A comparative study of MED-EL FMT attachment to the long process of the incus in intact middle ears and its attachment to disarticulated stapes head

Publication date: Available online 23 June 2017
Source:Hearing Research
Author(s): Tao Chen, Liu-Jie Ren, Dong-Ming Yin, Jia Li, Lin Yang, Pei-Dong Dai, Tian-Yu Zhang
The Vibrant Soundbridge^© (VSB) active middle-ear implant provides an effective treatment for mild-to-severe sensorineural hearing loss in the case of normal middle ear anatomy and mixed hearing loss in middle ear malformation. The VSB floating mass transducer (FMT), with proper couplers, can be installed on various structures of the ossicular chain, e.g., the short and long process of the incus, the stapes head, and the stapes footplate. A long process (LP) coupler is most commonly used for FMT attachment to the long process of the incus with intact ossicular chain, while CliP and Bell couplers are two standardized and reliable methods for FMT attachment to the stapes head with missing incus and malleus. However, the difference and relationship of the vibration properties among these three FMT couplers remain unclear.In the present study, the stapes footplate velocity responses of the LP, CliP, and Bell couplers have been investigated in eight fresh temporal bones (TBs) to evaluate the vibration properties of these three couplers. Normal and reconstructed middle ear transfer functions (METFs) were determined from laser Doppler vibrometer (LDV) measurements. A mastoidectomy and a posterior tympanotomy were performed to expose the ossicular chain. The METFs of the normal middle ear and middle ear with LP-FMT-coupler were compared under acoustic stimulation, thus the mass effect of the FMT with LP coupler was evaluated. Additional comparisons were made between the stapes footplate vibrations of the LP-FMT-coupler (with the intact ossicular chain at the long process of the incus), CliP-FMT-coupler and Bell-FMT-coupler on the stapes head (after incus and malleus removed) under active electromechanical stimulation. After the installation of CliP-FMT-coupler and Bell-FMT-coupler to the middle ear, the average velocity amplitude of the stapes footplate, comparing to the LP-FMT-coupler, was about 15 dB higher between 1 and 6 kHz, and 10 dB lower at about 0.5 kHz. Quantitatively, there was no significant difference between the CliP-FMT-coupler and Bell-FMT-coupler.According to our study, installation of CliP-FMT-coupler or Bell-FMT-coupler on the stapes head provides considerable improvement of the middle ear mechanical and functional responses, comparing with the LP-FMT-coupler in the temporal bone experiments. Moreover, the installation of the Bell-FMT-coupler to the stapes head produces essentially the same footplate velocity responses in comparison to the CliP-FMT-coupler.



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A comparative study of MED-EL FMT attachment to the long process of the incus in intact middle ears and its attachment to disarticulated stapes head

Publication date: Available online 23 June 2017
Source:Hearing Research
Author(s): Tao Chen, Liu-Jie Ren, Dong-Ming Yin, Jia Li, Lin Yang, Pei-Dong Dai, Tian-Yu Zhang
The Vibrant Soundbridge^© (VSB) active middle-ear implant provides an effective treatment for mild-to-severe sensorineural hearing loss in the case of normal middle ear anatomy and mixed hearing loss in middle ear malformation. The VSB floating mass transducer (FMT), with proper couplers, can be installed on various structures of the ossicular chain, e.g., the short and long process of the incus, the stapes head, and the stapes footplate. A long process (LP) coupler is most commonly used for FMT attachment to the long process of the incus with intact ossicular chain, while CliP and Bell couplers are two standardized and reliable methods for FMT attachment to the stapes head with missing incus and malleus. However, the difference and relationship of the vibration properties among these three FMT couplers remain unclear.In the present study, the stapes footplate velocity responses of the LP, CliP, and Bell couplers have been investigated in eight fresh temporal bones (TBs) to evaluate the vibration properties of these three couplers. Normal and reconstructed middle ear transfer functions (METFs) were determined from laser Doppler vibrometer (LDV) measurements. A mastoidectomy and a posterior tympanotomy were performed to expose the ossicular chain. The METFs of the normal middle ear and middle ear with LP-FMT-coupler were compared under acoustic stimulation, thus the mass effect of the FMT with LP coupler was evaluated. Additional comparisons were made between the stapes footplate vibrations of the LP-FMT-coupler (with the intact ossicular chain at the long process of the incus), CliP-FMT-coupler and Bell-FMT-coupler on the stapes head (after incus and malleus removed) under active electromechanical stimulation. After the installation of CliP-FMT-coupler and Bell-FMT-coupler to the middle ear, the average velocity amplitude of the stapes footplate, comparing to the LP-FMT-coupler, was about 15 dB higher between 1 and 6 kHz, and 10 dB lower at about 0.5 kHz. Quantitatively, there was no significant difference between the CliP-FMT-coupler and Bell-FMT-coupler.According to our study, installation of CliP-FMT-coupler or Bell-FMT-coupler on the stapes head provides considerable improvement of the middle ear mechanical and functional responses, comparing with the LP-FMT-coupler in the temporal bone experiments. Moreover, the installation of the Bell-FMT-coupler to the stapes head produces essentially the same footplate velocity responses in comparison to the CliP-FMT-coupler.



