Translation, Adaptation, and Preliminary Validation of Dacakis and Davies' “Transsexual Voice Questionnaire (Male to Female)” in French

Publication date: Available online 30 March 2018
Source:Journal of Voice
Author(s): Dominique Morsomme, Joana Revis, Elisabeth Thomas
Transgender MtF people (trans women) consult otorhinolaryngologists and vocologists with the aim of feminizing their voice and being consistently perceived as women. Treatment of these trans women always begins with a vocal assessment that is relatively unspecific as it was originally constructed for individuals with dysphonia.ObjectivesThis study examines the subjective portion of the assessment and specifically the self-assessment questionnaire. There is no French-language questionnaire designed to identify the issues facing people who want voice feminization and quantify the impact of their voice disorder on their daily lives.We present a translation and adaption into French of the questionnaire developed by Dacakis et al [6].MethodsThis work follows the World Health Organization recommendations [12] regarding translation. Thirty-six Belgian and French trans women took part in this study.ResultsThe results show excellent repeatability and reliability, while the construct validity measures show that the items correlate with six areas of concern for trans women identified by Davies and Johnson [7] in a previous study. The domains are the following: effect of voice on ease of social interaction, effect of voice on emotions, relationship between voice and gender identity, effort and concentration required to produce voice, physical aspects of voice production, and pitch.Concurrent validity could not be measured owing to lack of sufficiently detailed stories.ConclusionThe psychometric properties of the French version of the questionnaire are acceptable. The questionnaire can be used as is in daily clinical practice.



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Injectable Silk Protein Microparticle-based Fillers: A Novel Material for Potential Use in Glottic Insufficiency

Publication date: Available online 30 March 2018
Source:Journal of Voice
Author(s): Joseph E. Brown, Christopher P. Gulka, Jodie E.M. Giordano, Maria P. Montero, Anh Hoang, Thomas L. Carroll
Objectives and HypothesisA novel, silk protein-based injectable filler was engineered with the intention of vocal fold augmentation as its eventual intended use. This injectable filler leverages the unique properties of silk protein's superior biocompatibility, mechanical tunability, and slow in vivo degradation to one day better serve the needs of otolaryngologists. This paper intends to demonstrate the mechanical properties of the proposed novel injectable and to evaluate its longevity in animal models.Materials and MethodsExperimental. The mechanical properties of silk bulking agents were determined to characterize deformation resistance and recovery compared with commercially available calcium hydroxylapatite through rheologic testing. Fresh porcine vocal fold tissue was used for injectable placement to simulate the mechanical outcomes of native tissue after bulking procedures. In vivo subcutaneous rodent implantation examined immune response, particle migration, and volume retention.ResultsPorous, elastomeric silk microparticles demonstrate high recovery (>90% original volume) from compressive strain and mimic the native storage modulus of soft tissues (1–3 kPa). Injectable silk causes only a slight increase in porcine vocal fold stiffness immediately after injection (20%), preserving the native mechanics of bulked tissue. In the subcutaneous rat model, silk demonstrated biocompatibility and slow degradation, thus enabling host cell integration and tissue deposition.ConclusionsThe presented novel silk injectable material demonstrates favorable qualities for a vocal fold injection augmentation material. An in vivo long-term canine study is planned.



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A perspective on brain-behavior relationships and effects of age and hearing using speech-in-noise stimuli

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Curtis J. Billings, Brandon M. Madsen
Understanding speech in background noise is often more difficult for individuals who are older and have hearing impairment than for younger, normal-hearing individuals. In fact, speech-understanding abilities among older individuals with hearing impairment varies greatly. Researchers have hypothesized that some of that variability can be explained by how the brain encodes speech signals in the presence of noise, and that brain measures may be useful for predicting behavioral performance in difficult-to-test patients. In a series of experiments, we have explored the effects of age and hearing impairment in both brain and behavioral domains with the goal of using brain measures to improve our understanding of speech-in-noise difficulties. The behavioral measures examined showed effect sizes for hearing impairment that were 6–10 dB larger than the effects of age when tested in steady-state noise, whereas electrophysiological age effects were similar in magnitude to those of hearing impairment. Both age and hearing status influence neural responses to speech as well as speech understanding in background noise. These effects can in turn be modulated by other factors, such as the characteristics of the background noise itself. Finally, the use of electrophysiology to predict performance on receptive speech-in-noise tasks holds promise, demonstrating root-mean-square prediction errors as small as 1–2 dB. An important next step in this field of inquiry is to sample the aging and hearing impairment variables continuously (rather than categorically) – across the whole lifespan and audiogram – to improve effect estimates.



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Hearing, self-motion perception, mobility, and aging

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Jennifer Campos, Robert Ramkhalawansingh, M. Kathleen Pichora-Fuller
Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (vision, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experimental studies have shown evidence that hearing loss is associated with greater walking difficulties, poorer overall physical functioning, and a significantly increased risk of falling in older adults. Importantly, the mechanisms underlying the associations between hearing status and mobility are poorly understood. It is also critical to consider that age-related hearing loss is often concomitant with declines in other sensory, motor, and cognitive functions and that these declines may interact, particularly during realistic, everyday tasks. Overall, exploring the role of auditory cues and the effects of hearing loss on self-motion perception specifically, and mobility more generally, is important to both building fundamental knowledge on the perceptual processes underlying the ability to perceive our movements through space, as well as to optimizing mobility-related interventions for those with hearing loss so that they can function better when confronted by everyday real-world sensory-motor challenges. The goal of this paper is to explore the role of hearing in self-motion perception across a range of mobility-related behaviors. First, we briefly review the ways in which auditory cues are used to perceive self-motion and how sound inputs affect behaviors such as standing balance, walking, and driving. Next, we consider age-related changes in auditory self-motion perception and the potential consequences to the performance of mobility-related tasks. We then describe how hearing loss is associated with declines in mobility-related abilities and increased adverse outcomes such as falls. We describe age-related changes to other sensory and cognitive functions and how these may interact with hearing loss in ways that affect mobility. Finally, we briefly consider the implications of the hearing-mobility associations with respect to applied domains such as screening for mobility problems and falls risk in those with hearing loss and developing interventions and training approaches targeting safe and independent mobility throughout the lifespan.



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A perspective on brain-behavior relationships and effects of age and hearing using speech-in-noise stimuli

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Curtis J. Billings, Brandon M. Madsen
Understanding speech in background noise is often more difficult for individuals who are older and have hearing impairment than for younger, normal-hearing individuals. In fact, speech-understanding abilities among older individuals with hearing impairment varies greatly. Researchers have hypothesized that some of that variability can be explained by how the brain encodes speech signals in the presence of noise, and that brain measures may be useful for predicting behavioral performance in difficult-to-test patients. In a series of experiments, we have explored the effects of age and hearing impairment in both brain and behavioral domains with the goal of using brain measures to improve our understanding of speech-in-noise difficulties. The behavioral measures examined showed effect sizes for hearing impairment that were 6–10 dB larger than the effects of age when tested in steady-state noise, whereas electrophysiological age effects were similar in magnitude to those of hearing impairment. Both age and hearing status influence neural responses to speech as well as speech understanding in background noise. These effects can in turn be modulated by other factors, such as the characteristics of the background noise itself. Finally, the use of electrophysiology to predict performance on receptive speech-in-noise tasks holds promise, demonstrating root-mean-square prediction errors as small as 1–2 dB. An important next step in this field of inquiry is to sample the aging and hearing impairment variables continuously (rather than categorically) – across the whole lifespan and audiogram – to improve effect estimates.



