto Bone Anchored System: The Right Choice for Pediatrics
Today, I will begin with the fundamentals of bone anchored technology including an overview of osseointegration, and that will give us the foundation to discuss patient candidacy as well as surgical and fitting considerations. I will review Ponto practicalities, such as how the processor was designed to be durable and reliable – which is especially important when we fit children. I will talk about the signal processing in the Ponto processors and present evidence that supports how it benefits our youngest bone anchored patients. When fitting children with amplification, what is the goal? 
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Direction-reversing Nystagmus in Horizontal and Posterior Semicircular Canal Canalolithiasis.
Objectives: To investigate the incidence and characteristics of direction-reversing nystagmus in patients with horizontal (HSCC) and posterior semicircular canal (PSCC) canalolithiasis, and evaluate the effect of direction-reversing nystagmus on the treatment outcome. Study Design: A retrospective study. Methods: Between March 2014 and September 2015, 63 and 92 consecutive patients with HSCC and PSCC canalolithiasis, respectively, were enrolled. Positional nystagmus characteristics were examined using video-nystagmography. Results: In HSCC canalolithiasis, direction-reversing nystagmus was observed in 73% of patients (46 of 63), of which 19 cases were bilateral and 27 unilateral. In patients with bilateral reversal, maximal slow-phase velocity (mSPV) was significantly greater when the head turned to the lesioned side than to the healthy side in both the first and second phase. In all patients with unilateral reversal, direction-reversing nystagmus always occurred in the side of stronger initial nystagmus in a supine roll test. The mean mSPV of first phase nystagmus was significantly greater on the side with reversal than without (p
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The Effect of Simulated Mastoid Obliteration on the Mechanical Output of Electromagnetic Transducers.
Background: The electromagnetic transducers of implantable middle ear hearing devices or direct acoustic cochlear implants (DACIs) are intended for implantation in an air-filled middle ear cavity. When implanted in an obliterated radical mastoid cavity, they would be surrounded by fatty tissue of unknown elastic properties, potentially attenuating the mechanical output. Here, the elastic properties of this tissue were determined experimentally and the vibrational output of commonly used electromagnetic transducers in an obliterated radical mastoid cavity was investigated in vitro using a newly developed method. Methods: The Young's moduli of human fatty tissue samples (3-mm diameter), taken fresh from the abdomen or from the radical mastoid cavity during revision surgeries, were determined by indentation tests. Two phantom materials having Young's moduli similar to and higher than (worst case scenario) the tissue were identified. The displacement output of a DACI, a middle ear transducer (MET) and a floating mass transducer (FMT), was measured when embedded in the phantom materials in a model radical cavity and compared with the output of the nonembedded transducers. Results: The here-determined Young's moduli of fresh human abdominal fatty tissue were comparable to the moduli of human breast fat tissue. When embedded in the phantom materials, the displacement output amplitude at 0.1 to 10 kHz of the DACI and MET was attenuated by maximally 5 dB. The attenuation of the output of the FMT was also minor at 0.5 to 10 kHz, but significantly reduced by up to 35 dB at lower frequencies. Conclusion: Using the method developed here, the Young's moduli of small soft tissue samples could be estimated and the effect of obliteration on the mechanical output of electromagnetic transducers was investigated in vitro. Our results demonstrate that the decrease in vibrational output of the DACI and MET in obliterated mastoid cavities is expected to be minor, having no major impact on clinical indication. Although no major attenuation of vibrational output of the FMT was found for frequencies >0.5 kHz, for implantations in patients the attenuation at frequencies
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Surgical Anatomy of the Human Round Window Region: Implication for Cochlear Endoscopy Through the External Auditory Canal.
Objective: To enable development of an endoscope for cellular-level optical imaging of the inner ear. Study Design: A prospective study of 50 cadaveric human temporal bones to define detailed surgical anatomy of the round window (RW) region and the range of angles necessary to reach the RW membrane perpendicularly via the external ear canal. Main Outcome Measure: The transcanal angle to the RW membrane was surgically measured in 3D intact specimens, and correlated with the angle calculated from temporal bone computed tomography (CT) scans of the same specimens obtained before and after measurements in situ. Results: Surgically measured transcanal angles to the RW membrane correlated well with the radiographically measured angles. The angles ranged from 110 to 127 degrees, with the median of 115 degrees and the middle 50% ranging from 109 to 119 degrees. Four temporal bones were excluded because of pathology. The opening of the RW niche was located posteriorly in six bones (13%), inferiorly in 18 bones (39%), and postero-inferiorly in 22 bones (48%). The angles were not statistically different among the three orientations of the RW niche. Conclusions: By correlating measurement from cadaveric human temporal bones and their CT scans, we defined key parameters necessary for designing an endoscope for intracochlear imaging using a minimally invasive approach through the external auditory canal. The excellent correlation between the measurement on the CT scan and the actual shape of the probe that was able to reach the RW through the ear canal enables selection of the probe using the CT data. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Using Balance Function to Screen for Vestibular Impairment in Children With Sensorineural Hearing Loss and Cochlear Implants.
