Procedural Motor Learning in Children With Specific Language Impairment

Purpose

Specific language impairment (SLI) is a developmental disorder that affects language and motor development in the absence of a clear cause. An explanation for these impairments is offered by the procedural deficit hypothesis (PDH), which argues that motor difficulties in SLI are due to deficits in procedural memory. The aim of this study was to test the PDH by examining the procedural motor learning abilities of children with and without SLI.

Method

Thirteen children with SLI and 14 age-matched typically developing children completed the following procedural measures: (a) a knot-tying task as a measure of motor sequencing and (2) a mirror-drawing task as a measure of visual–motor adaptation.

Results

Although children with SLI produced significantly more errors on certain knot-tying tasks, they performed comparably on others. Also, children with SLI performed comparably with typically developing children on the mirror-drawing task.

Conclusions

The PDH requires reframing. The sequence learning deficits in SLI are modest and specific to more difficult tasks. Visual–motor adaptation, on the other hand, appears to be unaffected in SLI.

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Procedural Motor Learning in Children With Specific Language Impairment

Purpose

Specific language impairment (SLI) is a developmental disorder that affects language and motor development in the absence of a clear cause. An explanation for these impairments is offered by the procedural deficit hypothesis (PDH), which argues that motor difficulties in SLI are due to deficits in procedural memory. The aim of this study was to test the PDH by examining the procedural motor learning abilities of children with and without SLI.

Method

Thirteen children with SLI and 14 age-matched typically developing children completed the following procedural measures: (a) a knot-tying task as a measure of motor sequencing and (2) a mirror-drawing task as a measure of visual–motor adaptation.

Results

Although children with SLI produced significantly more errors on certain knot-tying tasks, they performed comparably on others. Also, children with SLI performed comparably with typically developing children on the mirror-drawing task.

Conclusions

The PDH requires reframing. The sequence learning deficits in SLI are modest and specific to more difficult tasks. Visual–motor adaptation, on the other hand, appears to be unaffected in SLI.

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Procedural Motor Learning in Children With Specific Language Impairment

Purpose

Specific language impairment (SLI) is a developmental disorder that affects language and motor development in the absence of a clear cause. An explanation for these impairments is offered by the procedural deficit hypothesis (PDH), which argues that motor difficulties in SLI are due to deficits in procedural memory. The aim of this study was to test the PDH by examining the procedural motor learning abilities of children with and without SLI.

Method

Thirteen children with SLI and 14 age-matched typically developing children completed the following procedural measures: (a) a knot-tying task as a measure of motor sequencing and (2) a mirror-drawing task as a measure of visual–motor adaptation.

Results

Although children with SLI produced significantly more errors on certain knot-tying tasks, they performed comparably on others. Also, children with SLI performed comparably with typically developing children on the mirror-drawing task.

Conclusions

The PDH requires reframing. The sequence learning deficits in SLI are modest and specific to more difficult tasks. Visual–motor adaptation, on the other hand, appears to be unaffected in SLI.

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Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep

Purpose

The aim of this study was to determine if a customized stimulus from the Otoharmonics Levo System reduces tinnitus perceptions and reactions for people with bothersome tinnitus.

Method

Sixty participants were randomized to 1 of 3 groups that used sound therapy devices during sleep that differed in their acoustic stimulus: (a) tinnitus-matched (TM), (b) noise stimulus (NS), and (c) bedside sound generator (BSG). Outcome measures were the Tinnitus Functional Index (TFI), numeric rating scale of tinnitus loudness, and tinnitus loudness match. A Bayesian hierarchical model was fit to estimate the differences in treatment efficacy among groups.

Results

Average tinnitus reactions and perceptions improved across treatment groups. We are at least 87% certain that treatment with TM or NS reduces mean TFI compared to treatment with BSG, with an estimated relative efficacy of 4.5–5 points greater reduction. We are at least 95% certain that treatment with TM results in greater reduction in mean numeric rating scale (NRS) of tinnitus loudness compared to the other groups, with an estimated relative efficacy of about 0.75 points greater reduction.

Conclusions

This study offers some support for greater average improvement in reactions to tinnitus with TM or NS devices compared to the BSG device. The TM group, compared to the BSG and NS groups, showed a greater reduction in ratings of tinnitus loudness on the NRS on average.

Supplemental Material

http://ift.tt/2h0o2h3

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Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep

Purpose

The aim of this study was to determine if a customized stimulus from the Otoharmonics Levo System reduces tinnitus perceptions and reactions for people with bothersome tinnitus.

Method

Sixty participants were randomized to 1 of 3 groups that used sound therapy devices during sleep that differed in their acoustic stimulus: (a) tinnitus-matched (TM), (b) noise stimulus (NS), and (c) bedside sound generator (BSG). Outcome measures were the Tinnitus Functional Index (TFI), numeric rating scale of tinnitus loudness, and tinnitus loudness match. A Bayesian hierarchical model was fit to estimate the differences in treatment efficacy among groups.

Results

Average tinnitus reactions and perceptions improved across treatment groups. We are at least 87% certain that treatment with TM or NS reduces mean TFI compared to treatment with BSG, with an estimated relative efficacy of 4.5–5 points greater reduction. We are at least 95% certain that treatment with TM results in greater reduction in mean numeric rating scale (NRS) of tinnitus loudness compared to the other groups, with an estimated relative efficacy of about 0.75 points greater reduction.

Conclusions

This study offers some support for greater average improvement in reactions to tinnitus with TM or NS devices compared to the BSG device. The TM group, compared to the BSG and NS groups, showed a greater reduction in ratings of tinnitus loudness on the NRS on average.

Supplemental Material

http://ift.tt/2h0o2h3

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Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep

Purpose

The aim of this study was to determine if a customized stimulus from the Otoharmonics Levo System reduces tinnitus perceptions and reactions for people with bothersome tinnitus.

Method

Sixty participants were randomized to 1 of 3 groups that used sound therapy devices during sleep that differed in their acoustic stimulus: (a) tinnitus-matched (TM), (b) noise stimulus (NS), and (c) bedside sound generator (BSG). Outcome measures were the Tinnitus Functional Index (TFI), numeric rating scale of tinnitus loudness, and tinnitus loudness match. A Bayesian hierarchical model was fit to estimate the differences in treatment efficacy among groups.

Results

Average tinnitus reactions and perceptions improved across treatment groups. We are at least 87% certain that treatment with TM or NS reduces mean TFI compared to treatment with BSG, with an estimated relative efficacy of 4.5–5 points greater reduction. We are at least 95% certain that treatment with TM results in greater reduction in mean numeric rating scale (NRS) of tinnitus loudness compared to the other groups, with an estimated relative efficacy of about 0.75 points greater reduction.

Conclusions

This study offers some support for greater average improvement in reactions to tinnitus with TM or NS devices compared to the BSG device. The TM group, compared to the BSG and NS groups, showed a greater reduction in ratings of tinnitus loudness on the NRS on average.

Supplemental Material

http://ift.tt/2h0o2h3

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Conciencia fonológica y resolución de problemas matemáticos en educación infantil

Publication date: Available online 26 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Laura Espinoza Pastén, Rafaela Marco Taverner, Amparo Ygual Fernández
IntroducciónAlgunos estudios revelan la participación del procesamiento lingüístico en la resolución de problemas matemáticos, subrayando su papel en la representación y en el procesamiento de información. Estas investigaciones no suelen considerar población en edades tempranas.ObjetivosEste estudio tiene un doble objetivo: analizar la influencia lingüística en resolución de problemas matemáticos en la etapa de educación infantil y analizar qué habilidades lingüísticas explican significativamente por sí solas la resolución de problemas matemáticos.MétodoParticiparon 76 niños españoles que cursaban tercero de educación infantil. Se evaluaron habilidades semánticas, morfosintácticas y conciencia fonológica, memoria verbal y velocidad de procesamiento verbal. El rendimiento en resolución de problemas se evaluó por medio de problemas de operaciones lógicas y a través de problemas con enunciados orales con y sin apoyo visual.ResultadosLas habilidades lingüísticas correlacionaron significativamente con las habilidades de resolución de problemas que involucran el pensamiento lógico y problemas con enunciado verbal, con y sin apoyo visual. Las habilidades lingüísticas, en conjunto, se relacionan con la resolución de problemas, explicando un incremento significativo de varianza adicional a la explicada por el nivel de inteligencia. La conciencia fonológica resulta ser la habilidad lingüística que mejor predice el rendimiento en problemas con enunciados sin apoyo de material concreto.ConclusionesLa conciencia fonológica es buen indicador de la calidad de las representaciones fonológicas que permiten manipular la información lingüística contenida en problemas matemáticos a edades tempranas. Estos hallazgos tienen relevancia en procesos de aprendizaje matemático, tanto en población con desarrollo típico como con dificultades de procesamiento fonológico.IntroductionSolving mathematical problems requires a number of different skills. Several studies have highlighted the role of language processing in problem solving through its influence on mental representation and information processing in mathematical problems. However, these studies usually focus on the primary school years and less often on children at preschool level.ObjectivesThe objective of this study was twofold: to analyse the effect of linguistic competence on problem solving in mathematics at the kindergarten stage and to identify which specific language skills are most closely associated with problem-solving skill.MethodThe sample included 76 children attending a kindergarten third grade class. Composed measures of semantic and morphosyntactic skills, phonological awareness, verbal memory and processing speed were formed from the CELF subscales. Problem-solving skill was assessed by asking children to solve a range of different mathematical problems involving Piagetian logical operations, and word problems with and without accompanying visual representations.ResultsLinguistic skills correlated significantly with skill in solving problems involving logical thinking, and verbal statement problems with and without visual representation. Linguistic skills predicted children’ problem-solving skills as they accounted for additional variance beyond that accounted for by IQ. Phonological awareness was the single best predictor of scores in solving word problems without visual support.ConclusionsPhonological awareness is a good indicator of the quality of phonological representations that allow manipulation of the linguistic information contained in mathematical problems at an early age. These findings have practical consequences for helping children to achieve normative development and for children with phonological processing difficulties.