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Hearing, self-motion perception, mobility, and aging

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Jennifer Campos, Robert Ramkhalawansingh, M. Kathleen Pichora-Fuller
Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (vision, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experimental studies have shown evidence that hearing loss is associated with greater walking difficulties, poorer overall physical functioning, and a significantly increased risk of falling in older adults. Importantly, the mechanisms underlying the associations between hearing status and mobility are poorly understood. It is also critical to consider that age-related hearing loss is often concomitant with declines in other sensory, motor, and cognitive functions and that these declines may interact, particularly during realistic, everyday tasks. Overall, exploring the role of auditory cues and the effects of hearing loss on self-motion perception specifically, and mobility more generally, is important to both building fundamental knowledge on the perceptual processes underlying the ability to perceive our movements through space, as well as to optimizing mobility-related interventions for those with hearing loss so that they can function better when confronted by everyday real-world sensory-motor challenges. The goal of this paper is to explore the role of hearing in self-motion perception across a range of mobility-related behaviors. First, we briefly review the ways in which auditory cues are used to perceive self-motion and how sound inputs affect behaviors such as standing balance, walking, and driving. Next, we consider age-related changes in auditory self-motion perception and the potential consequences to the performance of mobility-related tasks. We then describe how hearing loss is associated with declines in mobility-related abilities and increased adverse outcomes such as falls. We describe age-related changes to other sensory and cognitive functions and how these may interact with hearing loss in ways that affect mobility. Finally, we briefly consider the implications of the hearing-mobility associations with respect to applied domains such as screening for mobility problems and falls risk in those with hearing loss and developing interventions and training approaches targeting safe and independent mobility throughout the lifespan.



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A perspective on brain-behavior relationships and effects of age and hearing using speech-in-noise stimuli

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Curtis J. Billings, Brandon M. Madsen
Understanding speech in background noise is often more difficult for individuals who are older and have hearing impairment than for younger, normal-hearing individuals. In fact, speech-understanding abilities among older individuals with hearing impairment varies greatly. Researchers have hypothesized that some of that variability can be explained by how the brain encodes speech signals in the presence of noise, and that brain measures may be useful for predicting behavioral performance in difficult-to-test patients. In a series of experiments, we have explored the effects of age and hearing impairment in both brain and behavioral domains with the goal of using brain measures to improve our understanding of speech-in-noise difficulties. The behavioral measures examined showed effect sizes for hearing impairment that were 6–10 dB larger than the effects of age when tested in steady-state noise, whereas electrophysiological age effects were similar in magnitude to those of hearing impairment. Both age and hearing status influence neural responses to speech as well as speech understanding in background noise. These effects can in turn be modulated by other factors, such as the characteristics of the background noise itself. Finally, the use of electrophysiology to predict performance on receptive speech-in-noise tasks holds promise, demonstrating root-mean-square prediction errors as small as 1–2 dB. An important next step in this field of inquiry is to sample the aging and hearing impairment variables continuously (rather than categorically) – across the whole lifespan and audiogram – to improve effect estimates.



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Hearing, self-motion perception, mobility, and aging

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Jennifer Campos, Robert Ramkhalawansingh, M. Kathleen Pichora-Fuller
Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (vision, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experimental studies have shown evidence that hearing loss is associated with greater walking difficulties, poorer overall physical functioning, and a significantly increased risk of falling in older adults. Importantly, the mechanisms underlying the associations between hearing status and mobility are poorly understood. It is also critical to consider that age-related hearing loss is often concomitant with declines in other sensory, motor, and cognitive functions and that these declines may interact, particularly during realistic, everyday tasks. Overall, exploring the role of auditory cues and the effects of hearing loss on self-motion perception specifically, and mobility more generally, is important to both building fundamental knowledge on the perceptual processes underlying the ability to perceive our movements through space, as well as to optimizing mobility-related interventions for those with hearing loss so that they can function better when confronted by everyday real-world sensory-motor challenges. The goal of this paper is to explore the role of hearing in self-motion perception across a range of mobility-related behaviors. First, we briefly review the ways in which auditory cues are used to perceive self-motion and how sound inputs affect behaviors such as standing balance, walking, and driving. Next, we consider age-related changes in auditory self-motion perception and the potential consequences to the performance of mobility-related tasks. We then describe how hearing loss is associated with declines in mobility-related abilities and increased adverse outcomes such as falls. We describe age-related changes to other sensory and cognitive functions and how these may interact with hearing loss in ways that affect mobility. Finally, we briefly consider the implications of the hearing-mobility associations with respect to applied domains such as screening for mobility problems and falls risk in those with hearing loss and developing interventions and training approaches targeting safe and independent mobility throughout the lifespan.



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A perspective on brain-behavior relationships and effects of age and hearing using speech-in-noise stimuli

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Curtis J. Billings, Brandon M. Madsen
Understanding speech in background noise is often more difficult for individuals who are older and have hearing impairment than for younger, normal-hearing individuals. In fact, speech-understanding abilities among older individuals with hearing impairment varies greatly. Researchers have hypothesized that some of that variability can be explained by how the brain encodes speech signals in the presence of noise, and that brain measures may be useful for predicting behavioral performance in difficult-to-test patients. In a series of experiments, we have explored the effects of age and hearing impairment in both brain and behavioral domains with the goal of using brain measures to improve our understanding of speech-in-noise difficulties. The behavioral measures examined showed effect sizes for hearing impairment that were 6–10 dB larger than the effects of age when tested in steady-state noise, whereas electrophysiological age effects were similar in magnitude to those of hearing impairment. Both age and hearing status influence neural responses to speech as well as speech understanding in background noise. These effects can in turn be modulated by other factors, such as the characteristics of the background noise itself. Finally, the use of electrophysiology to predict performance on receptive speech-in-noise tasks holds promise, demonstrating root-mean-square prediction errors as small as 1–2 dB. An important next step in this field of inquiry is to sample the aging and hearing impairment variables continuously (rather than categorically) – across the whole lifespan and audiogram – to improve effect estimates.



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Hearing, self-motion perception, mobility, and aging

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Jennifer Campos, Robert Ramkhalawansingh, M. Kathleen Pichora-Fuller
Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (vision, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experimental studies have shown evidence that hearing loss is associated with greater walking difficulties, poorer overall physical functioning, and a significantly increased risk of falling in older adults. Importantly, the mechanisms underlying the associations between hearing status and mobility are poorly understood. It is also critical to consider that age-related hearing loss is often concomitant with declines in other sensory, motor, and cognitive functions and that these declines may interact, particularly during realistic, everyday tasks. Overall, exploring the role of auditory cues and the effects of hearing loss on self-motion perception specifically, and mobility more generally, is important to both building fundamental knowledge on the perceptual processes underlying the ability to perceive our movements through space, as well as to optimizing mobility-related interventions for those with hearing loss so that they can function better when confronted by everyday real-world sensory-motor challenges. The goal of this paper is to explore the role of hearing in self-motion perception across a range of mobility-related behaviors. First, we briefly review the ways in which auditory cues are used to perceive self-motion and how sound inputs affect behaviors such as standing balance, walking, and driving. Next, we consider age-related changes in auditory self-motion perception and the potential consequences to the performance of mobility-related tasks. We then describe how hearing loss is associated with declines in mobility-related abilities and increased adverse outcomes such as falls. We describe age-related changes to other sensory and cognitive functions and how these may interact with hearing loss in ways that affect mobility. Finally, we briefly consider the implications of the hearing-mobility associations with respect to applied domains such as screening for mobility problems and falls risk in those with hearing loss and developing interventions and training approaches targeting safe and independent mobility throughout the lifespan.