Objectives: 1) To determine if bilateral vestibular dysfunction can be predicted by performance on standardized balance tasks in children with sensorineural hearing loss (SNHL) and cochlear implants (CI). 2) To provide clinical recommendations for screening for vestibular impairment in children with SNHL. Study Design: Retrospective cohort study. Setting: Tertiary care pediatric implant center. Patients: Pediatric patients (4.8-18.6 years) with profound SNHL using CIs. Interventions: Vestibular end-organ (horizontal canal and otoliths), and balance assessment. Main Outcome Measures: Comparison of balance skills, measured by the Bruininks Oseretsky Test of Motor Proficiency II (BOT-2), was performed between two groups of children with SNHL and CI: 1) total bilateral vestibular loss (TBVL) (n = 45), and 2) normal bilateral vestibular function (n = 20). Sensitivity, specificity, and suitability of each task as a screening tool for the detection of TBVL were assessed. Results: Balance as measured by the BOT-2 balance subtest was significantly poorer in children with TBVL then those with normal vestibular function (p
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Participant-generated Cochlear Implant Programs: Speech Recognition, Sound Quality, and Satisfaction.
Objective: To determine whether patient-derived programming of one's cochlear implant (CI) stimulation levels may affect performance outcomes. Background: Increases in patient population, device complexity, outcome expectations, and clinician responsibility have demonstrated the necessity for improved clinical efficiency. Methods: Eighteen postlingually deafened adult CI recipients (mean = 53 years; range, 24-83 years) participated in a repeated-measures, within-participant study designed to compare their baseline listening program to an experimental program they created. Results: No significant group differences in aided sound-field thresholds, monosyllabic word recognition, speech understanding in quiet, speech understanding in noise, nor spectral modulation detection (SMD) were observed (p > 0.05). Four ears (17%) improved with the experimental program for speech presented at 45 dB SPL and two ears (9%) performed worse. Six ears (27.3%) improved significantly with the self-fit program at +10 dB signal-to-noise ratio (SNR) and four ears (26.6%) improved in speech understanding at +5 dB SNR. No individual scored significantly worse when speech was presented in quiet at 60 dB SPL or in any of the noise conditions tested. All but one participant opted to keep at least one of the self-fitting programs at the completion of this study. Participants viewed the process of creating their program more favorably (t = 2.11, p = 0.012) and thought creating the program was easier than the traditional fitting methodology (t = 2.12, p = 0.003). Average time to create the self-fit program was 10 minutes, 10 seconds (mean = 9:22; range, 4:46-24:40). Conclusions: Allowing experienced adult CI recipients to set their own stimulation levels without clinical guidance is not detrimental to success. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Long-term Follow-up Study of the Sandwich Cartilage Shoe Technique in Cases of Insecure Stapes Footplate.
Objective: Analysis of the audiometric results after repair of a defective footplate with the sandwich cartilage shoe technique in a follow-up study. Study Design: Retrospective analysis of audiometric data. Setting: Hospital. Patients: The cohort consisted of 12 patients, who underwent ossicular reconstruction after sandwich cartilage shoe technique in a case of insecure stapes footplate. The mean age was 42.7 years with an equal sex distribution. In every patient, cholesteatoma was the reason for surgery with 75% being revision cases. Intervention: Sandwich cartilage shoe technique in case of insecure stapes footplate at the department of otorhinolaryngology, head and neck surgery at the University of Cologne over an 8-year period (2007-2015). Main Outcome Measure: The use of the "sandwich cartilage shoe technique" in case of a broken or unstable footplate allows a safe occlusion of the open vestibule. Results: The statistical analysis revealed a significant improvement of the pure-tone average (p = 0.011) and air-bone gap (ABG) (p = 0.016) after total ossicular replacement prosthesis (TORP) implantation. The hearing was stable at 9 months of follow up. Conclusion: The sandwich cartilage shoe technique offers a safe and effective option as a two-stage procedure in treating patients with fractures of the stapes footplate in case of chronic otitis media. In view of the possible risk of deafness going along with a destruction of an inner ear window, our results can be considered substantial as all our patients will at least be able to regain "social hearing" as they all either achieved a hearing threshold is less than 30 dB or can be sufficiently supplied with a conventional hearing aid. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Characteristics and Spontaneous Recovery of Tinnitus Related to Idiopathic Sudden Sensorineural Hearing Loss.