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Uso del Inventario de Habilidades Comunicativas de MacArthur-Bates con lactantes en riesgo de daño cerebral

Publication date: Available online 16 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Amaya Soberón, Claudia Jiménez-Sánchez, Johanna Flores, Josefina Ricardo-Garcell, María Elizabeth Mónica Carlier, María Fernanda de la Llata, Verónica Paz, Thalía Harmony.
IntroducciónExisten escasas pruebas conductuales validadas para hispanoparlantes que incluyen dentro de sus normas lactantes normo-oyentes con riesgo de daño cerebral perinatal. Sin medidas conductuales validadas, los clínicos usan pruebas que no están normadas para esta población, como el Inventario de Habilidades Comunicativas MacArthur-Bates (SCDI). Estudios electrofisiológicos han mostrado que las subpruebas comprensión y producción de palabras de dicho inventario tienen un alto poder discriminante en estas poblaciones en riesgo cuando se ajusta la norma de la prueba al percentil 50. Se examinó dicha norma ajustada en la práctica clínica.MétodoDiseño de un solo grupo y selección de la muestra semialeatoria. Se seleccionaron 30 niños con factores de riesgo de daño cerebral perinatal de la Unidad de investigación en Neurodesarrollo a los que se les hubiera aplicado el inventario al año de edad y la Escala de Lenguaje Preescolar (PLS-5) entre los 3 y 4 años. Se comparó la proporción de niños identificados con alteraciones en el desarrollo del lenguaje por la PLS-5 entre los 3-4 años con la proporción de niños identificados con riesgo por el SCDI al año de edad usando la norma sin ajustar y la norma ajustada.ResultadosLa norma ajustada del SCDI permitió identificar una proporción de niños con riesgo del lenguaje al año de edad similar a la proporción que se identificó con alteraciones entre los 3 y 4 años.ConclusiónDebería considerarse una norma ajustada cuando se examinen poblaciones con riesgo de daño cerebral usando el Inventario SCDI al año de edad.IntroductionThere are few validated language test for Spanish speakers that cover normo-listeners infants at risk of brain damage. Without validated behavioural measures, clinicians use test that are not standardised for this population, such as the MacArthur-Bates Communicative Skills Inventory (SCDI). Electrophysiological studies have shown that the comprehension and word production sub-test of such inventory have high discriminatory power in these at-risk populations when the test standard is adjusted to the 50th percentile. This adjusted standard was examined in clinical practice.MethodsDesign of a single group and selection of the semi-random sample. We selected 30 infants at risk of brain damage from the Neurodevelopment Research Unit to which the Inventory at one year old and the Preschool Language Scale (PLS-5) were applied between the ages of 3 and 4 years. We compared the proportion of children identified with language developmental impairments by PLS-5 between the ages of 3-4 with the proportion of children identified at risk by SCDI at one year of age using the non-adjusted norm and adjusted norm.ResultsThe adjusted SCDI standard allowed the identification of a proportion of infants at risk of brain damage and also at risk of language development impairments at one year of age, similar to the proportion that was identified with impairments between 3 and 4 years.ConclusionAn adjusted norm should be considered when examining infants at risk of brain damage using the SCDI Inventory at one year of age.



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Editorial

Publication date: September–December 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 4
Author(s): David del Río




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Fonoaudiología/logopedia en cuidado intensivo: el valor de la comunicación, más allá de las alteraciones de deglución

Publication date: Available online 27 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Leidy-Johanna Rodríguez-Riaño, Adriana Duarte-Valderrama
Las personas que ingresan en la Unidad de Cuidado Intensivo (UCI) pueden generar alteraciones en deglución y comunicación, como consecuencia de patologías de base o por tratamientos e intervenciones usadas para preservar la vida. La fonoaudiología/logopedia asume el reto frente al manejo de pacientes en condiciones críticas de salud, con el fin de promover la calidad de vida desde la rehabilitación de procesos de deglución, aportar al bienestar comunicativo de pacientes, familiares y profesionales, para promover la humanización dentro de las UCI. Este análisis de literatura reunió evidencia sobre acciones fonoaudiológicas y terapéuticas del fonoaudiólogo/logopeda en UCI. Se revisó evidencia entre el 1 de enero de 2008 hasta el 1 de febrero de 2015 en bases de datos EBSCO, Scielo, PubMed Medline y EMBASE. Se incluyó evidencia sobre el rol y las acciones del fonoaudiólogo/logopeda dentro de las UCI. Del total de 200 artículos cruzados, se incluyeron 60 según criterios de inclusión. Esta búsqueda evidenció la importancia que se da en el mundo a la presencia del fonoaudiólogo/logopeda dentro del grupo multidisciplinario de las UCI, para la rehabilitación de la comunicación y la deglución y su aporte a la compleja labor de humanización de los servicios de salud desde la interacción comunicativa efectiva del paciente con su entorno.People entering the Intensive Care Unit (ICU) can develop changes in swallowing and communication, as a consequence of disease, or treatments and interventions used to preserve life. Speech and language therapists take on the challenge of managing patients in critical health conditions, to enhance their quality of life after swallowing rehabilitation, to contribute to the communicative wellbeing of patients, families and professionals, and to promote humanisation in ICU. This literature analysis gathered evidence of the therapeutic action of speech and language therapists in ICU. The evidence was reviewed between January 1, 2008 and February 1, 2015 in the EBSCO, Scielo, PubMed Medline and EMBASE databases. Evidence on the role and actions of speech and language therapists in ICU was included. Of the total 200 cross-items, 60 were included according to the inclusion criteria.This research demonstrated the global importance of speech and language therapists within the intensive care unit multidisciplinary team, in communication and swallowing rehabilitation. It highlighted their contribution to the complex work involved in humanising the health services by enabling patients to interact communicatively with their environment.



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Neuro-Developmental Treatment. A Guide to NDT Clinical Practice

Publication date: September–December 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 4
Author(s): Rosa M. Bermúdez de Alvear




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Conciencia fonológica y resolución de problemas matemáticos en educación infantil

Publication date: Available online 26 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Laura Espinoza Pastén, Rafaela Marco Taverner, Amparo Ygual Fernández
IntroducciónAlgunos estudios revelan la participación del procesamiento lingüístico en la resolución de problemas matemáticos, subrayando su papel en la representación y en el procesamiento de información. Estas investigaciones no suelen considerar población en edades tempranas.ObjetivosEste estudio tiene un doble objetivo: analizar la influencia lingüística en resolución de problemas matemáticos en la etapa de educación infantil y analizar qué habilidades lingüísticas explican significativamente por sí solas la resolución de problemas matemáticos.MétodoParticiparon 76 niños españoles que cursaban tercero de educación infantil. Se evaluaron habilidades semánticas, morfosintácticas y conciencia fonológica, memoria verbal y velocidad de procesamiento verbal. El rendimiento en resolución de problemas se evaluó por medio de problemas de operaciones lógicas y a través de problemas con enunciados orales con y sin apoyo visual.ResultadosLas habilidades lingüísticas correlacionaron significativamente con las habilidades de resolución de problemas que involucran el pensamiento lógico y problemas con enunciado verbal, con y sin apoyo visual. Las habilidades lingüísticas, en conjunto, se relacionan con la resolución de problemas, explicando un incremento significativo de varianza adicional a la explicada por el nivel de inteligencia. La conciencia fonológica resulta ser la habilidad lingüística que mejor predice el rendimiento en problemas con enunciados sin apoyo de material concreto.ConclusionesLa conciencia fonológica es buen indicador de la calidad de las representaciones fonológicas que permiten manipular la información lingüística contenida en problemas matemáticos a edades tempranas. Estos hallazgos tienen relevancia en procesos de aprendizaje matemático, tanto en población con desarrollo típico como con dificultades de procesamiento fonológico.IntroductionSolving mathematical problems requires a number of different skills. Several studies have highlighted the role of language processing in problem solving through its influence on mental representation and information processing in mathematical problems. However, these studies usually focus on the primary school years and less often on children at preschool level.ObjectivesThe objective of this study was twofold: to analyse the effect of linguistic competence on problem solving in mathematics at the kindergarten stage and to identify which specific language skills are most closely associated with problem-solving skill.MethodThe sample included 76 children attending a kindergarten third grade class. Composed measures of semantic and morphosyntactic skills, phonological awareness, verbal memory and processing speed were formed from the CELF subscales. Problem-solving skill was assessed by asking children to solve a range of different mathematical problems involving Piagetian logical operations, and word problems with and without accompanying visual representations.ResultsLinguistic skills correlated significantly with skill in solving problems involving logical thinking, and verbal statement problems with and without visual representation. Linguistic skills predicted children’ problem-solving skills as they accounted for additional variance beyond that accounted for by IQ. Phonological awareness was the single best predictor of scores in solving word problems without visual support.ConclusionsPhonological awareness is a good indicator of the quality of phonological representations that allow manipulation of the linguistic information contained in mathematical problems at an early age. These findings have practical consequences for helping children to achieve normative development and for children with phonological processing difficulties.