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A perspective on brain-behavior relationships and effects of age and hearing using speech-in-noise stimuli

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Curtis J. Billings, Brandon M. Madsen
Understanding speech in background noise is often more difficult for individuals who are older and have hearing impairment than for younger, normal-hearing individuals. In fact, speech-understanding abilities among older individuals with hearing impairment varies greatly. Researchers have hypothesized that some of that variability can be explained by how the brain encodes speech signals in the presence of noise, and that brain measures may be useful for predicting behavioral performance in difficult-to-test patients. In a series of experiments, we have explored the effects of age and hearing impairment in both brain and behavioral domains with the goal of using brain measures to improve our understanding of speech-in-noise difficulties. The behavioral measures examined showed effect sizes for hearing impairment that were 6–10 dB larger than the effects of age when tested in steady-state noise, whereas electrophysiological age effects were similar in magnitude to those of hearing impairment. Both age and hearing status influence neural responses to speech as well as speech understanding in background noise. These effects can in turn be modulated by other factors, such as the characteristics of the background noise itself. Finally, the use of electrophysiology to predict performance on receptive speech-in-noise tasks holds promise, demonstrating root-mean-square prediction errors as small as 1–2 dB. An important next step in this field of inquiry is to sample the aging and hearing impairment variables continuously (rather than categorically) – across the whole lifespan and audiogram – to improve effect estimates.



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Hearing, self-motion perception, mobility, and aging

Publication date: Available online 31 March 2018
Source:Hearing Research
Author(s): Jennifer Campos, Robert Ramkhalawansingh, M. Kathleen Pichora-Fuller
Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (vision, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experimental studies have shown evidence that hearing loss is associated with greater walking difficulties, poorer overall physical functioning, and a significantly increased risk of falling in older adults. Importantly, the mechanisms underlying the associations between hearing status and mobility are poorly understood. It is also critical to consider that age-related hearing loss is often concomitant with declines in other sensory, motor, and cognitive functions and that these declines may interact, particularly during realistic, everyday tasks. Overall, exploring the role of auditory cues and the effects of hearing loss on self-motion perception specifically, and mobility more generally, is important to both building fundamental knowledge on the perceptual processes underlying the ability to perceive our movements through space, as well as to optimizing mobility-related interventions for those with hearing loss so that they can function better when confronted by everyday real-world sensory-motor challenges. The goal of this paper is to explore the role of hearing in self-motion perception across a range of mobility-related behaviors. First, we briefly review the ways in which auditory cues are used to perceive self-motion and how sound inputs affect behaviors such as standing balance, walking, and driving. Next, we consider age-related changes in auditory self-motion perception and the potential consequences to the performance of mobility-related tasks. We then describe how hearing loss is associated with declines in mobility-related abilities and increased adverse outcomes such as falls. We describe age-related changes to other sensory and cognitive functions and how these may interact with hearing loss in ways that affect mobility. Finally, we briefly consider the implications of the hearing-mobility associations with respect to applied domains such as screening for mobility problems and falls risk in those with hearing loss and developing interventions and training approaches targeting safe and independent mobility throughout the lifespan.



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Pelvic excursion during walking post-stroke: A novel classification system

Publication date: Available online 31 March 2018
Source:Gait & Posture
Author(s): Virginia L. Little, Theresa E. McGuirk, Lindsay A. Perry, Carolynn Patten
BackgroundResearchers and clinicians often use gait speed to classify hemiparetic gait dysfunction because it offers clinical predictive capacity. However, gait speed fails to distinguish unique biomechanical characteristics that differentiate aspects of gait dysfunction.Research QuestionHere we describe a novel classification of hemiparetic gait dysfunction based on biomechanical traits of pelvic excursion. We hypothesize that individuals with greater deviation of pelvic excursion, relative to controls, demonstrate greater impairment in key gait characteristics.MethodsWe compared 41 participants (61.0 ± 11.2yrs) with chronic post-stroke hemiparesis to 21 non-disabled controls (55.8 ± 9.0yrs). Participants walked on an instrumented split-belt treadmill at self-selected walking speed. Pelvic excursion was quantified as the peak-to-peak magnitude of pelvic motion in three orthogonal planes (i.e., tilt, rotation, and obliquity). Raw values of pelvic excursion were compared against the distribution of control data to establish deviation scores which were assigned bilaterally for the three planes producing six values per individual. Deviation scores were then summed to produce a composite pelvic deviation score. Based on composite scores, participants were allocated to one of three categories of hemiparetic gait dysfunction with progressively increasing pelvic excursion deviation relative to controls: Type I (n = 15) – minimal pelvic excursion deviation; Type II (n = 20) – moderate pelvic excursion deviation; and Type III (n = 6) – marked pelvic excursion deviation. We assessed resulting groups for asymmetry in key gait parameters including: kinematics, joint powers temporally linked to the stance-to-swing transition, and timing of lower extremity muscle activity.ResultsAll groups post-stroke walked at similar self-selected speeds; however, classification based on pelvic excursion deviation revealed progressive asymmetry in gait kinematics, kinetics and temporal patterns of muscle activity.SignificanceThe progressive asymmetry revealed in multiple gait characteristics suggests exaggerated pelvic motion contributes to gait dysfunction post-stroke.



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Objective measures of unobstructed walking and obstacle avoidance in Parkinson’s disease subtypes

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Diego Orcioli-Silva, Rodrigo Vitório, Ellen Lirani-Silva, Paulo Cezar Rocha dos Santos, Victor Spiandor Beretta, Lilian Teresa Bucken Gobbi
BackgroundObjective measures of gait in Parkinson's disease (PD) patients according to motor subtypes are not yet fully understood. Although recent advances have been made for unobstructed walking, further work is required on locomotor tasks challenging postural stability, such as obstacle avoidance.Research questionThis study aimed to investigate the influence of PD motor subtypes on objective measures of locomotion during unobstructed walking and obstacle avoidance.MethodsThirty-five PD patients classified as postural instability and gait disorder (PIGD) and 30 as tremor dominant (TD), as well as 45 healthy controls (CG) walked along an 8-m pathway under two conditions: (a) unobstructed walking and (b) obstacle avoidance. Outcome measures included spatiotemporal parameters recorded by an optoelectronic tridimensional system.ResultsDuring unobstructed walking, the PIGD group exhibited shorter stride length, slower velocity, and longer double support phase compared to the TD and CG groups. The TD group also presented slower stride velocity compared to the CG. The PIGD and TD groups presented shorter stride duration than the CG. Regarding obstacle avoidance, the PIGD group exhibited shorter distances for leading foot placement before obstacle, trailing foot placement after obstacle and trailing crossing step length compared to the TD and CG groups. The PIGD group exhibited wider leading crossing step width, lower trailing toe clearance, and slower leading and trailing velocity during obstacle avoidance compared to the CG.SignificancePIGD subtype patients showed worse modifications in objective measures of unobstructed walking and obstacle avoidance. The observed modifications may contribute to increased fall occurrence in PIGD patients.



