Σάββατο 29 Ιουλίου 2017

Spatiotemporal and plantar pressure patterns of 1000 healthy individuals aged 3–101 years

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Marnee J. McKay, Jennifer N. Baldwin, Paulo Ferreira, Milena Simic, Natalie Vanicek, Elizabeth Wojciechowski, Anita Mudge, Joshua Burns
ObjectiveThe purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics.MethodsIn 1000 healthy males and females aged 3–101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3–9 years, adolescents aged 10–19 years, adults aged 20–59 years and older adults aged over 60 years.ResultsA comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength.ConclusionThis study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan.



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Muscle contributions to knee extension in the early stance phase in patients with knee osteoarthritis

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Shinya Ogaya, Ryo Kubota, Yuta Chujo, Eiko Hirooka, Kim Kwang-ho, Kimitaka Hase
The aim of this study was to analyze individual muscle contributions to knee angular acceleration using a musculoskeletal simulation analysis and evaluate knee extension mechanics in the early stance phase in patients with knee osteoarthritis (OA). The subjects comprised 15 patients with medial knee OA and 14 healthy elderly individuals. All participants underwent gait performance test using 8 infrared cameras and two force plates to measure the kinetic and kinematic data. The simulation was driven by 92 Hill-type muscle-tendon units of the lower extremities and a trunk with 23° of freedom. We analyzed each muscle contribution to knee angular acceleration in the 5%–15% and 15%–25% periods of the stance phase (% SP) using an induced acceleration analysis. We compared accelerations by individual muscles between the two groups using an analysis of covariance for controlling gait speed. Patients with knee OA had a significantly lesser knee extension acceleration by the vasti muscles and higher knee acceleration by hip adductors than those in controls in 5–15% SP. In addition, knee OA resulted in significantly lesser knee extension acceleration by the vasti muscles in 15–25% SP. These results indicate that patients with knee OA have decreased dependency on the vasti muscles to control knee movements during early stance phase. Hip adductor muscles, which mainly control mediolateral motion, partly compensate for the weak knee extension by the vasti muscles in patients with knee OA.



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Adding an arch support to a heel lift improves stability and comfort during gait

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Xianyi Zhang, Bo Li, Kun Hu, Qiufeng Wan, Yuhao Ding, Benedicte Vanwanseele
Heel lifts have been widely used as a conservative treatment for some musculoskeletal problems and complaints. However, the heel rise caused by heel lifts may also affect the plantar pressure distribution and stability during walking. This study aimed to test whether adding an arch support to a heel lift would improve its stability and comfort through comparing the center of pressure (COP) during walking and subjective ratings between heel lifts with and without an arch support. Fifteen healthy male participants were asked to walk along an 8m walkway while wearing high-cut footwear with the control heel lifts and the heel lifts with an arch support. A Footscan pressure plate was used to measure the COP during walking. Subjective ratings including medial-lateral control, dynamic foot/shoe fitting and overall comfort were assessed for each participant. The results showed that compared to the control condition, the COP trajectory was medially shifted during stance phase of gait in the arch support condition. The maximum displacements and velocity of medial-lateral COP in the forefoot contact phase were smaller in the arch support condition than in the control condition. Adding an arch support to a heel lift also significantly improved the subjective ratings in terms of the medial-lateral control, dynamic foot/shoe fitting and overall comfort. The findings of this study suggest that adding an arch support to a heel lift could improve its stability and comfort during walking.



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In-situ force plate calibration: 12 years’ experience with an approach for correcting the point of force application

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Renate List, Marina Hitz, Michael Angst, William R. Taylor, Silvio Lorenzetti
Force plates are common assessment tools used in biomechanics to measure ground reaction forces during motion capture or strength exercises. While the accuracy of the resulting kinetic data is critical for accurate gait analysis, factors such as plate mounting are thought to influence the measured point of force application (PFA) of the ground reaction forces. The aim of this study was therefore to present an accurate in-situ PFA calibration method. In addition, the approach was evaluated by examining the required PFA corrections over a period of ten years, which included plate remounting and a change of foundation.The in-situ PFA calibration was performed on six plates by assessing the locations of up to 98 points of force application per plate using an instrumented pole. Application of the in-situ PFA calibration approach reduced the root mean square errors by up to approximately 60% compared to the manufacturers calculation. Correction coefficients were strongly dependent on the individual platform as well as the location of the applied force on the plate. Remounting of the plates altered the plate coefficient corrections considerably, while changes over time were notable but not as extensive. We therefore recommend that plates should be recalibrated after remounting, but also at least every 5 years, in order to ensure the preservation of an accurate PFA.