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A comparative study of MED-EL FMT attachment to the long process of the incus in intact middle ears and its attachment to disarticulated stapes head

Publication date: Available online 23 June 2017
Source:Hearing Research
Author(s): Tao Chen, Liu-Jie Ren, Dong-Ming Yin, Jia Li, Lin Yang, Pei-Dong Dai, Tian-Yu Zhang
The Vibrant Soundbridge^© (VSB) active middle-ear implant provides an effective treatment for mild-to-severe sensorineural hearing loss in the case of normal middle ear anatomy and mixed hearing loss in middle ear malformation. The VSB floating mass transducer (FMT), with proper couplers, can be installed on various structures of the ossicular chain, e.g., the short and long process of the incus, the stapes head, and the stapes footplate. A long process (LP) coupler is most commonly used for FMT attachment to the long process of the incus with intact ossicular chain, while CliP and Bell couplers are two standardized and reliable methods for FMT attachment to the stapes head with missing incus and malleus. However, the difference and relationship of the vibration properties among these three FMT couplers remain unclear.In the present study, the stapes footplate velocity responses of the LP, CliP, and Bell couplers have been investigated in eight fresh temporal bones (TBs) to evaluate the vibration properties of these three couplers. Normal and reconstructed middle ear transfer functions (METFs) were determined from laser Doppler vibrometer (LDV) measurements. A mastoidectomy and a posterior tympanotomy were performed to expose the ossicular chain. The METFs of the normal middle ear and middle ear with LP-FMT-coupler were compared under acoustic stimulation, thus the mass effect of the FMT with LP coupler was evaluated. Additional comparisons were made between the stapes footplate vibrations of the LP-FMT-coupler (with the intact ossicular chain at the long process of the incus), CliP-FMT-coupler and Bell-FMT-coupler on the stapes head (after incus and malleus removed) under active electromechanical stimulation. After the installation of CliP-FMT-coupler and Bell-FMT-coupler to the middle ear, the average velocity amplitude of the stapes footplate, comparing to the LP-FMT-coupler, was about 15 dB higher between 1 and 6 kHz, and 10 dB lower at about 0.5 kHz. Quantitatively, there was no significant difference between the CliP-FMT-coupler and Bell-FMT-coupler.According to our study, installation of CliP-FMT-coupler or Bell-FMT-coupler on the stapes head provides considerable improvement of the middle ear mechanical and functional responses, comparing with the LP-FMT-coupler in the temporal bone experiments. Moreover, the installation of the Bell-FMT-coupler to the stapes head produces essentially the same footplate velocity responses in comparison to the CliP-FMT-coupler.



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A comparative study of MED-EL FMT attachment to the long process of the incus in intact middle ears and its attachment to disarticulated stapes head