Objective: To evaluate the characteristics and spontaneous recovery of tinnitus related to idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective analysis from two randomized placebo-controlled clinical trials for treatment of ISSNHL within 48 hours from onset (Study A), or of tinnitus related to ISSNHL within 3 months from onset (Study B). Setting: Forty-eight European sites (academic tertiary referral centers, private ENT practices). Patients: One hundred thirteen adult patients of which 65 with hearing loss >=30 dB (Study A) and 48 with persistent acute tinnitus (Study B) at baseline. Interventions: Intratympanic (i.t.) injection of placebo gel in single dose or in triple dose during 3 consecutive days. Main Outcome Measures: Frequency of tinnitus, subjective tinnitus loudness, rates of complete tinnitus remission, and complete hearing recovery during 3 months follow-up. Results: In acute ISSNHL, tinnitus loudness decreased rapidly in cases of mild-moderate hearing loss, and tinnitus had completely resolved in two-thirds of patients after 3 months. Hearing recovery preceded tinnitus resolution. When associated with severe-profound hearing loss, tinnitus improved significantly less. Complete hearing recovery and full tinnitus remission were both about three times more frequent in mild-moderate hearing loss patients than in severe-profound cases. Improvement in tinnitus loudness over time can be approximated by a negative exponential function. Conclusions: Prognosis for ISSNHL-related tinnitus is relatively poor in case of severe-profound hearing loss and the longer it has persisted. Alleviation or management of tinnitus should be a key therapeutic objective especially in pronounced ISSNHL cases. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://ift.tt/OBJ4xP Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Symbolic Play and Novel Noun Learning in Deaf and Hearing Children: Longitudinal Effects of Access to Sound on Early Precursors of Language
by Alexandra L. Quittner, Ivette Cejas, Nae-Yuh Wang, John K. Niparko, David H. Barker
In the largest, longitudinal study of young, deaf children before and three years after cochlear implantation, we compared symbolic play and novel noun learning to age-matched hearing peers. Participants were 180 children from six cochlear implant centers and 96 hearing children. Symbolic play was measured during five minutes of videotaped, structured solitary play. Play was coded as "symbolic" if the child used substitution (e.g., a wooden block as a bed). Novel noun learning was measured in 10 trials using a novel object and a distractor. Cochlear implant vs. normal hearing children were delayed in their use of symbolic play, however, those implanted before vs. after age two performed significantly better. Children with cochlear implants were also delayed in novel noun learning (median delay 1.54 years), with minimal evidence of catch-up growth. Quality of parent-child interactions was positively related to performance on the novel noun learning, but not symbolic play task. Early implantation was beneficial for both achievement of symbolic play and novel noun learning. Further, maternal sensitivity and linguistic stimulation by parents positively affected noun learning skills, although children with cochlear implants still lagged in comparison to hearing peers.from #Audiology via xlomafota13 on Inoreader http://ift.tt/1sd3YYx
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Accuracy and Repeatability of two methods of gait analysis − GaitRite™ und Mobility Lab™ − in subjects with cerebellar ataxia
Publication date: Available online 25 May 2016
Source:Gait & Posture
Author(s): Tanja Schmitz-Hübsch, Alexander U. Brandt, Caspar Pfueller, Leonora Zange, Adrian Seidel, Andrea A. Kühn, Friedemann Paul, Martina Minnerop, Sarah Doss
Instrumental gait analysis is increasingly recognized as a useful tool for the evaluation of movement disorders. The various assessment devices available to date have mostly been evaluated in healthy populations only. We aimed to explore whether reliability and validity seen in healthy subjects can also be assumed in subjects with cerebellar ataxic gait. Gait was recorded simultaneously with two devices − a sensor-embedded walkway and an inertial sensor based system − to explore test accuracy in two groups of subjects: one with mild to moderate cerebellar ataxia due to a subtype of autosomal-dominantly inherited neurodegenerative disorder (SCA14), the other were healthy subjects matched for age and height (CTR). Test precision was assessed by retest within session for each device. In conclusion, accuracy and repeatability of gait measurements were not compromised by ataxic gait disorder. The accuracy of spatial measures was speed-dependent and a direct comparison of stride length from both devices will be most reliably made at comfortable speed. Measures of stride variability had low agreement between methods in CTR and at retest in both groups. However, the marked increase of stride variability in ataxia outweighs the observed amount of imprecision.