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Crossover study of amputee stair ascent and descent biomechanics using Genium and C-Leg prostheses with comparison to non-amputee control

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Derek J. Lura, Matthew W. Wernke, Stephanie L. Carey, Jason T. Kahle, Rebecca M. Miro, M. Jason Highsmith
This study was a randomized crossover of stair ambulation of Transfemoral Amputees (TFAs) using the Genium and C-Leg prosthetic knees. TFAs typically have difficulty ascending and descending stairs, limiting community mobility. The objective of this study was to determine the relative efficacy of the Genium and C-Leg prostheses for stair ascent and descent, and their absolute efficacy relative to non-amputees. Twenty TFAs, and five non-amputees participated in the study. TFAs were randomized to begin the study with the Genium or C-Leg prosthesis. Informed consent was obtained from all participants prior to data collection and the study was listed on clinicaltrials.gov (#NCT01473662). After fitting, accommodation, and training, participants were asked to demonstrate their preferred gait pattern for stair ascent and descent and a step-over-step pattern if able. TFAs then switched prosthetic legs and repeated fitting, accommodation, training, and testing. An eight camera Vicon optical motion analysis system, and two AMTI force plates were used to track and analyze the participants’ gait patterns, knee flexion angles, knee moment normalized by body weight, and swing time. For stair descent, no significant differences were found between prostheses. For stair ascent, Genium use resulted in: increased ability to use a step-over-step gait pattern (p=0.03), increased prosthetic side peak knee flexion (p<0.01), and increased swing duration (p<0.01). Changes in contralateral side outcomes and in knee moment were not significant. Overall the Genium knee decreased deficiency in gait patterns for stair ascent relative to the C-Leg, by enabling gait patterns that more closely resembled non-amputees.



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Spatiotemporal and plantar pressure patterns of 1000 healthy individuals aged 3–101 years

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Marnee J. McKay, Jennifer N. Baldwin, Paulo Ferreira, Milena Simic, Natalie Vanicek, Elizabeth Wojciechowski, Anita Mudge, Joshua Burns
ObjectiveThe purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics.MethodsIn 1000 healthy males and females aged 3–101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3–9 years, adolescents aged 10–19 years, adults aged 20–59 years and older adults aged over 60 years.ResultsA comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength.ConclusionThis study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan.



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Muscle contributions to knee extension in the early stance phase in patients with knee osteoarthritis

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Shinya Ogaya, Ryo Kubota, Yuta Chujo, Eiko Hirooka, Kim Kwang-ho, Kimitaka Hase
The aim of this study was to analyze individual muscle contributions to knee angular acceleration using a musculoskeletal simulation analysis and evaluate knee extension mechanics in the early stance phase in patients with knee osteoarthritis (OA). The subjects comprised 15 patients with medial knee OA and 14 healthy elderly individuals. All participants underwent gait performance test using 8 infrared cameras and two force plates to measure the kinetic and kinematic data. The simulation was driven by 92 Hill-type muscle-tendon units of the lower extremities and a trunk with 23° of freedom. We analyzed each muscle contribution to knee angular acceleration in the 5%–15% and 15%–25% periods of the stance phase (% SP) using an induced acceleration analysis. We compared accelerations by individual muscles between the two groups using an analysis of covariance for controlling gait speed. Patients with knee OA had a significantly lesser knee extension acceleration by the vasti muscles and higher knee acceleration by hip adductors than those in controls in 5–15% SP. In addition, knee OA resulted in significantly lesser knee extension acceleration by the vasti muscles in 15–25% SP. These results indicate that patients with knee OA have decreased dependency on the vasti muscles to control knee movements during early stance phase. Hip adductor muscles, which mainly control mediolateral motion, partly compensate for the weak knee extension by the vasti muscles in patients with knee OA.