Publication date: Available online 23 June 2017
Source:Hearing Research
Author(s): Tao Chen, Liu-Jie Ren, Dong-Ming Yin, Jia Li, Lin Yang, Pei-Dong Dai, Tian-Yu Zhang
The Vibrant Soundbridge^© (VSB) active middle-ear implant provides an effective treatment for mild-to-severe sensorineural hearing loss in the case of normal middle ear anatomy and mixed hearing loss in middle ear malformation. The VSB floating mass transducer (FMT), with proper couplers, can be installed on various structures of the ossicular chain, e.g., the short and long process of the incus, the stapes head, and the stapes footplate. A long process (LP) coupler is most commonly used for FMT attachment to the long process of the incus with intact ossicular chain, while CliP and Bell couplers are two standardized and reliable methods for FMT attachment to the stapes head with missing incus and malleus. However, the difference and relationship of the vibration properties among these three FMT couplers remain unclear.In the present study, the stapes footplate velocity responses of the LP, CliP, and Bell couplers have been investigated in eight fresh temporal bones (TBs) to evaluate the vibration properties of these three couplers. Normal and reconstructed middle ear transfer functions (METFs) were determined from laser Doppler vibrometer (LDV) measurements. A mastoidectomy and a posterior tympanotomy were performed to expose the ossicular chain. The METFs of the normal middle ear and middle ear with LP-FMT-coupler were compared under acoustic stimulation, thus the mass effect of the FMT with LP coupler was evaluated. Additional comparisons were made between the stapes footplate vibrations of the LP-FMT-coupler (with the intact ossicular chain at the long process of the incus), CliP-FMT-coupler and Bell-FMT-coupler on the stapes head (after incus and malleus removed) under active electromechanical stimulation. After the installation of CliP-FMT-coupler and Bell-FMT-coupler to the middle ear, the average velocity amplitude of the stapes footplate, comparing to the LP-FMT-coupler, was about 15 dB higher between 1 and 6 kHz, and 10 dB lower at about 0.5 kHz. Quantitatively, there was no significant difference between the CliP-FMT-coupler and Bell-FMT-coupler.According to our study, installation of CliP-FMT-coupler or Bell-FMT-coupler on the stapes head provides considerable improvement of the middle ear mechanical and functional responses, comparing with the LP-FMT-coupler in the temporal bone experiments. Moreover, the installation of the Bell-FMT-coupler to the stapes head produces essentially the same footplate velocity responses in comparison to the CliP-FMT-coupler.



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A comparative study of MED-EL FMT attachment to the long process of the incus in intact middle ears and its attachment to disarticulated stapes head

Publication date: Available online 23 June 2017
Source:Hearing Research
Author(s): Tao Chen, Liu-Jie Ren, Dong-Ming Yin, Jia Li, Lin Yang, Pei-Dong Dai, Tian-Yu Zhang
The Vibrant Soundbridge^© (VSB) active middle-ear implant provides an effective treatment for mild-to-severe sensorineural hearing loss in the case of normal middle ear anatomy and mixed hearing loss in middle ear malformation. The VSB floating mass transducer (FMT), with proper couplers, can be installed on various structures of the ossicular chain, e.g., the short and long process of the incus, the stapes head, and the stapes footplate. A long process (LP) coupler is most commonly used for FMT attachment to the long process of the incus with intact ossicular chain, while CliP and Bell couplers are two standardized and reliable methods for FMT attachment to the stapes head with missing incus and malleus. However, the difference and relationship of the vibration properties among these three FMT couplers remain unclear.In the present study, the stapes footplate velocity responses of the LP, CliP, and Bell couplers have been investigated in eight fresh temporal bones (TBs) to evaluate the vibration properties of these three couplers. Normal and reconstructed middle ear transfer functions (METFs) were determined from laser Doppler vibrometer (LDV) measurements. A mastoidectomy and a posterior tympanotomy were performed to expose the ossicular chain. The METFs of the normal middle ear and middle ear with LP-FMT-coupler were compared under acoustic stimulation, thus the mass effect of the FMT with LP coupler was evaluated. Additional comparisons were made between the stapes footplate vibrations of the LP-FMT-coupler (with the intact ossicular chain at the long process of the incus), CliP-FMT-coupler and Bell-FMT-coupler on the stapes head (after incus and malleus removed) under active electromechanical stimulation. After the installation of CliP-FMT-coupler and Bell-FMT-coupler to the middle ear, the average velocity amplitude of the stapes footplate, comparing to the LP-FMT-coupler, was about 15 dB higher between 1 and 6 kHz, and 10 dB lower at about 0.5 kHz. Quantitatively, there was no significant difference between the CliP-FMT-coupler and Bell-FMT-coupler.According to our study, installation of CliP-FMT-coupler or Bell-FMT-coupler on the stapes head provides considerable improvement of the middle ear mechanical and functional responses, comparing with the LP-FMT-coupler in the temporal bone experiments. Moreover, the installation of the Bell-FMT-coupler to the stapes head produces essentially the same footplate velocity responses in comparison to the CliP-FMT-coupler.