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Uso del Inventario de Habilidades Comunicativas de MacArthur-Bates con lactantes en riesgo de daño cerebral

Publication date: Available online 16 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Amaya Soberón, Claudia Jiménez-Sánchez, Johanna Flores, Josefina Ricardo-Garcell, María Elizabeth Mónica Carlier, María Fernanda de la Llata, Verónica Paz, Thalía Harmony.
IntroducciónExisten escasas pruebas conductuales validadas para hispanoparlantes que incluyen dentro de sus normas lactantes normo-oyentes con riesgo de daño cerebral perinatal. Sin medidas conductuales validadas, los clínicos usan pruebas que no están normadas para esta población, como el Inventario de Habilidades Comunicativas MacArthur-Bates (SCDI). Estudios electrofisiológicos han mostrado que las subpruebas comprensión y producción de palabras de dicho inventario tienen un alto poder discriminante en estas poblaciones en riesgo cuando se ajusta la norma de la prueba al percentil 50. Se examinó dicha norma ajustada en la práctica clínica.MétodoDiseño de un solo grupo y selección de la muestra semialeatoria. Se seleccionaron 30 niños con factores de riesgo de daño cerebral perinatal de la Unidad de investigación en Neurodesarrollo a los que se les hubiera aplicado el inventario al año de edad y la Escala de Lenguaje Preescolar (PLS-5) entre los 3 y 4 años. Se comparó la proporción de niños identificados con alteraciones en el desarrollo del lenguaje por la PLS-5 entre los 3-4 años con la proporción de niños identificados con riesgo por el SCDI al año de edad usando la norma sin ajustar y la norma ajustada.ResultadosLa norma ajustada del SCDI permitió identificar una proporción de niños con riesgo del lenguaje al año de edad similar a la proporción que se identificó con alteraciones entre los 3 y 4 años.ConclusiónDebería considerarse una norma ajustada cuando se examinen poblaciones con riesgo de daño cerebral usando el Inventario SCDI al año de edad.IntroductionThere are few validated language test for Spanish speakers that cover normo-listeners infants at risk of brain damage. Without validated behavioural measures, clinicians use test that are not standardised for this population, such as the MacArthur-Bates Communicative Skills Inventory (SCDI). Electrophysiological studies have shown that the comprehension and word production sub-test of such inventory have high discriminatory power in these at-risk populations when the test standard is adjusted to the 50th percentile. This adjusted standard was examined in clinical practice.MethodsDesign of a single group and selection of the semi-random sample. We selected 30 infants at risk of brain damage from the Neurodevelopment Research Unit to which the Inventory at one year old and the Preschool Language Scale (PLS-5) were applied between the ages of 3 and 4 years. We compared the proportion of children identified with language developmental impairments by PLS-5 between the ages of 3-4 with the proportion of children identified at risk by SCDI at one year of age using the non-adjusted norm and adjusted norm.ResultsThe adjusted SCDI standard allowed the identification of a proportion of infants at risk of brain damage and also at risk of language development impairments at one year of age, similar to the proportion that was identified with impairments between 3 and 4 years.ConclusionAn adjusted norm should be considered when examining infants at risk of brain damage using the SCDI Inventory at one year of age.



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Editorial

Publication date: September–December 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 4
Author(s): David del Río




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Fonoaudiología/logopedia en cuidado intensivo: el valor de la comunicación, más allá de las alteraciones de deglución

Publication date: Available online 27 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Leidy-Johanna Rodríguez-Riaño, Adriana Duarte-Valderrama
Las personas que ingresan en la Unidad de Cuidado Intensivo (UCI) pueden generar alteraciones en deglución y comunicación, como consecuencia de patologías de base o por tratamientos e intervenciones usadas para preservar la vida. La fonoaudiología/logopedia asume el reto frente al manejo de pacientes en condiciones críticas de salud, con el fin de promover la calidad de vida desde la rehabilitación de procesos de deglución, aportar al bienestar comunicativo de pacientes, familiares y profesionales, para promover la humanización dentro de las UCI. Este análisis de literatura reunió evidencia sobre acciones fonoaudiológicas y terapéuticas del fonoaudiólogo/logopeda en UCI. Se revisó evidencia entre el 1 de enero de 2008 hasta el 1 de febrero de 2015 en bases de datos EBSCO, Scielo, PubMed Medline y EMBASE. Se incluyó evidencia sobre el rol y las acciones del fonoaudiólogo/logopeda dentro de las UCI. Del total de 200 artículos cruzados, se incluyeron 60 según criterios de inclusión. Esta búsqueda evidenció la importancia que se da en el mundo a la presencia del fonoaudiólogo/logopeda dentro del grupo multidisciplinario de las UCI, para la rehabilitación de la comunicación y la deglución y su aporte a la compleja labor de humanización de los servicios de salud desde la interacción comunicativa efectiva del paciente con su entorno.People entering the Intensive Care Unit (ICU) can develop changes in swallowing and communication, as a consequence of disease, or treatments and interventions used to preserve life. Speech and language therapists take on the challenge of managing patients in critical health conditions, to enhance their quality of life after swallowing rehabilitation, to contribute to the communicative wellbeing of patients, families and professionals, and to promote humanisation in ICU. This literature analysis gathered evidence of the therapeutic action of speech and language therapists in ICU. The evidence was reviewed between January 1, 2008 and February 1, 2015 in the EBSCO, Scielo, PubMed Medline and EMBASE databases. Evidence on the role and actions of speech and language therapists in ICU was included. Of the total 200 cross-items, 60 were included according to the inclusion criteria.This research demonstrated the global importance of speech and language therapists within the intensive care unit multidisciplinary team, in communication and swallowing rehabilitation. It highlighted their contribution to the complex work involved in humanising the health services by enabling patients to interact communicatively with their environment.



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via IFTTT

Neuro-Developmental Treatment. A Guide to NDT Clinical Practice

Publication date: September–December 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 4
Author(s): Rosa M. Bermúdez de Alvear




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via IFTTT

Conciencia fonológica y resolución de problemas matemáticos en educación infantil

Publication date: Available online 26 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Laura Espinoza Pastén, Rafaela Marco Taverner, Amparo Ygual Fernández
IntroducciónAlgunos estudios revelan la participación del procesamiento lingüístico en la resolución de problemas matemáticos, subrayando su papel en la representación y en el procesamiento de información. Estas investigaciones no suelen considerar población en edades tempranas.ObjetivosEste estudio tiene un doble objetivo: analizar la influencia lingüística en resolución de problemas matemáticos en la etapa de educación infantil y analizar qué habilidades lingüísticas explican significativamente por sí solas la resolución de problemas matemáticos.MétodoParticiparon 76 niños españoles que cursaban tercero de educación infantil. Se evaluaron habilidades semánticas, morfosintácticas y conciencia fonológica, memoria verbal y velocidad de procesamiento verbal. El rendimiento en resolución de problemas se evaluó por medio de problemas de operaciones lógicas y a través de problemas con enunciados orales con y sin apoyo visual.ResultadosLas habilidades lingüísticas correlacionaron significativamente con las habilidades de resolución de problemas que involucran el pensamiento lógico y problemas con enunciado verbal, con y sin apoyo visual. Las habilidades lingüísticas, en conjunto, se relacionan con la resolución de problemas, explicando un incremento significativo de varianza adicional a la explicada por el nivel de inteligencia. La conciencia fonológica resulta ser la habilidad lingüística que mejor predice el rendimiento en problemas con enunciados sin apoyo de material concreto.ConclusionesLa conciencia fonológica es buen indicador de la calidad de las representaciones fonológicas que permiten manipular la información lingüística contenida en problemas matemáticos a edades tempranas. Estos hallazgos tienen relevancia en procesos de aprendizaje matemático, tanto en población con desarrollo típico como con dificultades de procesamiento fonológico.IntroductionSolving mathematical problems requires a number of different skills. Several studies have highlighted the role of language processing in problem solving through its influence on mental representation and information processing in mathematical problems. However, these studies usually focus on the primary school years and less often on children at preschool level.ObjectivesThe objective of this study was twofold: to analyse the effect of linguistic competence on problem solving in mathematics at the kindergarten stage and to identify which specific language skills are most closely associated with problem-solving skill.MethodThe sample included 76 children attending a kindergarten third grade class. Composed measures of semantic and morphosyntactic skills, phonological awareness, verbal memory and processing speed were formed from the CELF subscales. Problem-solving skill was assessed by asking children to solve a range of different mathematical problems involving Piagetian logical operations, and word problems with and without accompanying visual representations.ResultsLinguistic skills correlated significantly with skill in solving problems involving logical thinking, and verbal statement problems with and without visual representation. Linguistic skills predicted children’ problem-solving skills as they accounted for additional variance beyond that accounted for by IQ. Phonological awareness was the single best predictor of scores in solving word problems without visual support.ConclusionsPhonological awareness is a good indicator of the quality of phonological representations that allow manipulation of the linguistic information contained in mathematical problems at an early age. These findings have practical consequences for helping children to achieve normative development and for children with phonological processing difficulties.