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Adding an arch support to a heel lift improves stability and comfort during gait

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Xianyi Zhang, Bo Li, Kun Hu, Qiufeng Wan, Yuhao Ding, Benedicte Vanwanseele
Heel lifts have been widely used as a conservative treatment for some musculoskeletal problems and complaints. However, the heel rise caused by heel lifts may also affect the plantar pressure distribution and stability during walking. This study aimed to test whether adding an arch support to a heel lift would improve its stability and comfort through comparing the center of pressure (COP) during walking and subjective ratings between heel lifts with and without an arch support. Fifteen healthy male participants were asked to walk along an 8m walkway while wearing high-cut footwear with the control heel lifts and the heel lifts with an arch support. A Footscan pressure plate was used to measure the COP during walking. Subjective ratings including medial-lateral control, dynamic foot/shoe fitting and overall comfort were assessed for each participant. The results showed that compared to the control condition, the COP trajectory was medially shifted during stance phase of gait in the arch support condition. The maximum displacements and velocity of medial-lateral COP in the forefoot contact phase were smaller in the arch support condition than in the control condition. Adding an arch support to a heel lift also significantly improved the subjective ratings in terms of the medial-lateral control, dynamic foot/shoe fitting and overall comfort. The findings of this study suggest that adding an arch support to a heel lift could improve its stability and comfort during walking.



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In-situ force plate calibration: 12 years’ experience with an approach for correcting the point of force application

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Renate List, Marina Hitz, Michael Angst, William R. Taylor, Silvio Lorenzetti
Force plates are common assessment tools used in biomechanics to measure ground reaction forces during motion capture or strength exercises. While the accuracy of the resulting kinetic data is critical for accurate gait analysis, factors such as plate mounting are thought to influence the measured point of force application (PFA) of the ground reaction forces. The aim of this study was therefore to present an accurate in-situ PFA calibration method. In addition, the approach was evaluated by examining the required PFA corrections over a period of ten years, which included plate remounting and a change of foundation.The in-situ PFA calibration was performed on six plates by assessing the locations of up to 98 points of force application per plate using an instrumented pole. Application of the in-situ PFA calibration approach reduced the root mean square errors by up to approximately 60% compared to the manufacturers calculation. Correction coefficients were strongly dependent on the individual platform as well as the location of the applied force on the plate. Remounting of the plates altered the plate coefficient corrections considerably, while changes over time were notable but not as extensive. We therefore recommend that plates should be recalibrated after remounting, but also at least every 5 years, in order to ensure the preservation of an accurate PFA.



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Crossover study of amputee stair ascent and descent biomechanics using Genium and C-Leg prostheses with comparison to non-amputee control

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Derek J. Lura, Matthew W. Wernke, Stephanie L. Carey, Jason T. Kahle, Rebecca M. Miro, M. Jason Highsmith
This study was a randomized crossover of stair ambulation of Transfemoral Amputees (TFAs) using the Genium and C-Leg prosthetic knees. TFAs typically have difficulty ascending and descending stairs, limiting community mobility. The objective of this study was to determine the relative efficacy of the Genium and C-Leg prostheses for stair ascent and descent, and their absolute efficacy relative to non-amputees. Twenty TFAs, and five non-amputees participated in the study. TFAs were randomized to begin the study with the Genium or C-Leg prosthesis. Informed consent was obtained from all participants prior to data collection and the study was listed on clinicaltrials.gov (#NCT01473662). After fitting, accommodation, and training, participants were asked to demonstrate their preferred gait pattern for stair ascent and descent and a step-over-step pattern if able. TFAs then switched prosthetic legs and repeated fitting, accommodation, training, and testing. An eight camera Vicon optical motion analysis system, and two AMTI force plates were used to track and analyze the participants’ gait patterns, knee flexion angles, knee moment normalized by body weight, and swing time. For stair descent, no significant differences were found between prostheses. For stair ascent, Genium use resulted in: increased ability to use a step-over-step gait pattern (p=0.03), increased prosthetic side peak knee flexion (p<0.01), and increased swing duration (p<0.01). Changes in contralateral side outcomes and in knee moment were not significant. Overall the Genium knee decreased deficiency in gait patterns for stair ascent relative to the C-Leg, by enabling gait patterns that more closely resembled non-amputees.