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Phonak Celebrates its 70 Years of History in Hearing Technology

​Phonak (http://ift.tt/1TpqSBL) is hosting an Open Door Day to celebrate its 70-year history on June 24, 2017, which is expected to draw over 8,000 people to the company's headquarters in Staefa, Switzerland. The event, which runs from 10 a.m. to 5 p.m. this Saturday, will feature a self-guided tour of the building, including of the labs and Research & Development, as well as a separate tour of the production facility. One of the highlights of the day will be a visual presentation of Phonak's innovations from 1947 to the present entitled Phonak's "Walk of Fame." Phonak has also created a microsite for those who can't make it in person to join in the celebration remotely. Visitors of the site can thank someone special by using the Phonak card creator, which allows them to upload their photos, choose from predefined card designs, customize a message, and send their cards to their recipients. The website also features a history page that details the company's milestones since its inception in the '40s. 

Published: 6/23/2017 9:35:00 AM

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Phonak Celebrates its 70 Years of History in Hearing Technology

​Phonak (http://ift.tt/1TpqSBL) is hosting an Open Door Day to celebrate its 70-year history on June 24, 2017, which is expected to draw over 8,000 people to the company's headquarters in Staefa, Switzerland. The event, which runs from 10 a.m. to 5 p.m. this Saturday, will feature a self-guided tour of the building, including of the labs and Research & Development, as well as a separate tour of the production facility. One of the highlights of the day will be a visual presentation of Phonak's innovations from 1947 to the present entitled Phonak's "Walk of Fame." Phonak has also created a microsite for those who can't make it in person to join in the celebration remotely. Visitors of the site can thank someone special by using the Phonak card creator, which allows them to upload their photos, choose from predefined card designs, customize a message, and send their cards to their recipients. The website also features a history page that details the company's milestones since its inception in the '40s. 

Published: 6/23/2017 9:35:00 AM

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Phonak Celebrates its 70 Years of History in Hearing Technology

​Phonak (http://ift.tt/1TpqSBL) is hosting an Open Door Day to celebrate its 70-year history on June 24, 2017, which is expected to draw over 8,000 people to the company's headquarters in Staefa, Switzerland. The event, which runs from 10 a.m. to 5 p.m. this Saturday, will feature a self-guided tour of the building, including of the labs and Research & Development, as well as a separate tour of the production facility. One of the highlights of the day will be a visual presentation of Phonak's innovations from 1947 to the present entitled Phonak's "Walk of Fame." Phonak has also created a microsite for those who can't make it in person to join in the celebration remotely. Visitors of the site can thank someone special by using the Phonak card creator, which allows them to upload their photos, choose from predefined card designs, customize a message, and send their cards to their recipients. The website also features a history page that details the company's milestones since its inception in the '40s. 

Published: 6/23/2017 9:35:00 AM

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How Often Is Hearing Loss Considered?

As audiologists, we know firsthand the impact that hearing loss has on communication. Before we begin speaking, we look at our patients and provide an unobstructed view of our face. As soon as patients walk into our office, we adjust the volume, pitch, and tempo of our speech to ensure that they can hear and understand us. We hope that other health-care providers, including physicians, are also attuned to their patients’ hearing needs particularly when helping older adults where a prevalence of hearing loss is high.

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Rhesus Cochlear and Vestibular Functions Are Preserved After Inner Ear Injection of Saline Volume Sufficient for Gene Therapy Delivery