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Source:Gait & Posture
Author(s): Tanja Schmitz-Hübsch, Alexander U. Brandt, Caspar Pfueller, Leonora Zange, Adrian Seidel, Andrea A. Kühn, Friedemann Paul, Martina Minnerop, Sarah Doss
Instrumental gait analysis is increasingly recognized as a useful tool for the evaluation of movement disorders. The various assessment devices available to date have mostly been evaluated in healthy populations only. We aimed to explore whether reliability and validity seen in healthy subjects can also be assumed in subjects with cerebellar ataxic gait. Gait was recorded simultaneously with two devices − a sensor-embedded walkway and an inertial sensor based system − to explore test accuracy in two groups of subjects: one with mild to moderate cerebellar ataxia due to a subtype of autosomal-dominantly inherited neurodegenerative disorder (SCA14), the other were healthy subjects matched for age and height (CTR). Test precision was assessed by retest within session for each device. In conclusion, accuracy and repeatability of gait measurements were not compromised by ataxic gait disorder. The accuracy of spatial measures was speed-dependent and a direct comparison of stride length from both devices will be most reliably made at comfortable speed. Measures of stride variability had low agreement between methods in CTR and at retest in both groups. However, the marked increase of stride variability in ataxia outweighs the observed amount of imprecision.
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Lexically driven selective adaptation by ambiguous auditory stimuli occurs after limited exposure to adaptors
Limited exposure to ambiguous auditory stimuli results in perceptual recalibration. When unambiguous stimuli are used instead, selective adaptation (SA) effects have been reported, even after few adaptor presentations. Crucially, selective adaptation by an ambiguous sound in biasing lexical contexts had previously been found only after massive adaptor repetition [Samuel (2001). Psychol. Sci. 12(4), 348–351]. The present study shows that extensive exposure is not necessary for lexically driven selective adaptation to occur. Lexically driven selective adaptation can arise after as few as nine adaptor presentations. Additionally, build-up course inspection reveals several parallelisms with the time course observed for SA with unambiguous stimuli.
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Lexically driven selective adaptation by ambiguous auditory stimuli occurs after limited exposure to adaptors
Limited exposure to ambiguous auditory stimuli results in perceptual recalibration. When unambiguous stimuli are used instead, selective adaptation (SA) effects have been reported, even after few adaptor presentations. Crucially, selective adaptation by an ambiguous sound in biasing lexical contexts had previously been found only after massive adaptor repetition [Samuel (2001). Psychol. Sci. 12(4), 348–351]. The present study shows that extensive exposure is not necessary for lexically driven selective adaptation to occur. Lexically driven selective adaptation can arise after as few as nine adaptor presentations. Additionally, build-up course inspection reveals several parallelisms with the time course observed for SA with unambiguous stimuli.
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Does clinician continuity influence hearing aid outcomes?
10.1080/14992027.2016.1185169<br/>Rebecca J. Bennett
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Book Review
10.1080/14992027.2016.1183826<br/>David M. Baguley
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Clinical Verification of Ear Level FM Systems: Classroom & Personal Use Applications
Dave Smriga: In today’s course, we’ll explore how Audioscan equipment easily facilitates the execution of the most current recommended FM verification procedures. In addition, we’ll discuss how you can use these procedures for both FM system verification and verification of remote microphone technology. Although we will be depicting the various test procedures included in today's webinar with images created using the Verifit2 hearing instrument fitting system, the same tests can be performed with the original Verifit system.
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The Ponto Bone Anchored System: The Right Choice for Pediatrics
Today, I will begin with the fundamentals of bone anchored technology including an overview of osseointegration, and that will give us the foundation to discuss patient candidacy as well as surgical and fitting considerations. I will review Ponto practicalities, such as how the processor was designed to be durable and reliable – which is especially important when we fit children. I will talk about the signal processing in the Ponto processors and present evidence that supports how it benefits our youngest bone anchored patients. When fitting children with amplification, what is the goal?