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Spatiotemporal and plantar pressure patterns of 1000 healthy individuals aged 3–101 years

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Marnee J. McKay, Jennifer N. Baldwin, Paulo Ferreira, Milena Simic, Natalie Vanicek, Elizabeth Wojciechowski, Anita Mudge, Joshua Burns
ObjectiveThe purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics.MethodsIn 1000 healthy males and females aged 3–101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3–9 years, adolescents aged 10–19 years, adults aged 20–59 years and older adults aged over 60 years.ResultsA comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength.ConclusionThis study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan.



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Muscle contributions to knee extension in the early stance phase in patients with knee osteoarthritis

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Shinya Ogaya, Ryo Kubota, Yuta Chujo, Eiko Hirooka, Kim Kwang-ho, Kimitaka Hase
The aim of this study was to analyze individual muscle contributions to knee angular acceleration using a musculoskeletal simulation analysis and evaluate knee extension mechanics in the early stance phase in patients with knee osteoarthritis (OA). The subjects comprised 15 patients with medial knee OA and 14 healthy elderly individuals. All participants underwent gait performance test using 8 infrared cameras and two force plates to measure the kinetic and kinematic data. The simulation was driven by 92 Hill-type muscle-tendon units of the lower extremities and a trunk with 23° of freedom. We analyzed each muscle contribution to knee angular acceleration in the 5%–15% and 15%–25% periods of the stance phase (% SP) using an induced acceleration analysis. We compared accelerations by individual muscles between the two groups using an analysis of covariance for controlling gait speed. Patients with knee OA had a significantly lesser knee extension acceleration by the vasti muscles and higher knee acceleration by hip adductors than those in controls in 5–15% SP. In addition, knee OA resulted in significantly lesser knee extension acceleration by the vasti muscles in 15–25% SP. These results indicate that patients with knee OA have decreased dependency on the vasti muscles to control knee movements during early stance phase. Hip adductor muscles, which mainly control mediolateral motion, partly compensate for the weak knee extension by the vasti muscles in patients with knee OA.



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Adding an arch support to a heel lift improves stability and comfort during gait

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Xianyi Zhang, Bo Li, Kun Hu, Qiufeng Wan, Yuhao Ding, Benedicte Vanwanseele
Heel lifts have been widely used as a conservative treatment for some musculoskeletal problems and complaints. However, the heel rise caused by heel lifts may also affect the plantar pressure distribution and stability during walking. This study aimed to test whether adding an arch support to a heel lift would improve its stability and comfort through comparing the center of pressure (COP) during walking and subjective ratings between heel lifts with and without an arch support. Fifteen healthy male participants were asked to walk along an 8m walkway while wearing high-cut footwear with the control heel lifts and the heel lifts with an arch support. A Footscan pressure plate was used to measure the COP during walking. Subjective ratings including medial-lateral control, dynamic foot/shoe fitting and overall comfort were assessed for each participant. The results showed that compared to the control condition, the COP trajectory was medially shifted during stance phase of gait in the arch support condition. The maximum displacements and velocity of medial-lateral COP in the forefoot contact phase were smaller in the arch support condition than in the control condition. Adding an arch support to a heel lift also significantly improved the subjective ratings in terms of the medial-lateral control, dynamic foot/shoe fitting and overall comfort. The findings of this study suggest that adding an arch support to a heel lift could improve its stability and comfort during walking.



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In-situ force plate calibration: 12 years’ experience with an approach for correcting the point of force application

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Renate List, Marina Hitz, Michael Angst, William R. Taylor, Silvio Lorenzetti
Force plates are common assessment tools used in biomechanics to measure ground reaction forces during motion capture or strength exercises. While the accuracy of the resulting kinetic data is critical for accurate gait analysis, factors such as plate mounting are thought to influence the measured point of force application (PFA) of the ground reaction forces. The aim of this study was therefore to present an accurate in-situ PFA calibration method. In addition, the approach was evaluated by examining the required PFA corrections over a period of ten years, which included plate remounting and a change of foundation.The in-situ PFA calibration was performed on six plates by assessing the locations of up to 98 points of force application per plate using an instrumented pole. Application of the in-situ PFA calibration approach reduced the root mean square errors by up to approximately 60% compared to the manufacturers calculation. Correction coefficients were strongly dependent on the individual platform as well as the location of the applied force on the plate. Remounting of the plates altered the plate coefficient corrections considerably, while changes over time were notable but not as extensive. We therefore recommend that plates should be recalibrated after remounting, but also at least every 5 years, in order to ensure the preservation of an accurate PFA.