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Uso del Inventario de Habilidades Comunicativas de MacArthur-Bates con lactantes en riesgo de daño cerebral

Publication date: Available online 16 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Amaya Soberón, Claudia Jiménez-Sánchez, Johanna Flores, Josefina Ricardo-Garcell, María Elizabeth Mónica Carlier, María Fernanda de la Llata, Verónica Paz, Thalía Harmony.
IntroducciónExisten escasas pruebas conductuales validadas para hispanoparlantes que incluyen dentro de sus normas lactantes normo-oyentes con riesgo de daño cerebral perinatal. Sin medidas conductuales validadas, los clínicos usan pruebas que no están normadas para esta población, como el Inventario de Habilidades Comunicativas MacArthur-Bates (SCDI). Estudios electrofisiológicos han mostrado que las subpruebas comprensión y producción de palabras de dicho inventario tienen un alto poder discriminante en estas poblaciones en riesgo cuando se ajusta la norma de la prueba al percentil 50. Se examinó dicha norma ajustada en la práctica clínica.MétodoDiseño de un solo grupo y selección de la muestra semialeatoria. Se seleccionaron 30 niños con factores de riesgo de daño cerebral perinatal de la Unidad de investigación en Neurodesarrollo a los que se les hubiera aplicado el inventario al año de edad y la Escala de Lenguaje Preescolar (PLS-5) entre los 3 y 4 años. Se comparó la proporción de niños identificados con alteraciones en el desarrollo del lenguaje por la PLS-5 entre los 3-4 años con la proporción de niños identificados con riesgo por el SCDI al año de edad usando la norma sin ajustar y la norma ajustada.ResultadosLa norma ajustada del SCDI permitió identificar una proporción de niños con riesgo del lenguaje al año de edad similar a la proporción que se identificó con alteraciones entre los 3 y 4 años.ConclusiónDebería considerarse una norma ajustada cuando se examinen poblaciones con riesgo de daño cerebral usando el Inventario SCDI al año de edad.IntroductionThere are few validated language test for Spanish speakers that cover normo-listeners infants at risk of brain damage. Without validated behavioural measures, clinicians use test that are not standardised for this population, such as the MacArthur-Bates Communicative Skills Inventory (SCDI). Electrophysiological studies have shown that the comprehension and word production sub-test of such inventory have high discriminatory power in these at-risk populations when the test standard is adjusted to the 50th percentile. This adjusted standard was examined in clinical practice.MethodsDesign of a single group and selection of the semi-random sample. We selected 30 infants at risk of brain damage from the Neurodevelopment Research Unit to which the Inventory at one year old and the Preschool Language Scale (PLS-5) were applied between the ages of 3 and 4 years. We compared the proportion of children identified with language developmental impairments by PLS-5 between the ages of 3-4 with the proportion of children identified at risk by SCDI at one year of age using the non-adjusted norm and adjusted norm.ResultsThe adjusted SCDI standard allowed the identification of a proportion of infants at risk of brain damage and also at risk of language development impairments at one year of age, similar to the proportion that was identified with impairments between 3 and 4 years.ConclusionAn adjusted norm should be considered when examining infants at risk of brain damage using the SCDI Inventory at one year of age.



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Editorial

Publication date: September–December 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 4
Author(s): David del Río




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Fonoaudiología/logopedia en cuidado intensivo: el valor de la comunicación, más allá de las alteraciones de deglución

Publication date: Available online 27 October 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Leidy-Johanna Rodríguez-Riaño, Adriana Duarte-Valderrama
Las personas que ingresan en la Unidad de Cuidado Intensivo (UCI) pueden generar alteraciones en deglución y comunicación, como consecuencia de patologías de base o por tratamientos e intervenciones usadas para preservar la vida. La fonoaudiología/logopedia asume el reto frente al manejo de pacientes en condiciones críticas de salud, con el fin de promover la calidad de vida desde la rehabilitación de procesos de deglución, aportar al bienestar comunicativo de pacientes, familiares y profesionales, para promover la humanización dentro de las UCI. Este análisis de literatura reunió evidencia sobre acciones fonoaudiológicas y terapéuticas del fonoaudiólogo/logopeda en UCI. Se revisó evidencia entre el 1 de enero de 2008 hasta el 1 de febrero de 2015 en bases de datos EBSCO, Scielo, PubMed Medline y EMBASE. Se incluyó evidencia sobre el rol y las acciones del fonoaudiólogo/logopeda dentro de las UCI. Del total de 200 artículos cruzados, se incluyeron 60 según criterios de inclusión. Esta búsqueda evidenció la importancia que se da en el mundo a la presencia del fonoaudiólogo/logopeda dentro del grupo multidisciplinario de las UCI, para la rehabilitación de la comunicación y la deglución y su aporte a la compleja labor de humanización de los servicios de salud desde la interacción comunicativa efectiva del paciente con su entorno.People entering the Intensive Care Unit (ICU) can develop changes in swallowing and communication, as a consequence of disease, or treatments and interventions used to preserve life. Speech and language therapists take on the challenge of managing patients in critical health conditions, to enhance their quality of life after swallowing rehabilitation, to contribute to the communicative wellbeing of patients, families and professionals, and to promote humanisation in ICU. This literature analysis gathered evidence of the therapeutic action of speech and language therapists in ICU. The evidence was reviewed between January 1, 2008 and February 1, 2015 in the EBSCO, Scielo, PubMed Medline and EMBASE databases. Evidence on the role and actions of speech and language therapists in ICU was included. Of the total 200 cross-items, 60 were included according to the inclusion criteria.This research demonstrated the global importance of speech and language therapists within the intensive care unit multidisciplinary team, in communication and swallowing rehabilitation. It highlighted their contribution to the complex work involved in humanising the health services by enabling patients to interact communicatively with their environment.



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Neuro-Developmental Treatment. A Guide to NDT Clinical Practice

Publication date: September–December 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 4
Author(s): Rosa M. Bermúdez de Alvear




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Inner ear manifestations in CHARGE: Abnormalities, treatments, animal models, and progress toward treatments in auditory and vestibular structures.

Inner ear manifestations in CHARGE: Abnormalities, treatments, animal models, and progress toward treatments in auditory and vestibular structures.

Am J Med Genet C Semin Med Genet. 2017 Oct 30;:

Authors: Choo DI, Tawfik KO, Martin DM, Raphael Y

Abstract
The inner ear contains the sensory organs for hearing and balance. Both hearing and balance are commonly affected in individuals with CHARGE syndrome (CS), an autosomal dominant condition caused by heterozygous pathogenic variants in the CHD7 gene. Semicircular canal dysplasia or aplasia is the single most prevalent feature in individuals with CHARGE leading to deficient gross motor skills and ambulation. Identification of CHD7 as the major gene affected in CHARGE has enabled acceleration of research in this field. Great progress has been made in understanding the role of CHD7 in the development and function of the inner ear, as well as in related organs such as the middle ear and auditory and vestibular neural pathways. The goals of current research on CHD7 and CS are to (a) improve our understanding of the pathology caused by CHD7 pathogenic variants and (b) to provide better tools for prognosis and treatment. Current studies utilize cells and whole animals, from flies to mammals. The mouse is an excellent model for exploring mechanisms of Chd7 function in the ear, given the evolutionary conservation of ear structure, function, Chd7 expression, and similarity of mutant phenotypes between mice and humans. Newly recognized developmental functions for mouse Chd7 are shedding light on how abnormalities in CHD7 might lead to CS symptoms in humans. Here we review known human inner ear phenotypes associated with CHD7 pathogenic variants and CS, summarize progress toward diagnosis and treatment of inner ear-related pathologies, and explore new avenues for treatment based on basic science discoveries.

PMID: 29082607 [PubMed - as supplied by publisher]

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Inner ear manifestations in CHARGE: Abnormalities, treatments, animal models, and progress toward treatments in auditory and vestibular structures.

Inner ear manifestations in CHARGE: Abnormalities, treatments, animal models, and progress toward treatments in auditory and vestibular structures.

Am J Med Genet C Semin Med Genet. 2017 Oct 30;:

Authors: Choo DI, Tawfik KO, Martin DM, Raphael Y

Abstract
The inner ear contains the sensory organs for hearing and balance. Both hearing and balance are commonly affected in individuals with CHARGE syndrome (CS), an autosomal dominant condition caused by heterozygous pathogenic variants in the CHD7 gene. Semicircular canal dysplasia or aplasia is the single most prevalent feature in individuals with CHARGE leading to deficient gross motor skills and ambulation. Identification of CHD7 as the major gene affected in CHARGE has enabled acceleration of research in this field. Great progress has been made in understanding the role of CHD7 in the development and function of the inner ear, as well as in related organs such as the middle ear and auditory and vestibular neural pathways. The goals of current research on CHD7 and CS are to (a) improve our understanding of the pathology caused by CHD7 pathogenic variants and (b) to provide better tools for prognosis and treatment. Current studies utilize cells and whole animals, from flies to mammals. The mouse is an excellent model for exploring mechanisms of Chd7 function in the ear, given the evolutionary conservation of ear structure, function, Chd7 expression, and similarity of mutant phenotypes between mice and humans. Newly recognized developmental functions for mouse Chd7 are shedding light on how abnormalities in CHD7 might lead to CS symptoms in humans. Here we review known human inner ear phenotypes associated with CHD7 pathogenic variants and CS, summarize progress toward diagnosis and treatment of inner ear-related pathologies, and explore new avenues for treatment based on basic science discoveries.

PMID: 29082607 [PubMed - as supplied by publisher]

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Assessing hearing loss self-management in older adults.

Assessing hearing loss self-management in older adults.

Int J Audiol. 2017 Oct 28;:1-8

Authors: Convery E, Meyer C, Keidser G, Hickson L

Abstract
OBJECTIVE: To evaluate the capacity of a self-management assessment tool to identify unmet hearing health care (HHC) needs; to determine whether such an assessment yields novel and clinically useful information.
DESIGN: Hearing loss self-management (HLSM) was assessed with the Partners in Health scale and the Cue and Response interview from the Flinders Chronic Condition Management Program™. The results of the scale and the interview were compared to determine the extent to which they each contributed to the assessment of HLSM.
STUDY SAMPLE: Thirty older adults who currently receive HHC.
RESULTS: The two assessment tools were useful in identifying the specific domains in which participants lacked good HLSM skills. While participants tended to have a high level of knowledge about hearing loss and technology-based interventions, many reported the presence of unmet psychosocial needs with no clear plan for addressing them. There was considerable variation in terms of the extent to which their audiologists facilitated shared decision-making.
CONCLUSIONS: The results suggest that HLSM has the potential to play an important role in audiological rehabilitation. A HLSM assessment tool that more precisely matches the unique needs of people with hearing loss should be developed, along with interventions to meet those needs.