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A novel approach for the detection and exploration of joint coupling patterns in the lower limb kinetic chain

Publication date: Available online 31 March 2018
Source:Gait & Posture
Author(s): Kevin Deschamps, Maarten Eerdekens, Jurre Geentjens, Lieselot Santermans, Lien Steurs, Bart Dingenen, Maarten Thysen, Filip Staes
BackgroundA comprehensive perspective on foot and lower limb joint coupling is lacking since previous studies did not consider the multi-articular nature of the foot and lower limb neither accounted for biomechanical heterogeneity.Research questionThe current manuscript describes a novel methodological process for detection and exploration of joint coupling patterns in the lower limb kinetic chain.MethodsThe first stage of the methodological process encompasses the measurement of 3D joint kinematics of the foot and lower limb kinetic chain during dynamic activities. The second stage consists of selecting the kinematic waveforms of interest. In the third stage, cross-correlation coefficients are calculated across the selected one-dimensional continua of each subject. In the fourth stage, all cross-correlation coefficients per subject are used as input variable in a cluster algorithm. Algorithm specific qualitative metrics are subsequently considered to determine the most robust clustering. Finally, in the fifth stage the process of biomechanical interpretation is initiated and further exploration is recommended by triangulating with other biomechanical variables.ResultsA first clinical illustration of the novel method was provided using data of fourteen young elite athletes. Cross-correlation coefficients for each leg were calculated across continua of the pelvis, hip, knee, rear foot and midfoot. A hierarchical clustering approach stratified the coefficients into two distinct clusters which was mainly guided by the frontal plane knee kinematics. Both clustered differed significantly from each other with respect to their frontal plane ankle, knee and hip kinetics.SignificanceThe presented method seems to provide a valuable approach to gain insight into foot and lower joint coupling.



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Modeling margin of stability with feet in place following a postural perturbation: Effect of altered anthropometric models for estimated extrapolated centre of mass

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Keaton A. Inkol, Andrew H. Huntley, Lori Ann Vallis
BackgroundMaintaining the centre of mass (CoM) of the body within the base of support is a critical component of upright balance; the ability to accurately quantify balance recovery mechanisms is critical for many research teams.Research QuestionThe purpose of this study was to investigate how exclusion of specific body segments in an anthropometric CoM model influenced a dynamic measure of postural stability, the margin of stability (MoS) following a support-surface perturbation.MethodsHealthy young adults (n = 10) were instrumented with kinematic markers and a safety harness. Sixteen support-surface translations, scaled to ensure responses did not involve a change in base of support, were then issued (backwards, forwards, left, or right). Whole-body CoM was estimated using four variations of a 13-segment anthropometric model: i) the full-model (WFM), and three simplified models, ii) excluding upper limbs (NAr); iii) excluding upper and lower limbs (HTP); iv) pelvis CoM (CoMp). The CoM calculated for each variant was then used to estimate extrapolated CoM (xCoM) position and the resulting MoS within the plane of postural disturbance.ResultsComparisons of simplified models to the full model revealed significant differences (p < 0.05) in MoS for all models in each perturbation condition; however, the largest differences were following sagittal-based perturbations. Poor estimates of WFM MoS were most evident for HTP and CoMp models; these were associated with the greatest values of RMS/maximum error, poorest correlations, etc. The simplified models provided low-error approximates for frontal perturbations.SignificanceFindings suggest that simplified calculations of CoM can be used by researchers without reducing MoS measurement accuracy, however the degree of simplification should be context-dependent. For example,CoMp models may be appropriate for questions pertaining to frontal MoS; sagittal MoS necessitates inclusion of lower limb and HTP segments to prevent underestimation of postural stability.



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Pelvic excursion during walking post-stroke: A novel classification system

Publication date: Available online 31 March 2018
Source:Gait & Posture
Author(s): Virginia L. Little, Theresa E. McGuirk, Lindsay A. Perry, Carolynn Patten
BackgroundResearchers and clinicians often use gait speed to classify hemiparetic gait dysfunction because it offers clinical predictive capacity. However, gait speed fails to distinguish unique biomechanical characteristics that differentiate aspects of gait dysfunction.Research QuestionHere we describe a novel classification of hemiparetic gait dysfunction based on biomechanical traits of pelvic excursion. We hypothesize that individuals with greater deviation of pelvic excursion, relative to controls, demonstrate greater impairment in key gait characteristics.MethodsWe compared 41 participants (61.0 ± 11.2yrs) with chronic post-stroke hemiparesis to 21 non-disabled controls (55.8 ± 9.0yrs). Participants walked on an instrumented split-belt treadmill at self-selected walking speed. Pelvic excursion was quantified as the peak-to-peak magnitude of pelvic motion in three orthogonal planes (i.e., tilt, rotation, and obliquity). Raw values of pelvic excursion were compared against the distribution of control data to establish deviation scores which were assigned bilaterally for the three planes producing six values per individual. Deviation scores were then summed to produce a composite pelvic deviation score. Based on composite scores, participants were allocated to one of three categories of hemiparetic gait dysfunction with progressively increasing pelvic excursion deviation relative to controls: Type I (n = 15) – minimal pelvic excursion deviation; Type II (n = 20) – moderate pelvic excursion deviation; and Type III (n = 6) – marked pelvic excursion deviation. We assessed resulting groups for asymmetry in key gait parameters including: kinematics, joint powers temporally linked to the stance-to-swing transition, and timing of lower extremity muscle activity.ResultsAll groups post-stroke walked at similar self-selected speeds; however, classification based on pelvic excursion deviation revealed progressive asymmetry in gait kinematics, kinetics and temporal patterns of muscle activity.SignificanceThe progressive asymmetry revealed in multiple gait characteristics suggests exaggerated pelvic motion contributes to gait dysfunction post-stroke.



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Objective measures of unobstructed walking and obstacle avoidance in Parkinson’s disease subtypes

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Diego Orcioli-Silva, Rodrigo Vitório, Ellen Lirani-Silva, Paulo Cezar Rocha dos Santos, Victor Spiandor Beretta, Lilian Teresa Bucken Gobbi
BackgroundObjective measures of gait in Parkinson's disease (PD) patients according to motor subtypes are not yet fully understood. Although recent advances have been made for unobstructed walking, further work is required on locomotor tasks challenging postural stability, such as obstacle avoidance.Research questionThis study aimed to investigate the influence of PD motor subtypes on objective measures of locomotion during unobstructed walking and obstacle avoidance.MethodsThirty-five PD patients classified as postural instability and gait disorder (PIGD) and 30 as tremor dominant (TD), as well as 45 healthy controls (CG) walked along an 8-m pathway under two conditions: (a) unobstructed walking and (b) obstacle avoidance. Outcome measures included spatiotemporal parameters recorded by an optoelectronic tridimensional system.ResultsDuring unobstructed walking, the PIGD group exhibited shorter stride length, slower velocity, and longer double support phase compared to the TD and CG groups. The TD group also presented slower stride velocity compared to the CG. The PIGD and TD groups presented shorter stride duration than the CG. Regarding obstacle avoidance, the PIGD group exhibited shorter distances for leading foot placement before obstacle, trailing foot placement after obstacle and trailing crossing step length compared to the TD and CG groups. The PIGD group exhibited wider leading crossing step width, lower trailing toe clearance, and slower leading and trailing velocity during obstacle avoidance compared to the CG.SignificancePIGD subtype patients showed worse modifications in objective measures of unobstructed walking and obstacle avoidance. The observed modifications may contribute to increased fall occurrence in PIGD patients.