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Crossover study of amputee stair ascent and descent biomechanics using Genium and C-Leg prostheses with comparison to non-amputee control

Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Derek J. Lura, Matthew W. Wernke, Stephanie L. Carey, Jason T. Kahle, Rebecca M. Miro, M. Jason Highsmith
This study was a randomized crossover of stair ambulation of Transfemoral Amputees (TFAs) using the Genium and C-Leg prosthetic knees. TFAs typically have difficulty ascending and descending stairs, limiting community mobility. The objective of this study was to determine the relative efficacy of the Genium and C-Leg prostheses for stair ascent and descent, and their absolute efficacy relative to non-amputees. Twenty TFAs, and five non-amputees participated in the study. TFAs were randomized to begin the study with the Genium or C-Leg prosthesis. Informed consent was obtained from all participants prior to data collection and the study was listed on clinicaltrials.gov (#NCT01473662). After fitting, accommodation, and training, participants were asked to demonstrate their preferred gait pattern for stair ascent and descent and a step-over-step pattern if able. TFAs then switched prosthetic legs and repeated fitting, accommodation, training, and testing. An eight camera Vicon optical motion analysis system, and two AMTI force plates were used to track and analyze the participants’ gait patterns, knee flexion angles, knee moment normalized by body weight, and swing time. For stair descent, no significant differences were found between prostheses. For stair ascent, Genium use resulted in: increased ability to use a step-over-step gait pattern (p=0.03), increased prosthetic side peak knee flexion (p<0.01), and increased swing duration (p<0.01). Changes in contralateral side outcomes and in knee moment were not significant. Overall the Genium knee decreased deficiency in gait patterns for stair ascent relative to the C-Leg, by enabling gait patterns that more closely resembled non-amputees.



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Speech reception with different bilateral directional processing schemes: Influence of binaural hearing, audiometric asymmetry, and acoustic scenario

Publication date: Available online 29 July 2017
Source:Hearing Research
Author(s): Tobias Neher, Kirsten C. Wagener, Matthias Latzel
Hearing aid (HA) users can differ markedly in their benefit from directional processing (or beamforming) algorithms. The current study therefore investigated candidacy for different bilateral directional processing schemes. Groups of elderly listeners with symmetric (N = 20) or asymmetric (N = 19) hearing thresholds for frequencies below 2 kHz, a large spread in the binaural intelligibility level difference (BILD), and no difference in age, overall degree of hearing loss, or performance on a measure of selective attention took part. Aided speech reception was measured using virtual acoustics together with a simulation of a linked pair of completely occluding behind-the-ear HAs. Five processing schemes and three acoustic scenarios were used. The processing schemes differed in the tradeoff between signal-to-noise ratio (SNR) improvement and binaural cue preservation. The acoustic scenarios consisted of a frontal target talker presented against two speech maskers from ±60° azimuth or spatially diffuse cafeteria noise. For both groups, a significant interaction between BILD, processing scheme, and acoustic scenario was found. This interaction implied that, in situations with lateral speech maskers, HA users with BILDs larger than about 2 dB profited more from preserved low-frequency binaural cues than from greater SNR improvement, whereas for smaller BILDs the opposite was true. Audiometric asymmetry reduced the influence of binaural hearing. In spatially diffuse noise, the maximal SNR improvement was generally beneficial. N0Sπ detection performance at 500 Hz predicted the benefit from low-frequency binaural cues. Together, these findings provide a basis for adapting bilateral directional processing to individual and situational influences. Further research is needed to investigate their generalizability to more realistic HA conditions (e.g., with low-frequency vent-transmitted sound).



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Speech reception with different bilateral directional processing schemes: Influence of binaural hearing, audiometric asymmetry, and acoustic scenario