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Accuracy and Repeatability of two methods of gait analysis − GaitRite™ und Mobility Lab™ − in subjects with cerebellar ataxia
Publication date: Available online 25 May 2016
Source:Gait & Posture
Author(s): Tanja Schmitz-Hübsch, Alexander U. Brandt, Caspar Pfueller, Leonora Zange, Adrian Seidel, Andrea A. Kühn, Friedemann Paul, Martina Minnerop, Sarah Doss
Instrumental gait analysis is increasingly recognized as a useful tool for the evaluation of movement disorders. The various assessment devices available to date have mostly been evaluated in healthy populations only. We aimed to explore whether reliability and validity seen in healthy subjects can also be assumed in subjects with cerebellar ataxic gait. Gait was recorded simultaneously with two devices − a sensor-embedded walkway and an inertial sensor based system − to explore test accuracy in two groups of subjects: one with mild to moderate cerebellar ataxia due to a subtype of autosomal-dominantly inherited neurodegenerative disorder (SCA14), the other were healthy subjects matched for age and height (CTR). Test precision was assessed by retest within session for each device. In conclusion, accuracy and repeatability of gait measurements were not compromised by ataxic gait disorder. The accuracy of spatial measures was speed-dependent and a direct comparison of stride length from both devices will be most reliably made at comfortable speed. Measures of stride variability had low agreement between methods in CTR and at retest in both groups. However, the marked increase of stride variability in ataxia outweighs the observed amount of imprecision.
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Source:Gait & Posture
Author(s): Tanja Schmitz-Hübsch, Alexander U. Brandt, Caspar Pfueller, Leonora Zange, Adrian Seidel, Andrea A. Kühn, Friedemann Paul, Martina Minnerop, Sarah Doss
Instrumental gait analysis is increasingly recognized as a useful tool for the evaluation of movement disorders. The various assessment devices available to date have mostly been evaluated in healthy populations only. We aimed to explore whether reliability and validity seen in healthy subjects can also be assumed in subjects with cerebellar ataxic gait. Gait was recorded simultaneously with two devices − a sensor-embedded walkway and an inertial sensor based system − to explore test accuracy in two groups of subjects: one with mild to moderate cerebellar ataxia due to a subtype of autosomal-dominantly inherited neurodegenerative disorder (SCA14), the other were healthy subjects matched for age and height (CTR). Test precision was assessed by retest within session for each device. In conclusion, accuracy and repeatability of gait measurements were not compromised by ataxic gait disorder. The accuracy of spatial measures was speed-dependent and a direct comparison of stride length from both devices will be most reliably made at comfortable speed. Measures of stride variability had low agreement between methods in CTR and at retest in both groups. However, the marked increase of stride variability in ataxia outweighs the observed amount of imprecision.
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Does clinician continuity influence hearing aid outcomes?
Does clinician continuity influence hearing aid outcomes?
Int J Audiol. 2016 May 25;:1-8
Authors: Bennett RJ, Meyer C, Eikelboom RH
Abstract
OBJECTIVE: To evaluate whether clinician continuity is associated with successful hearing aid outcomes.
DESIGN: A prospective cohort study. Clinician continuity was defined as occurring when a patient was cared for by the same clinician for the hearing assessment, hearing aid selection process, hearing aid fitting and programming, and subsequent hearing aid fine tuning appointments. The hearing aid outcome measures included self-reported hearing aid use, benefit and satisfaction as well as self-reported handling skills and problems experienced with hearing aids.
STUDY SAMPLE: Four hundred and sixty-eight adult hearing aid users (mean age 73.9 years ±10.9) and 26 qualified audiologists (mean age 34 years ±6.34) recruited from a single hearing clinic in Perth, Western Australia.
RESULTS: There were no significant differences in hearing aid outcomes between participants who experienced clinician continuity and those who did not.
CONCLUSIONS: Within a controlled practice setting, hearing aid outcomes may not be adversely effected if services are provided by more than one clinician.
PMID: 27224042 [PubMed - as supplied by publisher]
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Book Review.
Book Review.
Int J Audiol. 2016 May 25;:1
Authors: Baguley DM, Fagelson M
PMID: 27223682 [PubMed - as supplied by publisher]
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Does clinician continuity influence hearing aid outcomes?