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A novel approach for the detection and exploration of joint coupling patterns in the lower limb kinetic chain

Publication date: Available online 31 March 2018
Source:Gait & Posture
Author(s): Kevin Deschamps, Maarten Eerdekens, Jurre Geentjens, Lieselot Santermans, Lien Steurs, Bart Dingenen, Maarten Thysen, Filip Staes
BackgroundA comprehensive perspective on foot and lower limb joint coupling is lacking since previous studies did not consider the multi-articular nature of the foot and lower limb neither accounted for biomechanical heterogeneity.Research questionThe current manuscript describes a novel methodological process for detection and exploration of joint coupling patterns in the lower limb kinetic chain.MethodsThe first stage of the methodological process encompasses the measurement of 3D joint kinematics of the foot and lower limb kinetic chain during dynamic activities. The second stage consists of selecting the kinematic waveforms of interest. In the third stage, cross-correlation coefficients are calculated across the selected one-dimensional continua of each subject. In the fourth stage, all cross-correlation coefficients per subject are used as input variable in a cluster algorithm. Algorithm specific qualitative metrics are subsequently considered to determine the most robust clustering. Finally, in the fifth stage the process of biomechanical interpretation is initiated and further exploration is recommended by triangulating with other biomechanical variables.ResultsA first clinical illustration of the novel method was provided using data of fourteen young elite athletes. Cross-correlation coefficients for each leg were calculated across continua of the pelvis, hip, knee, rear foot and midfoot. A hierarchical clustering approach stratified the coefficients into two distinct clusters which was mainly guided by the frontal plane knee kinematics. Both clustered differed significantly from each other with respect to their frontal plane ankle, knee and hip kinetics.SignificanceThe presented method seems to provide a valuable approach to gain insight into foot and lower joint coupling.



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Modeling margin of stability with feet in place following a postural perturbation: Effect of altered anthropometric models for estimated extrapolated centre of mass

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Keaton A. Inkol, Andrew H. Huntley, Lori Ann Vallis
BackgroundMaintaining the centre of mass (CoM) of the body within the base of support is a critical component of upright balance; the ability to accurately quantify balance recovery mechanisms is critical for many research teams.Research QuestionThe purpose of this study was to investigate how exclusion of specific body segments in an anthropometric CoM model influenced a dynamic measure of postural stability, the margin of stability (MoS) following a support-surface perturbation.MethodsHealthy young adults (n = 10) were instrumented with kinematic markers and a safety harness. Sixteen support-surface translations, scaled to ensure responses did not involve a change in base of support, were then issued (backwards, forwards, left, or right). Whole-body CoM was estimated using four variations of a 13-segment anthropometric model: i) the full-model (WFM), and three simplified models, ii) excluding upper limbs (NAr); iii) excluding upper and lower limbs (HTP); iv) pelvis CoM (CoMp). The CoM calculated for each variant was then used to estimate extrapolated CoM (xCoM) position and the resulting MoS within the plane of postural disturbance.ResultsComparisons of simplified models to the full model revealed significant differences (p < 0.05) in MoS for all models in each perturbation condition; however, the largest differences were following sagittal-based perturbations. Poor estimates of WFM MoS were most evident for HTP and CoMp models; these were associated with the greatest values of RMS/maximum error, poorest correlations, etc. The simplified models provided low-error approximates for frontal perturbations.SignificanceFindings suggest that simplified calculations of CoM can be used by researchers without reducing MoS measurement accuracy, however the degree of simplification should be context-dependent. For example,CoMp models may be appropriate for questions pertaining to frontal MoS; sagittal MoS necessitates inclusion of lower limb and HTP segments to prevent underestimation of postural stability.



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Pelvic excursion during walking post-stroke: A novel classification system

Publication date: Available online 31 March 2018
Source:Gait & Posture
Author(s): Virginia L. Little, Theresa E. McGuirk, Lindsay A. Perry, Carolynn Patten
BackgroundResearchers and clinicians often use gait speed to classify hemiparetic gait dysfunction because it offers clinical predictive capacity. However, gait speed fails to distinguish unique biomechanical characteristics that differentiate aspects of gait dysfunction.Research QuestionHere we describe a novel classification of hemiparetic gait dysfunction based on biomechanical traits of pelvic excursion. We hypothesize that individuals with greater deviation of pelvic excursion, relative to controls, demonstrate greater impairment in key gait characteristics.MethodsWe compared 41 participants (61.0 ± 11.2yrs) with chronic post-stroke hemiparesis to 21 non-disabled controls (55.8 ± 9.0yrs). Participants walked on an instrumented split-belt treadmill at self-selected walking speed. Pelvic excursion was quantified as the peak-to-peak magnitude of pelvic motion in three orthogonal planes (i.e., tilt, rotation, and obliquity). Raw values of pelvic excursion were compared against the distribution of control data to establish deviation scores which were assigned bilaterally for the three planes producing six values per individual. Deviation scores were then summed to produce a composite pelvic deviation score. Based on composite scores, participants were allocated to one of three categories of hemiparetic gait dysfunction with progressively increasing pelvic excursion deviation relative to controls: Type I (n = 15) – minimal pelvic excursion deviation; Type II (n = 20) – moderate pelvic excursion deviation; and Type III (n = 6) – marked pelvic excursion deviation. We assessed resulting groups for asymmetry in key gait parameters including: kinematics, joint powers temporally linked to the stance-to-swing transition, and timing of lower extremity muscle activity.ResultsAll groups post-stroke walked at similar self-selected speeds; however, classification based on pelvic excursion deviation revealed progressive asymmetry in gait kinematics, kinetics and temporal patterns of muscle activity.SignificanceThe progressive asymmetry revealed in multiple gait characteristics suggests exaggerated pelvic motion contributes to gait dysfunction post-stroke.



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Objective measures of unobstructed walking and obstacle avoidance in Parkinson’s disease subtypes

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Diego Orcioli-Silva, Rodrigo Vitório, Ellen Lirani-Silva, Paulo Cezar Rocha dos Santos, Victor Spiandor Beretta, Lilian Teresa Bucken Gobbi
BackgroundObjective measures of gait in Parkinson's disease (PD) patients according to motor subtypes are not yet fully understood. Although recent advances have been made for unobstructed walking, further work is required on locomotor tasks challenging postural stability, such as obstacle avoidance.Research questionThis study aimed to investigate the influence of PD motor subtypes on objective measures of locomotion during unobstructed walking and obstacle avoidance.MethodsThirty-five PD patients classified as postural instability and gait disorder (PIGD) and 30 as tremor dominant (TD), as well as 45 healthy controls (CG) walked along an 8-m pathway under two conditions: (a) unobstructed walking and (b) obstacle avoidance. Outcome measures included spatiotemporal parameters recorded by an optoelectronic tridimensional system.ResultsDuring unobstructed walking, the PIGD group exhibited shorter stride length, slower velocity, and longer double support phase compared to the TD and CG groups. The TD group also presented slower stride velocity compared to the CG. The PIGD and TD groups presented shorter stride duration than the CG. Regarding obstacle avoidance, the PIGD group exhibited shorter distances for leading foot placement before obstacle, trailing foot placement after obstacle and trailing crossing step length compared to the TD and CG groups. The PIGD group exhibited wider leading crossing step width, lower trailing toe clearance, and slower leading and trailing velocity during obstacle avoidance compared to the CG.SignificancePIGD subtype patients showed worse modifications in objective measures of unobstructed walking and obstacle avoidance. The observed modifications may contribute to increased fall occurrence in PIGD patients.