Publication date: Available online 29 July 2017
Source:Hearing Research
Author(s): Tobias Neher, Kirsten C. Wagener, Matthias Latzel
Hearing aid (HA) users can differ markedly in their benefit from directional processing (or beamforming) algorithms. The current study therefore investigated candidacy for different bilateral directional processing schemes. Groups of elderly listeners with symmetric (N = 20) or asymmetric (N = 19) hearing thresholds for frequencies below 2 kHz, a large spread in the binaural intelligibility level difference (BILD), and no difference in age, overall degree of hearing loss, or performance on a measure of selective attention took part. Aided speech reception was measured using virtual acoustics together with a simulation of a linked pair of completely occluding behind-the-ear HAs. Five processing schemes and three acoustic scenarios were used. The processing schemes differed in the tradeoff between signal-to-noise ratio (SNR) improvement and binaural cue preservation. The acoustic scenarios consisted of a frontal target talker presented against two speech maskers from ±60° azimuth or spatially diffuse cafeteria noise. For both groups, a significant interaction between BILD, processing scheme, and acoustic scenario was found. This interaction implied that, in situations with lateral speech maskers, HA users with BILDs larger than about 2 dB profited more from preserved low-frequency binaural cues than from greater SNR improvement, whereas for smaller BILDs the opposite was true. Audiometric asymmetry reduced the influence of binaural hearing. In spatially diffuse noise, the maximal SNR improvement was generally beneficial. N0Sπ detection performance at 500 Hz predicted the benefit from low-frequency binaural cues. Together, these findings provide a basis for adapting bilateral directional processing to individual and situational influences. Further research is needed to investigate their generalizability to more realistic HA conditions (e.g., with low-frequency vent-transmitted sound).



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Speech reception with different bilateral directional processing schemes: Influence of binaural hearing, audiometric asymmetry, and acoustic scenario

Publication date: Available online 29 July 2017
Source:Hearing Research
Author(s): Tobias Neher, Kirsten C. Wagener, Matthias Latzel
Hearing aid (HA) users can differ markedly in their benefit from directional processing (or beamforming) algorithms. The current study therefore investigated candidacy for different bilateral directional processing schemes. Groups of elderly listeners with symmetric (N = 20) or asymmetric (N = 19) hearing thresholds for frequencies below 2 kHz, a large spread in the binaural intelligibility level difference (BILD), and no difference in age, overall degree of hearing loss, or performance on a measure of selective attention took part. Aided speech reception was measured using virtual acoustics together with a simulation of a linked pair of completely occluding behind-the-ear HAs. Five processing schemes and three acoustic scenarios were used. The processing schemes differed in the tradeoff between signal-to-noise ratio (SNR) improvement and binaural cue preservation. The acoustic scenarios consisted of a frontal target talker presented against two speech maskers from ±60° azimuth or spatially diffuse cafeteria noise. For both groups, a significant interaction between BILD, processing scheme, and acoustic scenario was found. This interaction implied that, in situations with lateral speech maskers, HA users with BILDs larger than about 2 dB profited more from preserved low-frequency binaural cues than from greater SNR improvement, whereas for smaller BILDs the opposite was true. Audiometric asymmetry reduced the influence of binaural hearing. In spatially diffuse noise, the maximal SNR improvement was generally beneficial. N0Sπ detection performance at 500 Hz predicted the benefit from low-frequency binaural cues. Together, these findings provide a basis for adapting bilateral directional processing to individual and situational influences. Further research is needed to investigate their generalizability to more realistic HA conditions (e.g., with low-frequency vent-transmitted sound).



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Speech reception with different bilateral directional processing schemes: Influence of binaural hearing, audiometric asymmetry, and acoustic scenario

Publication date: Available online 29 July 2017
Source:Hearing Research
Author(s): Tobias Neher, Kirsten C. Wagener, Matthias Latzel
Hearing aid (HA) users can differ markedly in their benefit from directional processing (or beamforming) algorithms. The current study therefore investigated candidacy for different bilateral directional processing schemes. Groups of elderly listeners with symmetric (N = 20) or asymmetric (N = 19) hearing thresholds for frequencies below 2 kHz, a large spread in the binaural intelligibility level difference (BILD), and no difference in age, overall degree of hearing loss, or performance on a measure of selective attention took part. Aided speech reception was measured using virtual acoustics together with a simulation of a linked pair of completely occluding behind-the-ear HAs. Five processing schemes and three acoustic scenarios were used. The processing schemes differed in the tradeoff between signal-to-noise ratio (SNR) improvement and binaural cue preservation. The acoustic scenarios consisted of a frontal target talker presented against two speech maskers from ±60° azimuth or spatially diffuse cafeteria noise. For both groups, a significant interaction between BILD, processing scheme, and acoustic scenario was found. This interaction implied that, in situations with lateral speech maskers, HA users with BILDs larger than about 2 dB profited more from preserved low-frequency binaural cues than from greater SNR improvement, whereas for smaller BILDs the opposite was true. Audiometric asymmetry reduced the influence of binaural hearing. In spatially diffuse noise, the maximal SNR improvement was generally beneficial. N0Sπ detection performance at 500 Hz predicted the benefit from low-frequency binaural cues. Together, these findings provide a basis for adapting bilateral directional processing to individual and situational influences. Further research is needed to investigate their generalizability to more realistic HA conditions (e.g., with low-frequency vent-transmitted sound).