PMID: 29081257 [PubMed - as supplied by publisher]

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Assessing hearing loss self-management in older adults.

Assessing hearing loss self-management in older adults.

Int J Audiol. 2017 Oct 28;:1-8

Authors: Convery E, Meyer C, Keidser G, Hickson L

Abstract
OBJECTIVE: To evaluate the capacity of a self-management assessment tool to identify unmet hearing health care (HHC) needs; to determine whether such an assessment yields novel and clinically useful information.
DESIGN: Hearing loss self-management (HLSM) was assessed with the Partners in Health scale and the Cue and Response interview from the Flinders Chronic Condition Management Program™. The results of the scale and the interview were compared to determine the extent to which they each contributed to the assessment of HLSM.
STUDY SAMPLE: Thirty older adults who currently receive HHC.
RESULTS: The two assessment tools were useful in identifying the specific domains in which participants lacked good HLSM skills. While participants tended to have a high level of knowledge about hearing loss and technology-based interventions, many reported the presence of unmet psychosocial needs with no clear plan for addressing them. There was considerable variation in terms of the extent to which their audiologists facilitated shared decision-making.
CONCLUSIONS: The results suggest that HLSM has the potential to play an important role in audiological rehabilitation. A HLSM assessment tool that more precisely matches the unique needs of people with hearing loss should be developed, along with interventions to meet those needs.

PMID: 29081257 [PubMed - as supplied by publisher]

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Assessing hearing loss self-management in older adults.

Assessing hearing loss self-management in older adults.

Int J Audiol. 2017 Oct 28;:1-8

Authors: Convery E, Meyer C, Keidser G, Hickson L

Abstract
OBJECTIVE: To evaluate the capacity of a self-management assessment tool to identify unmet hearing health care (HHC) needs; to determine whether such an assessment yields novel and clinically useful information.
DESIGN: Hearing loss self-management (HLSM) was assessed with the Partners in Health scale and the Cue and Response interview from the Flinders Chronic Condition Management Program™. The results of the scale and the interview were compared to determine the extent to which they each contributed to the assessment of HLSM.
STUDY SAMPLE: Thirty older adults who currently receive HHC.
RESULTS: The two assessment tools were useful in identifying the specific domains in which participants lacked good HLSM skills. While participants tended to have a high level of knowledge about hearing loss and technology-based interventions, many reported the presence of unmet psychosocial needs with no clear plan for addressing them. There was considerable variation in terms of the extent to which their audiologists facilitated shared decision-making.
CONCLUSIONS: The results suggest that HLSM has the potential to play an important role in audiological rehabilitation. A HLSM assessment tool that more precisely matches the unique needs of people with hearing loss should be developed, along with interventions to meet those needs.

PMID: 29081257 [PubMed - as supplied by publisher]

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Assessing hearing loss self-management in older adults.

Assessing hearing loss self-management in older adults.

Int J Audiol. 2017 Oct 28;:1-8

Authors: Convery E, Meyer C, Keidser G, Hickson L

Abstract
OBJECTIVE: To evaluate the capacity of a self-management assessment tool to identify unmet hearing health care (HHC) needs; to determine whether such an assessment yields novel and clinically useful information.
DESIGN: Hearing loss self-management (HLSM) was assessed with the Partners in Health scale and the Cue and Response interview from the Flinders Chronic Condition Management Program™. The results of the scale and the interview were compared to determine the extent to which they each contributed to the assessment of HLSM.
STUDY SAMPLE: Thirty older adults who currently receive HHC.
RESULTS: The two assessment tools were useful in identifying the specific domains in which participants lacked good HLSM skills. While participants tended to have a high level of knowledge about hearing loss and technology-based interventions, many reported the presence of unmet psychosocial needs with no clear plan for addressing them. There was considerable variation in terms of the extent to which their audiologists facilitated shared decision-making.
CONCLUSIONS: The results suggest that HLSM has the potential to play an important role in audiological rehabilitation. A HLSM assessment tool that more precisely matches the unique needs of people with hearing loss should be developed, along with interventions to meet those needs.

PMID: 29081257 [PubMed - as supplied by publisher]

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A New Age of Communication Powered by Purposeful Innovation

This course covers Phonak's latest product introductions as well as software and programming details to promote successful patient hearing instrument fittings.

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A New Age of Communication Powered by Purposeful Innovation

This course covers Phonak's latest product introductions as well as software and programming details to promote successful patient hearing instrument fittings.

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A New Age of Communication Powered by Purposeful Innovation

This course covers Phonak's latest product introductions as well as software and programming details to promote successful patient hearing instrument fittings.

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Language Outcomes in Children Who Are Deaf and Hard of Hearing: The Role of Language Ability Before Hearing Aid Intervention

Purpose

Early auditory experiences are fundamental in infant language acquisition. Research consistently demonstrates the benefits of early intervention (i.e., hearing aids) to language outcomes in children who are deaf and hard of hearing. The nature of these benefits and their relation with prefitting development are, however, not well understood.

Method

This study examined Ontario Infant Hearing Program birth cohorts to explore predictors of performance on the Preschool Language Scale–Fourth Edition at the time of (N = 47) and after (N = 19) initial hearing aid intervention.

Results

Regression analyses revealed that, before the hearing aid fitting, severity of hearing loss negatively predicted 19% and 10% of the variance in auditory comprehension and expressive communication, respectively. After hearing aid fitting, children's standard scores on language measures remained stable, but they made significant improvement in their progress values, which represent individual skills acquired on the test, rather than standing relative to same-age peers. Magnitude of change in progress values was predicted by a negative interaction of prefitting language ability and severity of hearing loss for the Auditory Comprehension scale.

Conclusions

These findings highlight the importance of considering a child's prefitting language ability in interpreting eventual language outcomes. Possible mechanisms of hearing aid benefit are discussed.

Supplemental Materials

http://ift.tt/2iPlF0N

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Associations Between the 2D:4D Proxy Biomarker for Prenatal Hormone Exposures and Symptoms of Developmental Language Disorder

Purpose

Relative lengths of the index (2D) and ring (4D) fingers in humans represent a retrospective biomarker of prenatal hormonal exposures. For this reason, the 2D:4D digit ratio can be used to investigate potential hormonal contributions to the etiology of neurodevelopmental disorders. This study tested potential group differences in 2D:4D digit ratios in a sample of boys with and without developmental language disorder (DLD) and examined the strength of associations between 2D:4D digit ratio and a battery of verbal and nonverbal measures.

Method

A group of 29 boys affected by DLD and a group of 76 boys with typical language abilities participated (age range = 5;6–11;0 years). Scanned images were used to measure finger lengths. Language measures included the core language subtests from the Clinical Evaluation of Language Fundamentals–Fourth Edition (Semel, Wiig, & Secord, 2003), a nonword repetition task, a sentence recall task, and the Test of Early Grammatical Impairment (Rice & Wexler, 2001).

Results

Significant group differences indicated lower 2D:4D digit ratios in the group with DLD. Modest associations were found between 2D:4D digit ratios and some Clinical Evaluation of Language Fundamentals–Fourth Edition subtests.

Conclusions

Prenatal hormone exposures may play a role in the etiology of some language symptoms.

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Predicting Intelligibility Gains in Individuals With Dysarthria From Baseline Speech Features

Purpose

Across the treatment literature, behavioral speech modifications have produced variable intelligibility changes in speakers with dysarthria. This study is the first of two articles exploring whether measurements of baseline speech features can predict speakers’ responses to these modifications.

Methods

Fifty speakers (7 older individuals and 43 speakers with dysarthria) read a standard passage in habitual, loud, and slow speaking modes. Eighteen listeners rated how easy the speech samples were to understand. Baseline acoustic measurements of articulation, prosody, and voice quality were collected with perceptual measures of severity.

Results

Cues to speak louder and reduce rate did not confer intelligibility benefits to every speaker. The degree to which cues to speak louder improved intelligibility could be predicted by speakers' baseline articulation rates and overall dysarthria severity. Improvements in the slow condition could be predicted by speakers' baseline severity and temporal variability. Speakers with a breathier voice quality tended to perform better in the loud condition than in the slow condition.

Conclusions

Assessments of baseline speech features can be used to predict appropriate treatment strategies for speakers with dysarthria. Further development of these assessments could provide the basis for more individualized treatment programs.

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Predicting Intelligibility Gains in Dysarthria Through Automated Speech Feature Analysis

Purpose

Behavioral speech modifications have variable effects on the intelligibility of speakers with dysarthria. In the companion article, a significant relationship was found between measures of speakers' baseline speech and their intelligibility gains following cues to speak louder and reduce rate (Fletcher, McAuliffe, Lansford, Sinex, & Liss, 2017). This study reexamines these features and assesses whether automated acoustic assessments can also be used to predict intelligibility gains.

Method

Fifty speakers (7 older individuals and 43 with dysarthria) read a passage in habitual, loud, and slow speaking modes. Automated measurements of long-term average spectra, envelope modulation spectra, and Mel-frequency cepstral coefficients were extracted from short segments of participants' baseline speech. Intelligibility gains were statistically modeled, and the predictive power of the baseline speech measures was assessed using cross-validation.