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A novel approach for the detection and exploration of joint coupling patterns in the lower limb kinetic chain

Publication date: Available online 31 March 2018
Source:Gait & Posture
Author(s): Kevin Deschamps, Maarten Eerdekens, Jurre Geentjens, Lieselot Santermans, Lien Steurs, Bart Dingenen, Maarten Thysen, Filip Staes
BackgroundA comprehensive perspective on foot and lower limb joint coupling is lacking since previous studies did not consider the multi-articular nature of the foot and lower limb neither accounted for biomechanical heterogeneity.Research questionThe current manuscript describes a novel methodological process for detection and exploration of joint coupling patterns in the lower limb kinetic chain.MethodsThe first stage of the methodological process encompasses the measurement of 3D joint kinematics of the foot and lower limb kinetic chain during dynamic activities. The second stage consists of selecting the kinematic waveforms of interest. In the third stage, cross-correlation coefficients are calculated across the selected one-dimensional continua of each subject. In the fourth stage, all cross-correlation coefficients per subject are used as input variable in a cluster algorithm. Algorithm specific qualitative metrics are subsequently considered to determine the most robust clustering. Finally, in the fifth stage the process of biomechanical interpretation is initiated and further exploration is recommended by triangulating with other biomechanical variables.ResultsA first clinical illustration of the novel method was provided using data of fourteen young elite athletes. Cross-correlation coefficients for each leg were calculated across continua of the pelvis, hip, knee, rear foot and midfoot. A hierarchical clustering approach stratified the coefficients into two distinct clusters which was mainly guided by the frontal plane knee kinematics. Both clustered differed significantly from each other with respect to their frontal plane ankle, knee and hip kinetics.SignificanceThe presented method seems to provide a valuable approach to gain insight into foot and lower joint coupling.



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Modeling margin of stability with feet in place following a postural perturbation: Effect of altered anthropometric models for estimated extrapolated centre of mass

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Keaton A. Inkol, Andrew H. Huntley, Lori Ann Vallis
BackgroundMaintaining the centre of mass (CoM) of the body within the base of support is a critical component of upright balance; the ability to accurately quantify balance recovery mechanisms is critical for many research teams.Research QuestionThe purpose of this study was to investigate how exclusion of specific body segments in an anthropometric CoM model influenced a dynamic measure of postural stability, the margin of stability (MoS) following a support-surface perturbation.MethodsHealthy young adults (n = 10) were instrumented with kinematic markers and a safety harness. Sixteen support-surface translations, scaled to ensure responses did not involve a change in base of support, were then issued (backwards, forwards, left, or right). Whole-body CoM was estimated using four variations of a 13-segment anthropometric model: i) the full-model (WFM), and three simplified models, ii) excluding upper limbs (NAr); iii) excluding upper and lower limbs (HTP); iv) pelvis CoM (CoMp). The CoM calculated for each variant was then used to estimate extrapolated CoM (xCoM) position and the resulting MoS within the plane of postural disturbance.ResultsComparisons of simplified models to the full model revealed significant differences (p < 0.05) in MoS for all models in each perturbation condition; however, the largest differences were following sagittal-based perturbations. Poor estimates of WFM MoS were most evident for HTP and CoMp models; these were associated with the greatest values of RMS/maximum error, poorest correlations, etc. The simplified models provided low-error approximates for frontal perturbations.SignificanceFindings suggest that simplified calculations of CoM can be used by researchers without reducing MoS measurement accuracy, however the degree of simplification should be context-dependent. For example,CoMp models may be appropriate for questions pertaining to frontal MoS; sagittal MoS necessitates inclusion of lower limb and HTP segments to prevent underestimation of postural stability.



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Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance.

Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance.

Br J Health Psychol. 2018 Mar 30;:

Authors: Lehane CM, Nielsen T, Wittich W, Langer S, Dammeyer J

Abstract
OBJECTIVES: Hearing-, vision-, and dual-sensory loss have been linked to relational and psychological distress among adults with sensory loss (AWSLs) and their spouses. Regardless, research on factors associated with couples' adjustment is lacking. This study examined the stability and strength of associations between self-acceptance of sensory loss, perceived partner acceptance of sensory loss, and relationship satisfaction and psychological distress among AWSLs and their spouses over time.
DESIGN: A total of 122 AWSLs and their spouses completed an online survey at two time points over a 6-month period.
METHODS: A multigroup (i.e., time 1 and time 2) actor-partner interdependence model assessed the stability and strength of actor and partner effects of self-acceptance and perceived partner acceptance on each partner's relationship satisfaction and psychological distress over time.
RESULTS: No moderation by time was identified, indicating stability in associations over the 6-month period. Overall, both actor and partner effects were evident. Specifically, self-acceptance among AWSLs was inversely associated with own psychological distress and the relationship satisfaction of spouses. Self-acceptance by spouses was inversely associated with the psychological distress of AWSLs and spouses. Perception of spouse acceptance by AWSLs was positively associated with own and spouse relationship satisfaction.
CONCLUSIONS: Interventions targeting acceptance that incorporate a family systems perspective may be beneficial in alleviating psychological and relational distress among couples coping with sensory loss. Statement of contribution What is already known on this subject? The experience of hearing and/or vision loss has been linked to heightened distress both psychologically and within intimate relationships. Prior research has demonstrated a link between an individual's ability to accept their sensory loss and healthier well-being. What does this study add? This is the first dyadic study of sensory loss acceptance and its link to relationship satisfaction and distress. Acceptance operates interpersonally protecting against distress for those with sensory loss and their spouses. Perceiving that one's spouse accepts the sensory loss is important for both partner's relationship satisfaction.

PMID: 29602197 [PubMed - as supplied by publisher]

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A Tool to Quantify the Functional Impact of Oscillopsia.

Related Articles

A Tool to Quantify the Functional Impact of Oscillopsia.

Front Neurol. 2018;9:142

Authors: Anson ER, Gimmon Y, Kiemel T, Jeka JJ, Carey JP

Abstract
Background: Individuals with bilateral vestibular hypofunction (BVH) often report symptoms of oscillopsia during walking. Existing assessments of oscillopsia are limited to descriptions of severity and symptom frequency, neither of which provides a description of functional limitations attributed to oscillopsia. A novel questionnaire, the Oscillopsia Functional Impact scale (OFI) was developed to describe the impact of oscillopsia on daily life activities. Questions on the OFI ask how often individuals are able to execute specific activities considered to depend on gaze stability in an effort to link functional mobility impairments to oscillopsia for individuals with vestibular loss.
Methods: Subjective reports of oscillopsia and balance confidence were recorded for 21 individuals with BVH and 48 healthy controls. Spearman correlation coefficients were calculated to determine the relationship between the OFI and oscillopsia visual analog scale (OS VAS), oscillopsia severity questionnaire (OSQ), and Activities-Specific Balance Confidence scale to demonstrate face validity. Chronbach's α was calculated to determine internal validity for the items of the OFI. A one-way MANOVA was conducted with planned post hoc paired t-tests for group differences on all oscillopsia questionnaires using a corrected α = 0.0125.
Results: The OFI was highly correlated with measures of oscillopsia severity (OS VAS; r = 0.69, p < 0.001) and frequency (OSQ; r = 0.84, p < 0.001) and also with the Activities-Specific Balance Confidence scale (r = -0.84, p < 0.001). Cronbach's α for the OFI was 0.97. Individuals with BVH scored worse on all measures of oscillopsia and balance confidence compared to healthy individuals (p's < 0.001).
Conclusion: The OFI appears to capture the construct of oscillopsia in the context of functional mobility. Combining with oscillopsia metrics that quantify severity and frequency allows for a more complete characterization of the impact of oscillopsia on an individual's daily behavior. The OFI discriminated individuals with BVH from healthy individuals.