Abstract

Sensorineural losses of hearing and vestibular sensation due to hair cell dysfunction are among the most common disabilities. Recent preclinical research demonstrates that treatment of the inner ear with a variety of compounds, including gene therapy agents, may elicit regeneration and/or repair of hair cells in animals exposed to ototoxic medications or other insults to the inner ear. Delivery of gene therapy may also offer a means for treatment of hereditary hearing loss. However, injection of a fluid volume sufficient to deliver an adequate dose of a pharmacologic agent could, in theory, cause inner ear trauma that compromises functional outcome. The primary goal of the present study was to assess that risk in rhesus monkeys, which closely approximates humans with regard to middle and inner ear anatomy. Secondary goals were to identify the best delivery route into the primate ear from among two common surgical approaches (i.e., via an oval window stapedotomy and via the round window) and to determine the relative volumes of rhesus, rodent, and human labyrinths for extrapolation of results to other species. We measured hearing and vestibular functions before and 2, 4, and 8 weeks after unilateral injection of phosphate-buffered saline vehicle (PBSV) into the perilymphatic space of normal rhesus monkeys at volumes sufficient to deliver an atoh1 gene therapy vector. To isolate effects of injection, PBSV without vector was used. Assays included behavioral observation, auditory brainstem responses, distortion product otoacoustic emissions, and scleral coil measurement of vestibulo-ocular reflexes during whole-body rotation in darkness. Three groups (N = 3 each) were studied. Group A received a 10 μL transmastoid/trans-stapes injection via a laser stapedotomy. Group B received a 10 μL transmastoid/trans-round window injection. Group C received a 30 μL transmastoid/trans-round window injection. We also measured inner ear fluid space volume via 3D reconstruction of computed tomography (CT) images of adult C57BL6 mouse, rat, rhesus macaque, and human temporal bones (N = 3 each). Injection was well tolerated by all animals, with eight of nine exhibiting no signs of disequilibrium and one animal exhibiting transient disequilibrium that resolved spontaneously by 24 h after surgery. Physiologic results at the final, 8-week post-injection measurement showed that injection was well tolerated. Compared to its pretreatment values, no treated ear’s ABR threshold had worsened by more than 5 dB at any stimulus frequency; distortion product otoacoustic emissions remained detectable above the noise floor for every treated ear (mean, SD and maximum deviation from baseline: −1.3, 9.0, and −18 dB, respectively); and no animal exhibited a reduction of more than 3 % in vestibulo-ocular reflex gain during high-acceleration, whole-body, passive yaw rotations in darkness toward the treated side. All control ears and all operated ears with definite histologic evidence of injection through the intended site showed similar findings, with intact hair cells in all five inner ear sensory epithelia and intact auditory/vestibular neurons. The relative volumes of mouse, rat, rhesus, and human inner ears as measured by CT were (mean ± SD) 2.5 ± 0.1, 5.5 ± 0.4, 59.4 ± 4.7 and 191.1 ± 4.7 μL. These results indicate that injection of PBSV at volumes sufficient for gene therapy delivery can be accomplished without destruction of inner ear structures required for hearing and vestibular sensation.

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ReSound Relief: A Comprehensive Tool for Tinnitus Management

The Resound Relief app is a comprehensive tool that addresses all aspects of tinnitus management, not just the sound therapy component. With regular updates and collaborations with key opinion leaders in tinnitus research and treatment, the ReSound Relief app continuously evolves to offer more benefits to both tinnitus patients and clinicians. This course reviews the components of the ReSound Relief app along with the underlying rationale and evidence for its features.

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ReSound Relief: A Comprehensive Tool for Tinnitus Management

The Resound Relief app is a comprehensive tool that addresses all aspects of tinnitus management, not just the sound therapy component. With regular updates and collaborations with key opinion leaders in tinnitus research and treatment, the ReSound Relief app continuously evolves to offer more benefits to both tinnitus patients and clinicians. This course reviews the components of the ReSound Relief app along with the underlying rationale and evidence for its features.

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Effects of Straw Phonation Through Tubes of Varied Lengths on Sustained Vowels in Normal-Voiced Participants

Publication date: Available online 22 June 2017
Source:Journal of Voice
Author(s): Randal D. Mills, Shawna Rivedal, Colten DeMorett, Grace Maples, Jack J. Jiang
ObjectiveTo examine the immediate effects of straw phonation exercises in normal subjects while altering the effective length of the vocal tract.Study DesignA nonrandomized comparison of semi-occluded vocal tract length during straw phonation exercises was carried out.MethodsOral pressure, mean airflow, aerodynamic resistance, and contact quotient were measured in 20 healthy subjects immediately before and after straw phonation exercises. A short- and long-duration phonatory task was used to examine the voice parameters during semi-occluded vocal tract exercises. These tasks involved repeating a vocalization of the vowel /a/ through a tube. Each subject underwent the protocol using tubes of three different lengths (7.5 cm, 15 cm, and 30 cm) to allow for the effect of moving the outlet of the vocal tract distal to the mouth to be monitored.ResultsOral pressure and aerodynamic resistance decreased significantly, contact quotient showed a decreasing trend, and airflow increased significantly in pre- and postmeasurements 15 minutes after a long-duration phonatory task. Short-duration tasks were found to have no effect on voice parameters.ConclusionThe results present and validate a method to isolate the effect that the length of a semi-occluded vocal tract has during straw phonation exercises.