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Speech reception with different bilateral directional processing schemes: Influence of binaural hearing, audiometric asymmetry, and acoustic scenario

Publication date: Available online 29 July 2017
Source:Hearing Research
Author(s): Tobias Neher, Kirsten C. Wagener, Matthias Latzel
Hearing aid (HA) users can differ markedly in their benefit from directional processing (or beamforming) algorithms. The current study therefore investigated candidacy for different bilateral directional processing schemes. Groups of elderly listeners with symmetric (N = 20) or asymmetric (N = 19) hearing thresholds for frequencies below 2 kHz, a large spread in the binaural intelligibility level difference (BILD), and no difference in age, overall degree of hearing loss, or performance on a measure of selective attention took part. Aided speech reception was measured using virtual acoustics together with a simulation of a linked pair of completely occluding behind-the-ear HAs. Five processing schemes and three acoustic scenarios were used. The processing schemes differed in the tradeoff between signal-to-noise ratio (SNR) improvement and binaural cue preservation. The acoustic scenarios consisted of a frontal target talker presented against two speech maskers from ±60° azimuth or spatially diffuse cafeteria noise. For both groups, a significant interaction between BILD, processing scheme, and acoustic scenario was found. This interaction implied that, in situations with lateral speech maskers, HA users with BILDs larger than about 2 dB profited more from preserved low-frequency binaural cues than from greater SNR improvement, whereas for smaller BILDs the opposite was true. Audiometric asymmetry reduced the influence of binaural hearing. In spatially diffuse noise, the maximal SNR improvement was generally beneficial. N0Sπ detection performance at 500 Hz predicted the benefit from low-frequency binaural cues. Together, these findings provide a basis for adapting bilateral directional processing to individual and situational influences. Further research is needed to investigate their generalizability to more realistic HA conditions (e.g., with low-frequency vent-transmitted sound).



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Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings

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Publication date: Available online 29 July 2017
Source:Journal of Voice
Author(s): Leah McKinnon-Howe, Jayme Dowdall
ObjectiveThe goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings.Study DesignThis pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist.MethodsA web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists.ResultsTwenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index.ConclusionThe data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population.



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Auditory Phenotype of Smith-Magenis Syndrome.

http:--pubs.asha.org-images-b_pubmed_ful Related Articles

Auditory Phenotype of Smith-Magenis Syndrome.

J Speech Lang Hear Res. 2017 Apr 14;60(4):1076-1087

Authors: Brendal MA, King KA, Zalewski CK, Finucane BM, Introne W, Brewer CC, Smith ACM

Abstract
Purpose: The purpose of this study was to describe the auditory phenotype of a large cohort with Smith-Magenis syndrome (SMS), a rare disorder including physical anomalies, cognitive deficits, sleep disturbances, and a distinct behavioral phenotype.
Method: Hearing-related data were collected for 133 individuals with SMS aged 1-49 years. Audiogram data (97 participants) were used for cross-sectional and longitudinal analyses. Caregivers completed a sound sensitivity survey for 98 individuals with SMS and a control group of 24 unaffected siblings.
Results: Nearly 80% of participants with interpretable audiograms (n = 76) had hearing loss, which was typically slight to mild in degree. When hearing loss type could be determined (40 participants), sensorineural hearing loss (48.1%) occurred most often in participants aged 11-49 years. Conductive hearing loss (35.2%) was typically observed in children aged 1-10 years. A pattern of fluctuating and progressive hearing decline was documented. Hyperacusis was reported in 73.5% of participants with SMS compared with 12.5% of unaffected siblings.
Conclusions: This study offers the most comprehensive characterization of the auditory phenotype of SMS to date. The auditory profile in SMS is multifaceted and can include a previously unreported manifestation of hyperacusis. Routine audiologic surveillance is recommended as part of standard clinical care.