PMID: 29599743 [PubMed]

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A Tool to Quantify the Functional Impact of Oscillopsia.

Related Articles

A Tool to Quantify the Functional Impact of Oscillopsia.

Front Neurol. 2018;9:142

Authors: Anson ER, Gimmon Y, Kiemel T, Jeka JJ, Carey JP

Abstract
Background: Individuals with bilateral vestibular hypofunction (BVH) often report symptoms of oscillopsia during walking. Existing assessments of oscillopsia are limited to descriptions of severity and symptom frequency, neither of which provides a description of functional limitations attributed to oscillopsia. A novel questionnaire, the Oscillopsia Functional Impact scale (OFI) was developed to describe the impact of oscillopsia on daily life activities. Questions on the OFI ask how often individuals are able to execute specific activities considered to depend on gaze stability in an effort to link functional mobility impairments to oscillopsia for individuals with vestibular loss.
Methods: Subjective reports of oscillopsia and balance confidence were recorded for 21 individuals with BVH and 48 healthy controls. Spearman correlation coefficients were calculated to determine the relationship between the OFI and oscillopsia visual analog scale (OS VAS), oscillopsia severity questionnaire (OSQ), and Activities-Specific Balance Confidence scale to demonstrate face validity. Chronbach's α was calculated to determine internal validity for the items of the OFI. A one-way MANOVA was conducted with planned post hoc paired t-tests for group differences on all oscillopsia questionnaires using a corrected α = 0.0125.
Results: The OFI was highly correlated with measures of oscillopsia severity (OS VAS; r = 0.69, p < 0.001) and frequency (OSQ; r = 0.84, p < 0.001) and also with the Activities-Specific Balance Confidence scale (r = -0.84, p < 0.001). Cronbach's α for the OFI was 0.97. Individuals with BVH scored worse on all measures of oscillopsia and balance confidence compared to healthy individuals (p's < 0.001).
Conclusion: The OFI appears to capture the construct of oscillopsia in the context of functional mobility. Combining with oscillopsia metrics that quantify severity and frequency allows for a more complete characterization of the impact of oscillopsia on an individual's daily behavior. The OFI discriminated individuals with BVH from healthy individuals.

PMID: 29599743 [PubMed]

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Ketamine Tinnitus

Please note: the following information does not constitute professional medical advice, and is provided for general informational purposes only. Please speak to your doctor if you have tinnitus.

With one in five Americans suffering from chronic ringing in the ears, better known as tinnitus, there’s no doubt this is a condition that greatly affects millions of individuals each and every day. From preventing people from holding down a job or enjoying numerous activities with their family and friends, tinnitus is a condition that up until recently had few effective treatment options. However, based on recent research and clinical trials, it has been found that the antidepressant medication Ketamine has in many cases given tinnitus sufferers relief from their condition.

What is Ketamine?
Invented in 1962 as an anesthetic to be used in surgery, ketamine has been used as an antidepressant to help patients with severe depression. Able to block various neurotransmitters in the nervous system, the drug has gained acclaim in recent years for its ability to help those with tinnitus. In fact, when it comes to ketamine tinnitus sufferers have reported dramatic improvements in short periods of time. According to researchers at Texas A&M, when using ketamine tinnitus sufferers who have even the most severe cases report improvements. In many cases, this is thought to be due to the fact that many of the symptoms associated with depression and PTSD, such as pain and phantom noises, are also part of tinnitus.

How is Ketamine Used with Tinnitus Patients?
When using ketamine tinnitus patients usually have two choices as to how the medication will be administered. For some patients, this involves an injection directly into their ear, with the benefits often lasting several months. In other instances, patients choose to have a series of four to six IV infusions over a two-week period, which also provides relief lasting several months.

When Should Treatment Begin?
When deciding to use ketamine, patients should be aware that the sooner they begin treatment after experiencing tinnitus symptoms, the better the chances they will experience positive treatment results. According to most tinnitus experts involved in ketamine research, tinnitus patients who have had an onset of symptoms within the past year are the ideal candidates for ketamine treatments.

The Future of Ketamine Treatment
Due to some patients experiencing relief within 20 minutes of an injection or IV treatment, the future of ketamine treatment looks quite positive. However, as with any new type of medical treatment, much more research will be conducted before a final conclusion is reached. But for those suffering from tinnitus, these new treatments offer much hope for the years ahead.

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Gait and functionality of individuals with visual impairment who participate in sports

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Edson Soares da Silva, Gabriela Fischer, Rodrigo Gomes da Rosa, Pedro Schons, Luísa Beatriz Trevisan Teixeira, Wouter Hoogkamer, Leonardo Alexandre Peyré-Tartaruga
BackgroundIndividuals with visual impairment (VI) have often been observed to walk slower than individuals with unimpaired vision. These observations might be confounded by typical low levels of physical activity and greater sedentary behavior in individuals with VI than the overall population.Research questionHere, we compared gait and balance measures between individuals with VI who participate in disability sports, and activity level matched sighted individuals.MethodsWe assessed static balance, anthropometry, self-selected walking speed, locomotion rehabilitation index, and lower limb muscular endurance; and applied physical activity level and fear of falling questionnaires.ResultsIndividuals with VI who participate in disability sports, self-selected a similar walking speed (1.29 ± 0.26 m/s) as active sighted individuals (1.39 ± 0.21 m/s). Locomotor rehabilitation index and muscular endurance of lower limbs were also similar between groups. Individuals with VI presented lower static balance (42.0 ± 17.0s) than the sighted control group (45.0 ± 0s) when the controls were tested with their eyes open. However, no difference was found when the controls were tested with their eyes closed (30.3 ± 17.0s). Furthermore, individuals with VI showed a greater fear of falling.SignificanceIn conclusion, individuals with VI who participate in disability sports, as goalball and football, walk with similar self-selected walking speeds as active sighted individuals, but have slightly worse static balance and fear of falling.



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Gait and functionality of individuals with visual impairment who participate in sports

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Edson Soares da Silva, Gabriela Fischer, Rodrigo Gomes da Rosa, Pedro Schons, Luísa Beatriz Trevisan Teixeira, Wouter Hoogkamer, Leonardo Alexandre Peyré-Tartaruga
BackgroundIndividuals with visual impairment (VI) have often been observed to walk slower than individuals with unimpaired vision. These observations might be confounded by typical low levels of physical activity and greater sedentary behavior in individuals with VI than the overall population.Research questionHere, we compared gait and balance measures between individuals with VI who participate in disability sports, and activity level matched sighted individuals.MethodsWe assessed static balance, anthropometry, self-selected walking speed, locomotion rehabilitation index, and lower limb muscular endurance; and applied physical activity level and fear of falling questionnaires.ResultsIndividuals with VI who participate in disability sports, self-selected a similar walking speed (1.29 ± 0.26 m/s) as active sighted individuals (1.39 ± 0.21 m/s). Locomotor rehabilitation index and muscular endurance of lower limbs were also similar between groups. Individuals with VI presented lower static balance (42.0 ± 17.0s) than the sighted control group (45.0 ± 0s) when the controls were tested with their eyes open. However, no difference was found when the controls were tested with their eyes closed (30.3 ± 17.0s). Furthermore, individuals with VI showed a greater fear of falling.SignificanceIn conclusion, individuals with VI who participate in disability sports, as goalball and football, walk with similar self-selected walking speeds as active sighted individuals, but have slightly worse static balance and fear of falling.