Results

Statistical models could predict the intelligibility gains of speakers they had not been trained on. The automated acoustic features were better able to predict speakers' improvement in the loud condition than the manual measures reported in the companion article.

Conclusions

These acoustic analyses present a promising tool for rapidly assessing treatment options. Automated measures of baseline speech patterns may enable more selective inclusion criteria and stronger group outcomes within treatment studies.

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Language Outcomes in Children Who Are Deaf and Hard of Hearing: The Role of Language Ability Before Hearing Aid Intervention

Purpose

Early auditory experiences are fundamental in infant language acquisition. Research consistently demonstrates the benefits of early intervention (i.e., hearing aids) to language outcomes in children who are deaf and hard of hearing. The nature of these benefits and their relation with prefitting development are, however, not well understood.

Method

This study examined Ontario Infant Hearing Program birth cohorts to explore predictors of performance on the Preschool Language Scale–Fourth Edition at the time of (N = 47) and after (N = 19) initial hearing aid intervention.

Results

Regression analyses revealed that, before the hearing aid fitting, severity of hearing loss negatively predicted 19% and 10% of the variance in auditory comprehension and expressive communication, respectively. After hearing aid fitting, children's standard scores on language measures remained stable, but they made significant improvement in their progress values, which represent individual skills acquired on the test, rather than standing relative to same-age peers. Magnitude of change in progress values was predicted by a negative interaction of prefitting language ability and severity of hearing loss for the Auditory Comprehension scale.

Conclusions

These findings highlight the importance of considering a child's prefitting language ability in interpreting eventual language outcomes. Possible mechanisms of hearing aid benefit are discussed.

Supplemental Materials

http://ift.tt/2iPlF0N

from #Audiology via ola Kala on Inoreader http://article/doi/10.1044/2017_JSLHR-L-16-0222/2661522/Language-Outcomes-in-Children-Who-Are-Deaf-and
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Associations Between the 2D:4D Proxy Biomarker for Prenatal Hormone Exposures and Symptoms of Developmental Language Disorder

Purpose

Relative lengths of the index (2D) and ring (4D) fingers in humans represent a retrospective biomarker of prenatal hormonal exposures. For this reason, the 2D:4D digit ratio can be used to investigate potential hormonal contributions to the etiology of neurodevelopmental disorders. This study tested potential group differences in 2D:4D digit ratios in a sample of boys with and without developmental language disorder (DLD) and examined the strength of associations between 2D:4D digit ratio and a battery of verbal and nonverbal measures.

Method

A group of 29 boys affected by DLD and a group of 76 boys with typical language abilities participated (age range = 5;6–11;0 years). Scanned images were used to measure finger lengths. Language measures included the core language subtests from the Clinical Evaluation of Language Fundamentals–Fourth Edition (Semel, Wiig, & Secord, 2003), a nonword repetition task, a sentence recall task, and the Test of Early Grammatical Impairment (Rice & Wexler, 2001).

Results

Significant group differences indicated lower 2D:4D digit ratios in the group with DLD. Modest associations were found between 2D:4D digit ratios and some Clinical Evaluation of Language Fundamentals–Fourth Edition subtests.

Conclusions

Prenatal hormone exposures may play a role in the etiology of some language symptoms.

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Predicting Intelligibility Gains in Individuals With Dysarthria From Baseline Speech Features

Purpose

Across the treatment literature, behavioral speech modifications have produced variable intelligibility changes in speakers with dysarthria. This study is the first of two articles exploring whether measurements of baseline speech features can predict speakers’ responses to these modifications.

Methods

Fifty speakers (7 older individuals and 43 speakers with dysarthria) read a standard passage in habitual, loud, and slow speaking modes. Eighteen listeners rated how easy the speech samples were to understand. Baseline acoustic measurements of articulation, prosody, and voice quality were collected with perceptual measures of severity.

Results

Cues to speak louder and reduce rate did not confer intelligibility benefits to every speaker. The degree to which cues to speak louder improved intelligibility could be predicted by speakers' baseline articulation rates and overall dysarthria severity. Improvements in the slow condition could be predicted by speakers' baseline severity and temporal variability. Speakers with a breathier voice quality tended to perform better in the loud condition than in the slow condition.

Conclusions

Assessments of baseline speech features can be used to predict appropriate treatment strategies for speakers with dysarthria. Further development of these assessments could provide the basis for more individualized treatment programs.

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Predicting Intelligibility Gains in Dysarthria Through Automated Speech Feature Analysis

Purpose

Behavioral speech modifications have variable effects on the intelligibility of speakers with dysarthria. In the companion article, a significant relationship was found between measures of speakers' baseline speech and their intelligibility gains following cues to speak louder and reduce rate (Fletcher, McAuliffe, Lansford, Sinex, & Liss, 2017). This study reexamines these features and assesses whether automated acoustic assessments can also be used to predict intelligibility gains.

Method

Fifty speakers (7 older individuals and 43 with dysarthria) read a passage in habitual, loud, and slow speaking modes. Automated measurements of long-term average spectra, envelope modulation spectra, and Mel-frequency cepstral coefficients were extracted from short segments of participants' baseline speech. Intelligibility gains were statistically modeled, and the predictive power of the baseline speech measures was assessed using cross-validation.

Results

Statistical models could predict the intelligibility gains of speakers they had not been trained on. The automated acoustic features were better able to predict speakers' improvement in the loud condition than the manual measures reported in the companion article.

Conclusions

These acoustic analyses present a promising tool for rapidly assessing treatment options. Automated measures of baseline speech patterns may enable more selective inclusion criteria and stronger group outcomes within treatment studies.

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Language Outcomes in Children Who Are Deaf and Hard of Hearing: The Role of Language Ability Before Hearing Aid Intervention

Purpose

Early auditory experiences are fundamental in infant language acquisition. Research consistently demonstrates the benefits of early intervention (i.e., hearing aids) to language outcomes in children who are deaf and hard of hearing. The nature of these benefits and their relation with prefitting development are, however, not well understood.

Method

This study examined Ontario Infant Hearing Program birth cohorts to explore predictors of performance on the Preschool Language Scale–Fourth Edition at the time of (N = 47) and after (N = 19) initial hearing aid intervention.

Results

Regression analyses revealed that, before the hearing aid fitting, severity of hearing loss negatively predicted 19% and 10% of the variance in auditory comprehension and expressive communication, respectively. After hearing aid fitting, children's standard scores on language measures remained stable, but they made significant improvement in their progress values, which represent individual skills acquired on the test, rather than standing relative to same-age peers. Magnitude of change in progress values was predicted by a negative interaction of prefitting language ability and severity of hearing loss for the Auditory Comprehension scale.

Conclusions

These findings highlight the importance of considering a child's prefitting language ability in interpreting eventual language outcomes. Possible mechanisms of hearing aid benefit are discussed.

Supplemental Materials

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Associations Between the 2D:4D Proxy Biomarker for Prenatal Hormone Exposures and Symptoms of Developmental Language Disorder

Purpose

Relative lengths of the index (2D) and ring (4D) fingers in humans represent a retrospective biomarker of prenatal hormonal exposures. For this reason, the 2D:4D digit ratio can be used to investigate potential hormonal contributions to the etiology of neurodevelopmental disorders. This study tested potential group differences in 2D:4D digit ratios in a sample of boys with and without developmental language disorder (DLD) and examined the strength of associations between 2D:4D digit ratio and a battery of verbal and nonverbal measures.

Method

A group of 29 boys affected by DLD and a group of 76 boys with typical language abilities participated (age range = 5;6–11;0 years). Scanned images were used to measure finger lengths. Language measures included the core language subtests from the Clinical Evaluation of Language Fundamentals–Fourth Edition (Semel, Wiig, & Secord, 2003), a nonword repetition task, a sentence recall task, and the Test of Early Grammatical Impairment (Rice & Wexler, 2001).

Results

Significant group differences indicated lower 2D:4D digit ratios in the group with DLD. Modest associations were found between 2D:4D digit ratios and some Clinical Evaluation of Language Fundamentals–Fourth Edition subtests.

Conclusions

Prenatal hormone exposures may play a role in the etiology of some language symptoms.

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Predicting Intelligibility Gains in Individuals With Dysarthria From Baseline Speech Features

Purpose

Across the treatment literature, behavioral speech modifications have produced variable intelligibility changes in speakers with dysarthria. This study is the first of two articles exploring whether measurements of baseline speech features can predict speakers’ responses to these modifications.

Methods

Fifty speakers (7 older individuals and 43 speakers with dysarthria) read a standard passage in habitual, loud, and slow speaking modes. Eighteen listeners rated how easy the speech samples were to understand. Baseline acoustic measurements of articulation, prosody, and voice quality were collected with perceptual measures of severity.

Results

Cues to speak louder and reduce rate did not confer intelligibility benefits to every speaker. The degree to which cues to speak louder improved intelligibility could be predicted by speakers' baseline articulation rates and overall dysarthria severity. Improvements in the slow condition could be predicted by speakers' baseline severity and temporal variability. Speakers with a breathier voice quality tended to perform better in the loud condition than in the slow condition.

Conclusions

Assessments of baseline speech features can be used to predict appropriate treatment strategies for speakers with dysarthria. Further development of these assessments could provide the basis for more individualized treatment programs.

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Predicting Intelligibility Gains in Dysarthria Through Automated Speech Feature Analysis

Purpose

Behavioral speech modifications have variable effects on the intelligibility of speakers with dysarthria. In the companion article, a significant relationship was found between measures of speakers' baseline speech and their intelligibility gains following cues to speak louder and reduce rate (Fletcher, McAuliffe, Lansford, Sinex, & Liss, 2017). This study reexamines these features and assesses whether automated acoustic assessments can also be used to predict intelligibility gains.