10.1080/14992027.2016.1185169<br/>Rebecca J. Bennett
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Book Review
10.1080/14992027.2016.1183826<br/>David M. Baguley
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Does clinician continuity influence hearing aid outcomes?
Does clinician continuity influence hearing aid outcomes?
Int J Audiol. 2016 May 25;:1-8
Authors: Bennett RJ, Meyer C, Eikelboom RH
Abstract
OBJECTIVE: To evaluate whether clinician continuity is associated with successful hearing aid outcomes.
DESIGN: A prospective cohort study. Clinician continuity was defined as occurring when a patient was cared for by the same clinician for the hearing assessment, hearing aid selection process, hearing aid fitting and programming, and subsequent hearing aid fine tuning appointments. The hearing aid outcome measures included self-reported hearing aid use, benefit and satisfaction as well as self-reported handling skills and problems experienced with hearing aids.
STUDY SAMPLE: Four hundred and sixty-eight adult hearing aid users (mean age 73.9 years ±10.9) and 26 qualified audiologists (mean age 34 years ±6.34) recruited from a single hearing clinic in Perth, Western Australia.
RESULTS: There were no significant differences in hearing aid outcomes between participants who experienced clinician continuity and those who did not.
CONCLUSIONS: Within a controlled practice setting, hearing aid outcomes may not be adversely effected if services are provided by more than one clinician.
PMID: 27224042 [PubMed - as supplied by publisher]
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Book Review.
Book Review.
Int J Audiol. 2016 May 25;:1
Authors: Baguley DM, Fagelson M
PMID: 27223682 [PubMed - as supplied by publisher]
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Does clinician continuity influence hearing aid outcomes?
10.1080/14992027.2016.1185169<br/>Rebecca J. Bennett
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Book Review
10.1080/14992027.2016.1183826<br/>David M. Baguley
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Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study
10.1080/14992027.2016.1182651<br/>Ning-Chia Chang
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Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study
10.1080/14992027.2016.1182651<br/>Ning-Chia Chang
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Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Int J Audiol. 2016 May 24;:1-8
Authors: Chang NC, Dai CY, Lin WY, Chien CY, Hsieh MH, Ho KY
Abstract
OBJECTIVES: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan.
DESIGN: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed.
STUDY SAMPLE: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older.
RESULTS: The prevalence of HI >25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%).
CONCLUSIONS: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.
PMID: 27218891 [PubMed - as supplied by publisher]
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Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Int J Audiol. 2016 May 23;:1-11
Authors: Plant K, van Hoesel R, McDermott H, Dawson P, Cowan R
Abstract
OBJECTIVE: To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines.
DESIGN: Prospective, within-subject experimental design.
STUDY SAMPLE: Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%).
RESULTS: Post-implantation improvement of 2.4 dB and 4.0 dB was observed on a sentence in coincident babble test at presentation levels of 65 and 55 dB SPL respectively, and a 2.1 dB benefit in spatial release from masking (SRM) advantage observed when the noise location favoured the implanted side. Significant post-operative group mean change of between 2.1 and 3.0 was observed on the sub-scales of the speech, spatial, and qualities (SSQ) questionnaire. Degree of post-implantation speech reception threshold (SRT) benefit on the coincident babble test and on perception of soft speech and sounds in the environment was greater for subjects with less contralateral hearing. The degree of contralateral acoustic hearing did not affect time taken to acclimate to the device.
CONCLUSIONS: The findings from this study support cochlear implantation for candidates with substantial acoustic hearing in the contralateral ear, and provide guidance regarding post-implantation expectations.
PMID: 27216386 [PubMed - as supplied by publisher]
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Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study.
Int J Audiol. 2016 May 24;:1-8
Authors: Chang NC, Dai CY, Lin WY, Chien CY, Hsieh MH, Ho KY
Abstract
OBJECTIVES: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan.
DESIGN: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed.
STUDY SAMPLE: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older.
RESULTS: The prevalence of HI >25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%).
CONCLUSIONS: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.
PMID: 27218891 [PubMed - as supplied by publisher]
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Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.
Int J Audiol. 2016 May 23;:1-11
Authors: Plant K, van Hoesel R, McDermott H, Dawson P, Cowan R
Abstract
OBJECTIVE: To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines.
DESIGN: Prospective, within-subject experimental design.