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Pharyngeal Dystonia Mimicking Spasmodic Dysphonia

Publication date: Available online 23 June 2017
Source:Journal of Voice
Author(s): Lucy L. Shi, C. Blake Simpson, Edie R. Hapner, Hyder A. Jinnah, Michael M. Johns
ObjectiveThe aim of this study was to describe the presentation of pharyngeal dystonia (PD), which can occur as a focal or segmental dystonia with a primarily pharyngeal involvement for the discussion of treatment methods for controlling consequent symptoms. PD is specific to speech-related tasks.MethodsA retrospective medical record review of four patients with PD was performed.ResultsAll patients were initially misdiagnosed with adductor spasmodic dysphonia and failed standard treatment with botulinum toxin type A (BTX). On laryngoscopy, the patients were discovered to have segmental or focal dystonia primarily affecting the pharyngeal musculature contributing to their vocal manifestations. A novel treatment regimen was designed, which involved directing BTX injections into the muscles involved in spasmodic valving at the oropharyngeal level. After titrating to an optimal dose, all patients showed improvement in their voice and speech with only mild dysphagia. These patients have maintained favorable results with repeat injections at 6- to 12-week intervals.ConclusionsPD, or dystonia with predominant pharyngeal involvement, is a rare entity with vocal manifestations that are not well described. It can be easily mistaken for spasmodic dysphonia. PD is specific to speech-related tasks. A novel method of BTX injections into the involved muscles results in a significant improvement in voice without significant dysphagia.



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ReSound Relief: A Comprehensive Tool for Tinnitus Management

The Resound Relief app is a comprehensive tool that addresses all aspects of tinnitus management, not just the sound therapy component. With regular updates and collaborations with key opinion leaders in tinnitus research and treatment, the ReSound Relief app continuously evolves to offer more benefits to both tinnitus patients and clinicians. This course reviews the components of the ReSound Relief app along with the underlying rationale and evidence for its features.

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Difficult conversations: talking about cost in audiology consultations with older adults

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Difficult conversations: talking about cost in audiology consultations with older adults

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Difficult conversations: talking about cost in audiology consultations with older adults

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Difficult conversations: talking about cost in audiology consultations with older adults

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Difficult conversations: talking about cost in audiology consultations with older adults

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Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Tomonori Sawada, Kenji Tanimoto, Kazuki Tokuda, Yoshitaka Iwamoto, Yuta Ogata, Masaya Anan, Makoto Takahashi, Nobuhiro Kito, Koichi Shinkoda
Lateral wedge insoles (LWIs) are prescribed for patients with medial knee osteoarthritis to reduce the external knee adduction moment (KAM). However, the biomechanical effects of LWIs are limited in some patients. The purpose of this study was to investigate whether the biomechanical effects of LWIs depend on individual foot alignment and to examine the relationship between change in KAM and changes in foot and ankle biomechanics when wearing LWIs. Twenty-one patients participated in this study. They were categorized into normal or abnormal foot groups based on the foot posture index (FPI). All patients were requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record 1st and 2nd KAM, knee adduction angular impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm. Furthermore, the foot and ankle frontal plane kinematic parameters were evaluated. The 1st KAM was significantly reduced under the LWI condition compared to that under the barefoot condition in the normal foot group. In contrast, there was no significant difference in 1st KAM between both conditions in the abnormal foot group. Decreased rear foot eversion strongly correlated with reduction in the 1st KAM in the normal foot group. These findings suggested that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with medial knee osteoarthritis and that decreased rear foot eversion during the early stance phase is significantly involved in the reduction of 1st KAM when wearing LWIs with normal feet.