Method

Fifty speakers (7 older individuals and 43 with dysarthria) read a passage in habitual, loud, and slow speaking modes. Automated measurements of long-term average spectra, envelope modulation spectra, and Mel-frequency cepstral coefficients were extracted from short segments of participants' baseline speech. Intelligibility gains were statistically modeled, and the predictive power of the baseline speech measures was assessed using cross-validation.

Results

Statistical models could predict the intelligibility gains of speakers they had not been trained on. The automated acoustic features were better able to predict speakers' improvement in the loud condition than the manual measures reported in the companion article.

Conclusions

These acoustic analyses present a promising tool for rapidly assessing treatment options. Automated measures of baseline speech patterns may enable more selective inclusion criteria and stronger group outcomes within treatment studies.

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Value of T1-weighted Magnetic Resonance Imaging in Cholesteatoma Detection.

Objective: To reveal the usefulness of T1-weighted (T1W) imaging on diagnostic magnetic resonance (MR) imaging for cholesteatoma. Study Design: A retrospective case review. Setting: Tertiary referral center. Patients: Fifty-three patients (57 ears) suspected to have cholesteatomas and treated (6-82 yr of age). Intervention: Preoperative MR imaging, including non-echo planar (non-EP) diffusion-weighted (DW) and T1W imaging. Main Outcome Measures: Primary outcome measures included the comparison between the diagnostic accuracy for the detection of cholesteatomas using non-EP DW imaging alone (criterion 1) and non-EP DW imaging along with T1W imaging (criterion 2). Diagnostic accuracy was evaluated in each case by comparing MR imaging with surgical findings. Secondary outcome measures included the comparison of the rates of cases showing a high T1W signal between cholesteatomas and noncholesteatomas which showed a high non-EP DW signal. Results: The sensitivity, specificity, and accuracy according to criterion 1 were 93.5, 63.6, and 87.7% and those according to criterion 2 were 89.1, 100, and 91.2%, respectively. Of 43 cholesteatoma cases indicating a high non-EP DW signal, only 2 cases showed a high T1W signal (5%). On the other hand, all four noncholesteatoma cases indicating high non-EP DW signal showed a high T1W signal (100%), and these rates were significantly different (p

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Usefulness of Electrical Auditory Brainstem Responses to Assess the Functionality of the Cochlear Nerve Using an Intracochlear Test Electrode.

Objective: To use an intracochlear test electrode to assess the integrity and the functionality of the auditory nerve in cochlear implant (CI) recipients and to compare electrical auditory brainstem responses (eABR) via the test electrode with the eABR responses with the CI. Setting: Otolaryngology department, tertiary referral hospital. Patients: Ten subjects (age at implantation 55 yr, range, 19-72) were subsequently implanted with a MED-EL CONCERTO CI on the side without any useful residual hearing. Interventions: Following identification of the round window (RW), the test electrode was inserted in the cochlea previous to cochlear implantation. Main Outcome Measures: To assess the quality of an eABR waveform, scoring criteria from Walton et al. (2008) were chosen. The waveforms in each session were classified by detecting waves III and V by the algorithm and visual assessment of the waveform. Speech performance was evaluated with monosyllables, disyllables, and sentence recognition tests. Results: It was possible to evoke electrical stimulation responses along with both the test electrode and the CI in all subjects. No significant differences in latencies or amplitudes after stimulation were found between the test electrode and the CI. All subjects obtained useful hearing with their CI and use their implants daily. Conclusions: The intracochlear test electrode may be suitable to test the integrity of the auditory nerve by recording eABR signals. This allows for further research on the status of the auditory nerve after tumor removal and correlation with auditory performance. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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The Etiological Relationship Between Migraine and Sudden Hearing Loss.

Objectives: To investigate the relationship between sudden sensorineural hearing loss (SSNHL) and migraine, assess the prevalence of migraine in patients with idiopathic SSNHL, and determine a possible common vascular etiopathogenesis for migraine and SSNHL. Study Design: Prospective cohort study. Setting: Tertiary referral center. Patients: This study initially assessed 178 SSNHL cases obtained from the Head and Neck Surgery Clinic patient database at a tertiary hospital in Turkey between January 2011 and March 2016. Ultimately, a total of 61 idiopathic SSNHL patients participated in the present study. Interventions: Diagnostic. Main Outcome Measures: Cases with inflammation in the middle or inner ear; a retro cochlear tumor; autoimmune, infectious, functional, metabolic, neoplastic, traumatic, toxic, or vascular causes; Meniere's disease; otosclerosis; multiple sclerosis; and/or cerebrovascular diseases were excluded. Results: Of the 61 idiopathic SSHNL patients, 34 were women (55.74%); and 24 (39.34%) had migraine, according to the criteria of the International Headache Society (IHS). The mean age of the migraine patients (Group 1) was 43.83 +/- 13.16 years, and that of those without migraine (Group 2) was 51.05 +/- 16.49 years. The groups did not significantly differ in terms of age, sex, or SSNHL recovery rates according to the Siegel criteria (p > 0.05). Ten of the migraine patients experienced visual aura, and the recovery rates of this group were higher. Additionally, the rate of total hearing loss was lower in Group 1 (n = 3, 12.5%) than in Group 2 (n = 10, 27%). Conclusion: SSNHL patients had a higher prevalence of migraine. Although those with migraine had higher recovery rates, the differences were not statistically significant. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Therapeutic Mastoidectomy Does Not Increase Postoperative Complications in the Management of the Chronic Ear.

Objective: Tympanoplasty with or without concurrent therapeutic mastoidectomy is a controversial topic in the management of chronic ear disease. We sought to describe whether there is a significant difference in postoperative complications. Study Design: Retrospective cohort study. Setting: American College of Surgeons National Surgical Quality Improvement Program public files. Patients: Current procedural terminology codes were used to identify patients with chronic ear disease undergoing tympanoplasty +/- concurrent mastoidectomy in the 2011 to 14 American College of Surgeons National Surgical Quality Improvement Program files. Intervention: Therapeutic. Main Outcome Measures: Variables were compared with [chi]2, Fischer's exact, and Mann-Whitney U tests, as appropriate to analyze postoperative complications between tympanoplasty with or without concurrent mastoidectomy. To account for confounding factors, presence of a complication was analyzed in binary logistic regression. Analysis considered sex, hypertension, obesity, advanced age, diabetes, smoking status, American Society of Anesthesiologists Physical status, procedure. Results: There were 4,087 patients identified meeting criteria (tympanoplasty = 2,798, tympanomastoidectomy = 1,289). There was no statistical difference in postoperative complications (tympanoplasty n = 49 [1. 8%], tympanomastoidectomy n = 33 [2. 6%]; p = 0. 087) or return to the operating room (tympanoplasty = 4 [0. 1%], tympanomastoidectomy = 6 [0. 5%]; p = 0. 082). Binary logistic regression demonstrated smoking as a predictor of a postoperative complication (OR: 1. 758, 95% CI: 1. 084-2. 851; p = 0. 022), while concurrent mastoidectomy did not significantly increase the risk of complication (OR: 1. 440, 95% CI: 0. 915-2. 268; p = 0. 115). There was a significant difference in mean operative time between tympanoplasty and tympanomastoidectomy: 85.7 versus 154.23 min, p

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Intracochlear Measurements of Interaural Time and Level Differences Conveyed by Bilateral Bone Conduction Systems.

Hypothesis: Intracochlear pressures (PIC) and stapes velocity (Vstap) elicited by bilaterally placed bone-anchored hearing devices (BAHD) will be systematically modulated by imposed interaural time (ITD) and level differences (ILD), demonstrating the potential for users of bilateral BAHD to access these binaural cues. Background: BAHD are traditionally implanted unilaterally under the assumption that transcranial cross-talk limits interaural differences. Recent studies have demonstrated improvements in binaural and spatial performance with bilateral BAHD; however, objective measures of binaural cues from bilateral BAHDs are lacking. Methods: Bone-conduction transducers were coupled to both mastoids of cadaveric specimens via implanted titanium abutments. PIC and Vstap were measured using intracochlear pressure probes and laser Doppler vibrometry, respectively, during stimulation with pure-tone stimuli of varied frequency (250-4000 Hz) under ipsilateral, contralateral, and bilateral ITD (-1 to 1 ms) and ILD (-20 to 20 dB) conditions. Results: Bilateral stimulation produced constructive and destructive interference patterns that varied dramatically with ITD and stimulus frequency. Variation of ITD led to large variation of PIC and Vstap, with opposing effects in ipsilateral and contralateral ears expected to lead to "ITD to ILD conversion." Variation of ILD produced more straightforward (monotonic) variations of PIC and Vstap, with ipsilateral-favoring ILD producing higher PIC and Vstap than contralateral-favoring. Conclusion: Variation of ITDs and ILDs conveyed by BAHDs systematically modulated cochlear inputs. While transcranial cross-talk leads to complex interactions that depend on cue type and stimulus frequency, binaural disparities potentiate binaural benefit, providing a basis for improved sound localization and speech-in-noise perception. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Evaluating Multipulse Integration as a Neural-Health Correlate in Human Cochlear Implant Users: Effects of Stimulation Mode

Abstract

Previous psychophysical studies have shown that a steep detection-threshold-versus-stimulation-rate function (multipulse integration; MPI) is associated with laterally positioned electrodes producing a broad neural excitation pattern. These findings are consistent with steep MPI depending on either a certain width of neural excitation allowing a large population of neurons operating at a low point on their dynamic range to respond to an increase in stimulation rate or a certain slope of excitation pattern that allows recruitment of neurons at the excitation periphery. Results of the current study provide additional support for these mechanisms by demonstrating significantly flattened MPI functions in narrow bipolar than monopolar stimulation. The study further examined the relationship between the steepness of the psychometric functions for detection (d’ versus log current level) and MPI. In contrast to findings in monopolar stimulation, current data measured in bipolar stimulation suggest that steepness of the psychometric functions explained a moderate amount of the across-site variance in MPI. Steepness of the psychometric functions, however, cannot explain why MPI flattened in bipolar stimulation, since slopes of the psychometric functions were comparable in the two stimulation modes. Lastly, our results show that across-site mean MPI measured in monopolar and bipolar stimulation correlated with speech recognition in opposite signs, with steeper monopolar MPI being associated with poorer performance but steeper bipolar MPI being associated with better performance. If steeper MPI requires broad stimulation of the cochlea, the correlation between monopolar MPI and speech recognition can be interpreted as the detrimental effect of poor spectral resolution on speech recognition. Assuming bipolar stimulation produces narrow excitation, and MPI measured in bipolar stimulation reflects primarily responses of the on-site neurons, the correlation between bipolar MPI and speech recognition can be understood in light of the importance of neural survival for speech recognition.