STUDY SAMPLE: Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%).
RESULTS: Post-implantation improvement of 2.4 dB and 4.0 dB was observed on a sentence in coincident babble test at presentation levels of 65 and 55 dB SPL respectively, and a 2.1 dB benefit in spatial release from masking (SRM) advantage observed when the noise location favoured the implanted side. Significant post-operative group mean change of between 2.1 and 3.0 was observed on the sub-scales of the speech, spatial, and qualities (SSQ) questionnaire. Degree of post-implantation speech reception threshold (SRT) benefit on the coincident babble test and on perception of soft speech and sounds in the environment was greater for subjects with less contralateral hearing. The degree of contralateral acoustic hearing did not affect time taken to acclimate to the device.
CONCLUSIONS: The findings from this study support cochlear implantation for candidates with substantial acoustic hearing in the contralateral ear, and provide guidance regarding post-implantation expectations.
PMID: 27216386 [PubMed - as supplied by publisher]
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The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries
Publication date: Available online 24 May 2016
Source:Gait & Posture
Author(s): I. Hanzlíková, J. Richards, M. Tomsa, A. Chohan, K. May, D. Smékal, J. Selfe
IntroductionProprioceptive knee braces have been shown to improve knee mechanics, however much of the work to date has focused on tasks such as slow step down tasks rather than more dynamic sporting tasks.ObjectiveThis study aimed to explore if such improvements in stability may be seen during faster sports specific tasks as well as slower tasks.MethodTwelve subjects performed a slow step down, single leg drop jump and pivot turn jump with and without a silicone web brace. 3D kinematics of the knee were collected using a ten camera Qualisys motion analysis system. Reflective markers were placed on the foot, shank, thigh and pelvis using the Calibrated Anatomical Systems Technique. A two way ANOVA with repeated measures was performed with post-hoc pairwise comparison to explore the differences between the two conditions and three tasks.ResultsSignificant differences were seen in the knee joint angles and angular velocities in the sagittal, coronal and transverse planes between the tasks. The brace showed a reduction in knee valgum and internal rotation across all tasks, with the most notable effect during the single leg drop jump and pivot turn jump. The transverse plane also showed a significant reduction in the external rotation knee angular velocity when wearing the brace.DiscussionThe brace influenced the knee joint kinematics in coronal and transverse planes which confirms that such braces can have a significant effect on knee control during dynamic tasks. Further studies are required exploring the efficacy of proprioceptive braces in athletic patient cohort.
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Source:Gait & Posture
Author(s): I. Hanzlíková, J. Richards, M. Tomsa, A. Chohan, K. May, D. Smékal, J. Selfe
IntroductionProprioceptive knee braces have been shown to improve knee mechanics, however much of the work to date has focused on tasks such as slow step down tasks rather than more dynamic sporting tasks.ObjectiveThis study aimed to explore if such improvements in stability may be seen during faster sports specific tasks as well as slower tasks.MethodTwelve subjects performed a slow step down, single leg drop jump and pivot turn jump with and without a silicone web brace. 3D kinematics of the knee were collected using a ten camera Qualisys motion analysis system. Reflective markers were placed on the foot, shank, thigh and pelvis using the Calibrated Anatomical Systems Technique. A two way ANOVA with repeated measures was performed with post-hoc pairwise comparison to explore the differences between the two conditions and three tasks.ResultsSignificant differences were seen in the knee joint angles and angular velocities in the sagittal, coronal and transverse planes between the tasks. The brace showed a reduction in knee valgum and internal rotation across all tasks, with the most notable effect during the single leg drop jump and pivot turn jump. The transverse plane also showed a significant reduction in the external rotation knee angular velocity when wearing the brace.DiscussionThe brace influenced the knee joint kinematics in coronal and transverse planes which confirms that such braces can have a significant effect on knee control during dynamic tasks. Further studies are required exploring the efficacy of proprioceptive braces in athletic patient cohort.