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Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Tomonori Sawada, Kenji Tanimoto, Kazuki Tokuda, Yoshitaka Iwamoto, Yuta Ogata, Masaya Anan, Makoto Takahashi, Nobuhiro Kito, Koichi Shinkoda
Lateral wedge insoles (LWIs) are prescribed for patients with medial knee osteoarthritis to reduce the external knee adduction moment (KAM). However, the biomechanical effects of LWIs are limited in some patients. The purpose of this study was to investigate whether the biomechanical effects of LWIs depend on individual foot alignment and to examine the relationship between change in KAM and changes in foot and ankle biomechanics when wearing LWIs. Twenty-one patients participated in this study. They were categorized into normal or abnormal foot groups based on the foot posture index (FPI). All patients were requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record 1st and 2nd KAM, knee adduction angular impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm. Furthermore, the foot and ankle frontal plane kinematic parameters were evaluated. The 1st KAM was significantly reduced under the LWI condition compared to that under the barefoot condition in the normal foot group. In contrast, there was no significant difference in 1st KAM between both conditions in the abnormal foot group. Decreased rear foot eversion strongly correlated with reduction in the 1st KAM in the normal foot group. These findings suggested that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with medial knee osteoarthritis and that decreased rear foot eversion during the early stance phase is significantly involved in the reduction of 1st KAM when wearing LWIs with normal feet.



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Rear foot kinematics when wearing lateral wedge insoles and foot alignment influence the effect of knee adduction moment for medial knee osteoarthritis

Publication date: September 2017
Source:Gait & Posture, Volume 57
Author(s): Tomonori Sawada, Kenji Tanimoto, Kazuki Tokuda, Yoshitaka Iwamoto, Yuta Ogata, Masaya Anan, Makoto Takahashi, Nobuhiro Kito, Koichi Shinkoda
Lateral wedge insoles (LWIs) are prescribed for patients with medial knee osteoarthritis to reduce the external knee adduction moment (KAM). However, the biomechanical effects of LWIs are limited in some patients. The purpose of this study was to investigate whether the biomechanical effects of LWIs depend on individual foot alignment and to examine the relationship between change in KAM and changes in foot and ankle biomechanics when wearing LWIs. Twenty-one patients participated in this study. They were categorized into normal or abnormal foot groups based on the foot posture index (FPI). All patients were requested to perform a normal gait under barefoot and LWI conditions. A three-dimensional motion analysis system was used to record 1st and 2nd KAM, knee adduction angular impulse (KAAI), center of pressure displacement, and knee-ground reaction force lever arm. Furthermore, the foot and ankle frontal plane kinematic parameters were evaluated. The 1st KAM was significantly reduced under the LWI condition compared to that under the barefoot condition in the normal foot group. In contrast, there was no significant difference in 1st KAM between both conditions in the abnormal foot group. Decreased rear foot eversion strongly correlated with reduction in the 1st KAM in the normal foot group. These findings suggested that it is helpful to assess individual foot alignment to ensure adequate insole treatment for patients with medial knee osteoarthritis and that decreased rear foot eversion during the early stance phase is significantly involved in the reduction of 1st KAM when wearing LWIs with normal feet.



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Impact of Noise and Noise Reduction on Processing Effort: A Pupillometry Study.

Objectives: Speech perception in adverse listening situations can be exhausting. Hearing loss particularly affects processing demands, as it requires increased effort for successful speech perception in background noise. Signal processing in hearing aids and noise reduction (NR) schemes aim to counteract the effect of noise and reduce the effort required for speech recognition in adverse listening situations. The present study examined the benefit of NR schemes, applying a combination of a digital NR and directional microphones, for reducing the processing effort during speech recognition. Design: The effect of noise (intelligibility level) and different NR schemes on effort were evaluated by measuring the pupil dilation of listeners. In 2 different experiments, performance accuracy and peak pupil dilation (PPD) were measured in 24 listeners with hearing impairment while they performed a speech recognition task. The listeners were tested at 2 different signal to noise ratios corresponding to either the individual 50% correct (L50) or the 95% correct (L95) performance level in a 4-talker babble condition with and without the use of a NR scheme. Results: In experiment 1, the PPD differed in response to both changes in the speech intelligibility level (L50 versus L95) and NR scheme. The PPD increased with decreasing intelligibility, indicating higher processing effort under the L50 condition compared with the L95 condition. Moreover, the PPD decreased when the NR scheme was applied, suggesting that the processing effort was reduced. In experiment 2, 2 hearing aids using different NR schemes (fast-acting and slow-acting) were compared. Processing effort changed as indicated by the PPD depending on the hearing aids and therefore on the NR scheme. Larger PPDs were measured for the slow-acting NR scheme. Conclusions: The benefit of applying an NR scheme was demonstrated for both L50 and L95, that is, a situation at which the performance level was at a ceiling. This opens the opportunity for new means of evaluating hearing aids in situations in which traditional speech reception measures are shown not to be sensitive. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Impact of Noise and Noise Reduction on Processing Effort: A Pupillometry Study.