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Electrophysiological Evidence of the Basilar-Membrane Travelling Wave and Frequency Place Coding of Sound in Cochlear Implant Recipients

Aim: To obtain direct evidence for the cochlear travelling wave in humans by performing electrocochleography from within the cochlea in subjects implanted with an auditory prosthesis. Background: Sound induces a travelling wave that propagates along the basilar membrane, exhibiting cochleotopic tuning with a frequency-dependent phase delay. To date, evoked potentials and psychophysical experiments have supported the presence of the travelling wave in humans, but direct measurements have not been made. Methods: Electrical potentials in response to rarefaction and condensation acoustic tone bursts were recorded from multiple sites along the human cochlea, directly from a cochlear implant electrode during, and immediately after, its insertion. These recordings were made from individuals with residual hearing. Results: Electrocochleography was recorded from 11 intracochlear electrodes in 7 ears from 6 subjects, with detectable responses on all electrodes in 5 ears. Cochleotopic tuning and frequency-dependent phase delay of the cochlear microphonic were demonstrated. The response latencies were slightly shorter than those anticipated which we attribute to the subjects' hearing loss. Conclusions: Direct evidence for the travelling wave was observed. Electrocochleography from cochlear implant electrodes provides site-specific information on hair cell and neural function of the cochlea with potential diagnostic value.
Audiol Neurotol 2017;22:180-189

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A New Dimension in Hearing

An overview of Starkey's new Muse iQ, SoundLens Synergy iQ, and Halo iQ products that utilize the latest advanced signal processing, Acuity Immersion & Immersion Directionality, to focus on aspects of sound and hearing that contribute to the listener's spatial experience. The course will also introduce Starkey's latest 2.4 GHz accessory.

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A New Dimension in Hearing

An overview of Starkey's new Muse iQ, SoundLens Synergy iQ, and Halo iQ products that utilize the latest advanced signal processing, Acuity Immersion & Immersion Directionality, to focus on aspects of sound and hearing that contribute to the listener's spatial experience. The course will also introduce Starkey's latest 2.4 GHz accessory.

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A New Dimension in Hearing

An overview of Starkey's new Muse iQ, SoundLens Synergy iQ, and Halo iQ products that utilize the latest advanced signal processing, Acuity Immersion & Immersion Directionality, to focus on aspects of sound and hearing that contribute to the listener's spatial experience. The course will also introduce Starkey's latest 2.4 GHz accessory.

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Modifications in lower leg muscle activation when walking barefoot or in minimalist shoes across different age-groups.

Publication date: Available online 28 October 2017
Source:Gait & Posture
Author(s): Simon Franklin, François-Xavier Li, Michael J. Grey
Ageing is associated with a decline in muscle strength and impaired sensory mechanisms which contribute to an increased risk of falls. Walking barefooted has been suggested to promote increased muscle strength and improved proprioceptive sensibility through better activation of foot and ankle musculature. Minimalist footwear has been marketed as a method of reaping the suggested benefits of barefoot walking whilst still providing a protective surface. The aim of this study was to investigate if walking barefoot or in minimalist footwear provokes increased muscle activation compared to walking in conventional footwear. Seventy healthy adults (age range 20-87) volunteered for this study. All participants walked along a 7m walking lane five times in four different footwear conditions (barefoot (BF), minimalist shoes (MSH), their own shoes (SH) and control shoes (CON)). Muscle activity of their tibialis anterior (TA), gastrocnemius medialis (GCM) and peroneus longus (PL) were recorded simultaneously and normalised to the BF condition. MSH are intermediate in terms of ankle kinematics and muscle activation patterns. Walking BF or in MSH results in a decrease in TA activity at initial stance due to a flatter foot at contact in comparison to conventional footwear. Walking BF reduces PL activity at initial stance in the young and middle age but not the old. Walking in supportive footwear appears to reduce the balance modulation role of the GCM in the young and middle age but not the old, possibly as a result of slower walking speed when BF.



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Modifications in lower leg muscle activation when walking barefoot or in minimalist shoes across different age-groups.

Publication date: Available online 28 October 2017
Source:Gait & Posture
Author(s): Simon Franklin, François-Xavier Li, Michael J. Grey
Ageing is associated with a decline in muscle strength and impaired sensory mechanisms which contribute to an increased risk of falls. Walking barefooted has been suggested to promote increased muscle strength and improved proprioceptive sensibility through better activation of foot and ankle musculature. Minimalist footwear has been marketed as a method of reaping the suggested benefits of barefoot walking whilst still providing a protective surface. The aim of this study was to investigate if walking barefoot or in minimalist footwear provokes increased muscle activation compared to walking in conventional footwear. Seventy healthy adults (age range 20-87) volunteered for this study. All participants walked along a 7m walking lane five times in four different footwear conditions (barefoot (BF), minimalist shoes (MSH), their own shoes (SH) and control shoes (CON)). Muscle activity of their tibialis anterior (TA), gastrocnemius medialis (GCM) and peroneus longus (PL) were recorded simultaneously and normalised to the BF condition. MSH are intermediate in terms of ankle kinematics and muscle activation patterns. Walking BF or in MSH results in a decrease in TA activity at initial stance due to a flatter foot at contact in comparison to conventional footwear. Walking BF reduces PL activity at initial stance in the young and middle age but not the old. Walking in supportive footwear appears to reduce the balance modulation role of the GCM in the young and middle age but not the old, possibly as a result of slower walking speed when BF.



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Modifications in lower leg muscle activation when walking barefoot or in minimalist shoes across different age-groups.

Publication date: Available online 28 October 2017
Source:Gait & Posture
Author(s): Simon Franklin, François-Xavier Li, Michael J. Grey
Ageing is associated with a decline in muscle strength and impaired sensory mechanisms which contribute to an increased risk of falls. Walking barefooted has been suggested to promote increased muscle strength and improved proprioceptive sensibility through better activation of foot and ankle musculature. Minimalist footwear has been marketed as a method of reaping the suggested benefits of barefoot walking whilst still providing a protective surface. The aim of this study was to investigate if walking barefoot or in minimalist footwear provokes increased muscle activation compared to walking in conventional footwear. Seventy healthy adults (age range 20-87) volunteered for this study. All participants walked along a 7m walking lane five times in four different footwear conditions (barefoot (BF), minimalist shoes (MSH), their own shoes (SH) and control shoes (CON)). Muscle activity of their tibialis anterior (TA), gastrocnemius medialis (GCM) and peroneus longus (PL) were recorded simultaneously and normalised to the BF condition. MSH are intermediate in terms of ankle kinematics and muscle activation patterns. Walking BF or in MSH results in a decrease in TA activity at initial stance due to a flatter foot at contact in comparison to conventional footwear. Walking BF reduces PL activity at initial stance in the young and middle age but not the old. Walking in supportive footwear appears to reduce the balance modulation role of the GCM in the young and middle age but not the old, possibly as a result of slower walking speed when BF.



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Preoperative determination of nerve of origin in patients with vestibular schwannoma.

Related Articles

Preoperative determination of nerve of origin in patients with vestibular schwannoma.

HNO. 2017 Oct 27;:

Authors: Rahne T, Plößl S, Plontke SK, Strauss C

Abstract
BACKGROUND: Vestibular schwannoma (VS) is a benign tumor that develops in the internal auditory canal and the cerebellopontine angle, potentially diminishing hearing or balance. Most VS tumors arise from one of two vestibular branches: the superior or inferior vestibular nerve. Determining the specific nerve of origin could improve patient management in terms of preoperative counseling, treatment selection, and surgical decision-making and planning. The aim of this study was to introduce a novel scoring system that was designed to determine the nerve of origin.
METHODS: The nerve of origin was predicted based on video head impulse assessments of all semicircular channels, together with cervical/ocular vestibular-evoked myogenic potential tests. The acquired data were entered into a scoring system developed to allocate the tumor origin. Finally, the nerve of origin was definitively determined intraoperatively.
RESULTS: The novel scoring system was applied to five consecutive patients undergoing surgical VS treatment. In one case, no determination was possible. In all other cases, the preoperatively predicted tumor origin was the same as the origin determined during surgery.
CONCLUSION: The scoring system predicts the nerve of origin and will be evaluated in a larger prospective cohort study of VS patients in the near future.

PMID: 29079887 [PubMed - as supplied by publisher]

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