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The effects of visual feedback during a rhythmic weight-shifting task in patients with Parkinson's disease
Publication date: Available online 24 May 2016
Source:Gait & Posture
Author(s): Maarten R.C. van den Heuvel, Andreas Daffertshofer, Peter J. Beek, Gert Kwakkel, Erwin E.H. van Wegen
Augmented visual feedback (VF) may offer benefits similar to those of rhythmic external cues in alleviating some mobility-related difficulties in individuals with Parkinson's disease (PD). However, due to an impaired ability to reweigh sensory information under changing circumstances, subjects with PD may be rather vulnerable to incongruity of visual information. In the present study, we investigated whether VF is indeed effective in improving motor functioning in a weight-shifting task during upright stance, and whether subjects with PD are affected more by incongruent VF than healthy controls. Participants performed sideways swaying motions based on tracking of real-time and delayed VF–the first providing congruent, and hence more accurate, visual information than the latter. We analyzed center-of-pressure signals patterns for 28 individuals with PD and 16 healthy, age- and gender-matched controls by estimating task accuracy, movement pattern variability, and normalized movement amplitude. For conditions without feedback and with real-time feedback, subjects with PD performed lateral swaying motions with greater error (F(1,42)=12.065, p=.001) and with more variable movement patterns than healthy controls (F(1, 24)=113.086, p<.001). Error change scores revealed that patients with PD were nevertheless still able to use VF to improve tracking performance (t(24)=-2.366, p=.026). However, whereas controls were able to adapt to a certain amount of visual incongruity, patients with PD were not. Instead, movement amplitude was significantly reduced in this group (F(1.448, 60.820)=17.639, p<.001). By reducing movement amplitude, subjects with PD appear to resort to a ‘conservative’ strategy to minimize performance breakdown.
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Source:Gait & Posture
Author(s): Maarten R.C. van den Heuvel, Andreas Daffertshofer, Peter J. Beek, Gert Kwakkel, Erwin E.H. van Wegen
Augmented visual feedback (VF) may offer benefits similar to those of rhythmic external cues in alleviating some mobility-related difficulties in individuals with Parkinson's disease (PD). However, due to an impaired ability to reweigh sensory information under changing circumstances, subjects with PD may be rather vulnerable to incongruity of visual information. In the present study, we investigated whether VF is indeed effective in improving motor functioning in a weight-shifting task during upright stance, and whether subjects with PD are affected more by incongruent VF than healthy controls. Participants performed sideways swaying motions based on tracking of real-time and delayed VF–the first providing congruent, and hence more accurate, visual information than the latter. We analyzed center-of-pressure signals patterns for 28 individuals with PD and 16 healthy, age- and gender-matched controls by estimating task accuracy, movement pattern variability, and normalized movement amplitude. For conditions without feedback and with real-time feedback, subjects with PD performed lateral swaying motions with greater error (F(1,42)=12.065, p=.001) and with more variable movement patterns than healthy controls (F(1, 24)=113.086, p<.001). Error change scores revealed that patients with PD were nevertheless still able to use VF to improve tracking performance (t(24)=-2.366, p=.026). However, whereas controls were able to adapt to a certain amount of visual incongruity, patients with PD were not. Instead, movement amplitude was significantly reduced in this group (F(1.448, 60.820)=17.639, p<.001). By reducing movement amplitude, subjects with PD appear to resort to a ‘conservative’ strategy to minimize performance breakdown.
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Acquired Hearing Loss and Brain Plasticity
Source:Hearing Research
Author(s): Jos J. Eggermont
Acquired hearing loss results in an imbalance of the cochlear output across frequency. Central auditory system homeostatic processes responding to this result in frequency specific gain changes consequent to the emerging imbalance between excitation and inhibition. Several consequences thereof are increased spontaneous firing rates, increased neural synchrony, and (in adults) potentially restricted to the auditory thalamus and cortex a reorganization of tonotopic areas. It does not seem to matter much whether the hearing loss is acquired neonatally or in adulthood. In humans, no clear evidence of tonotopic map changes with hearing loss has so far been provided, but frequency specific gain changes are well documented. Unilateral hearing loss in addition makes brain activity across hemispheres more symmetrical and more synchronous. Molecular studies indicate that in the brainstem, after 2-5 days post trauma, the glutamatergic activity is reduced, whereas glycinergic and GABAergic activity is largely unchanged. At 2 months post trauma, excitatory activity remains decreased but the inhibitory one is significantly increased. In contrast protein assays related to inhibitory transmission are all decreased or unchanged in the brainstem, midbrain and auditory cortex. Comparison of neurophysiological data with the molecular findings during a time-line of changes following noise trauma suggests that increases in spontaneous firing rates are related to decreases in inhibition, and not to increases in excitation. Because noise-induced hearing loss in cats resulted in a loss of cortical temporal processing capabilities, this may also underlie speech understanding in humans.
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