Objectives: Speech perception in adverse listening situations can be exhausting. Hearing loss particularly affects processing demands, as it requires increased effort for successful speech perception in background noise. Signal processing in hearing aids and noise reduction (NR) schemes aim to counteract the effect of noise and reduce the effort required for speech recognition in adverse listening situations. The present study examined the benefit of NR schemes, applying a combination of a digital NR and directional microphones, for reducing the processing effort during speech recognition. Design: The effect of noise (intelligibility level) and different NR schemes on effort were evaluated by measuring the pupil dilation of listeners. In 2 different experiments, performance accuracy and peak pupil dilation (PPD) were measured in 24 listeners with hearing impairment while they performed a speech recognition task. The listeners were tested at 2 different signal to noise ratios corresponding to either the individual 50% correct (L50) or the 95% correct (L95) performance level in a 4-talker babble condition with and without the use of a NR scheme. Results: In experiment 1, the PPD differed in response to both changes in the speech intelligibility level (L50 versus L95) and NR scheme. The PPD increased with decreasing intelligibility, indicating higher processing effort under the L50 condition compared with the L95 condition. Moreover, the PPD decreased when the NR scheme was applied, suggesting that the processing effort was reduced. In experiment 2, 2 hearing aids using different NR schemes (fast-acting and slow-acting) were compared. Processing effort changed as indicated by the PPD depending on the hearing aids and therefore on the NR scheme. Larger PPDs were measured for the slow-acting NR scheme. Conclusions: The benefit of applying an NR scheme was demonstrated for both L50 and L95, that is, a situation at which the performance level was at a ceiling. This opens the opportunity for new means of evaluating hearing aids in situations in which traditional speech reception measures are shown not to be sensitive. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Impact of Noise and Noise Reduction on Processing Effort: A Pupillometry Study.

Objectives: Speech perception in adverse listening situations can be exhausting. Hearing loss particularly affects processing demands, as it requires increased effort for successful speech perception in background noise. Signal processing in hearing aids and noise reduction (NR) schemes aim to counteract the effect of noise and reduce the effort required for speech recognition in adverse listening situations. The present study examined the benefit of NR schemes, applying a combination of a digital NR and directional microphones, for reducing the processing effort during speech recognition. Design: The effect of noise (intelligibility level) and different NR schemes on effort were evaluated by measuring the pupil dilation of listeners. In 2 different experiments, performance accuracy and peak pupil dilation (PPD) were measured in 24 listeners with hearing impairment while they performed a speech recognition task. The listeners were tested at 2 different signal to noise ratios corresponding to either the individual 50% correct (L50) or the 95% correct (L95) performance level in a 4-talker babble condition with and without the use of a NR scheme. Results: In experiment 1, the PPD differed in response to both changes in the speech intelligibility level (L50 versus L95) and NR scheme. The PPD increased with decreasing intelligibility, indicating higher processing effort under the L50 condition compared with the L95 condition. Moreover, the PPD decreased when the NR scheme was applied, suggesting that the processing effort was reduced. In experiment 2, 2 hearing aids using different NR schemes (fast-acting and slow-acting) were compared. Processing effort changed as indicated by the PPD depending on the hearing aids and therefore on the NR scheme. Larger PPDs were measured for the slow-acting NR scheme. Conclusions: The benefit of applying an NR scheme was demonstrated for both L50 and L95, that is, a situation at which the performance level was at a ceiling. This opens the opportunity for new means of evaluating hearing aids in situations in which traditional speech reception measures are shown not to be sensitive. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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