PMID: 28384694 [PubMed - indexed for MEDLINE]



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Re: Skin Necrosis After Implantation With the BAHA Attract: a Case Report and Review of the Literature: Chen SY, Mancuso D, and Lalwani AK. Otol Neurotol 2017 Mar;38(3): 364-367.

No abstract available

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New Study Finds Noise Exposure Not Linked to Hearing Loss in Youths

Researchers have found that prolonged or recent noise exposure is not consistently associated with an increased risk of hearing loss among those aged 12-19 based on data from the National Health and Nutrition Examination Surveys from 1988 to 2010 (JAMA Otolaryngol Head Neck Surg. 2017 [Epub ahead of print]). They analyzed the audiometric measurements of 7,036 survey participants in this study; and while there was an overall rise in exposure to loud noise or music through headphones 24 hours prior to audiometric testing, they discovered that the prevalence of hearing loss has dropped to 15.2 percent in 2009-2010, compared with 17 and 22.5 percent in the 1988-1994 and 2007-2008 surveys respectively. The authors concluded that there was no association between noise-induced threshold shift and noise exposures and that their findings call into question previous conclusions that increasing noise exposure is responsible for increasing levels of pediatric hearing loss.

​One of the authors, Dylan Chan, MD, PhD, spoke to the New York Times about the study and attributed the decrease in prevalence to behavioral changes such as avoiding noise and wearing volume-limiting headphones designed for children. "I hope people don't take this as an excuse to say noise-induced hearing loss is not a problem, so we can go back to listening to headphones at full volume," he said. 

Published: 7/28/2017 9:33:00 AM


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New Study Finds Noise Exposure Not Linked to Hearing Loss in Youths

Researchers have found that prolonged or recent noise exposure is not consistently associated with an increased risk of hearing loss among those aged 12-19 based on data from the National Health and Nutrition Examination Surveys from 1988 to 2010 (JAMA Otolaryngol Head Neck Surg. 2017 [Epub ahead of print]). They analyzed the audiometric measurements of 7,036 survey participants in this study; and while there was an overall rise in exposure to loud noise or music through headphones 24 hours prior to audiometric testing, they discovered that the prevalence of hearing loss has dropped to 15.2 percent in 2009-2010, compared with 17 and 22.5 percent in the 1988-1994 and 2007-2008 surveys respectively. The authors concluded that there was no association between noise-induced threshold shift and noise exposures and that their findings call into question previous conclusions that increasing noise exposure is responsible for increasing levels of pediatric hearing loss.

​One of the authors, Dylan Chan, MD, PhD, spoke to the New York Times about the study and attributed the decrease in prevalence to behavioral changes such as avoiding noise and wearing volume-limiting headphones designed for children. "I hope people don't take this as an excuse to say noise-induced hearing loss is not a problem, so we can go back to listening to headphones at full volume," he said. 

Published: 7/28/2017 9:33:00 AM


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New Study Finds Noise Exposure Not Linked to Hearing Loss in Youths

Researchers have found that prolonged or recent noise exposure is not consistently associated with an increased risk of hearing loss among those aged 12-19 based on data from the National Health and Nutrition Examination Surveys from 1988 to 2010 (JAMA Otolaryngol Head Neck Surg. 2017 [Epub ahead of print]). They analyzed the audiometric measurements of 7,036 survey participants in this study; and while there was an overall rise in exposure to loud noise or music through headphones 24 hours prior to audiometric testing, they discovered that the prevalence of hearing loss has dropped to 15.2 percent in 2009-2010, compared with 17 and 22.5 percent in the 1988-1994 and 2007-2008 surveys respectively. The authors concluded that there was no association between noise-induced threshold shift and noise exposures and that their findings call into question previous conclusions that increasing noise exposure is responsible for increasing levels of pediatric hearing loss.

​One of the authors, Dylan Chan, MD, PhD, spoke to the New York Times about the study and attributed the decrease in prevalence to behavioral changes such as avoiding noise and wearing volume-limiting headphones designed for children. "I hope people don't take this as an excuse to say noise-induced hearing loss is not a problem, so we can go back to listening to headphones at full volume," he said. 

Published: 7/28/2017 9:33:00 AM


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