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Gait and functionality of individuals with visual impairment who participate in sports

Publication date: Available online 30 March 2018
Source:Gait & Posture
Author(s): Edson Soares da Silva, Gabriela Fischer, Rodrigo Gomes da Rosa, Pedro Schons, Luísa Beatriz Trevisan Teixeira, Wouter Hoogkamer, Leonardo Alexandre Peyré-Tartaruga
BackgroundIndividuals with visual impairment (VI) have often been observed to walk slower than individuals with unimpaired vision. These observations might be confounded by typical low levels of physical activity and greater sedentary behavior in individuals with VI than the overall population.Research questionHere, we compared gait and balance measures between individuals with VI who participate in disability sports, and activity level matched sighted individuals.MethodsWe assessed static balance, anthropometry, self-selected walking speed, locomotion rehabilitation index, and lower limb muscular endurance; and applied physical activity level and fear of falling questionnaires.ResultsIndividuals with VI who participate in disability sports, self-selected a similar walking speed (1.29 ± 0.26 m/s) as active sighted individuals (1.39 ± 0.21 m/s). Locomotor rehabilitation index and muscular endurance of lower limbs were also similar between groups. Individuals with VI presented lower static balance (42.0 ± 17.0s) than the sighted control group (45.0 ± 0s) when the controls were tested with their eyes open. However, no difference was found when the controls were tested with their eyes closed (30.3 ± 17.0s). Furthermore, individuals with VI showed a greater fear of falling.SignificanceIn conclusion, individuals with VI who participate in disability sports, as goalball and football, walk with similar self-selected walking speeds as active sighted individuals, but have slightly worse static balance and fear of falling.



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Hearing What You See

A recent gif image has been circulating  where individual can report hearing a “thud” sound

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Loyola Medicine Marks 500th Cochlear Implant

Loyola Medicine reached a landmark feat with its 500^th cochlear implant surgery. A standard treatment for patients with hearing loss but do not benefit as much from hearing aids, cochlear implants (CIs) have been reported to improve the quality of life of recipients.

"Loyola Medicine has an adult population of CI recipients, the vast majority of whom present with progressive hearing loss ranging from several years to decades," shared Candace R. Blank, AuD, audiologist chief at Loyola Medicine. "We see patients who range in age from their late teens through their 90s, with expected co-morbidities including anxiety, depression, and social isolation."
 
Over 37.5 million American adults have reported some form of hearing difficulty—an issue that worsens with age and gets aggravated by factors like occupational noise and excessive listening to recreational sounds.
 
Hearing loss is also associated with increased health risks like depression and cognitive impairment. However, a recent study based on a large-scale NHIS survey has pointed to the gap in audiology referral of many adults who could benefit from a hearing test, hearing aids, and CIs (Hearing Journal. 2018;71(3):6). In fact, only 22 percent of CI candidates actually get the device, the study found.
 
"There is a lack of information and awareness of current guidelines for implantable solutions among the public as well as with primary care physicians," explained Blank. "The survey underscores the importance of the primary care physician in taking an active role in understanding the significant implications of hearing loss.It is extremely unfortunate that majority of people who could benefit from a CI are not directed to the proper avenues necessary to be evaluated."
 
But Loyola offers a different scene, being one of the busiest hearing centers in the Midwest. It is also one of the first centers to implant a hybrid system—a combination of a CI and a hearing aid.
 
"Loyola Medicine's successful CI program is directly related to the close relationship between our excellent audiology and neurotology team," Blank told The Hearing Journal. The 500^th CI surgery was done by John Leonetti, MD, one of Loyola's four otolaryngologists with expertise in this procedure. "Together we determine if someone is medically, audiologically, and holistically a candidate—even if the patient is 96 years old… We treat both the patient's body and soul."

Published: 3/30/2018 10:15:00 AM

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Loyola Medicine Marks 500th Cochlear Implant

Loyola Medicine reached a landmark feat with its 500^th cochlear implant surgery. A standard treatment for patients with hearing loss but do not benefit as much from hearing aids, cochlear implants (CIs) have been reported to improve the quality of life of recipients.

"Loyola Medicine has an adult population of CI recipients, the vast majority of whom present with progressive hearing loss ranging from several years to decades," shared Candace R. Blank, AuD, audiologist chief at Loyola Medicine. "We see patients who range in age from their late teens through their 90s, with expected co-morbidities including anxiety, depression, and social isolation."
 
Over 37.5 million American adults have reported some form of hearing difficulty—an issue that worsens with age and gets aggravated by factors like occupational noise and excessive listening to recreational sounds.
 
Hearing loss is also associated with increased health risks like depression and cognitive impairment. However, a recent study based on a large-scale NHIS survey has pointed to the gap in audiology referral of many adults who could benefit from a hearing test, hearing aids, and CIs (Hearing Journal. 2018;71(3):6). In fact, only 22 percent of CI candidates actually get the device, the study found.
 
"There is a lack of information and awareness of current guidelines for implantable solutions among the public as well as with primary care physicians," explained Blank. "The survey underscores the importance of the primary care physician in taking an active role in understanding the significant implications of hearing loss.It is extremely unfortunate that majority of people who could benefit from a CI are not directed to the proper avenues necessary to be evaluated."
 
But Loyola offers a different scene, being one of the busiest hearing centers in the Midwest. It is also one of the first centers to implant a hybrid system—a combination of a CI and a hearing aid.
 
"Loyola Medicine's successful CI program is directly related to the close relationship between our excellent audiology and neurotology team," Blank told The Hearing Journal. The 500^th CI surgery was done by John Leonetti, MD, one of Loyola's four otolaryngologists with expertise in this procedure. "Together we determine if someone is medically, audiologically, and holistically a candidate—even if the patient is 96 years old… We treat both the patient's body and soul."

Published: 3/30/2018 10:15:00 AM

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Loyola Medicine Marks 500th Cochlear Implant

Loyola Medicine reached a landmark feat with its 500^th cochlear implant surgery. A standard treatment for patients with hearing loss but do not benefit as much from hearing aids, cochlear implants (CIs) have been reported to improve the quality of life of recipients.

"Loyola Medicine has an adult population of CI recipients, the vast majority of whom present with progressive hearing loss ranging from several years to decades," shared Candace R. Blank, AuD, audiologist chief at Loyola Medicine. "We see patients who range in age from their late teens through their 90s, with expected co-morbidities including anxiety, depression, and social isolation."
 
Over 37.5 million American adults have reported some form of hearing difficulty—an issue that worsens with age and gets aggravated by factors like occupational noise and excessive listening to recreational sounds.
 
Hearing loss is also associated with increased health risks like depression and cognitive impairment. However, a recent study based on a large-scale NHIS survey has pointed to the gap in audiology referral of many adults who could benefit from a hearing test, hearing aids, and CIs (Hearing Journal. 2018;71(3):6). In fact, only 22 percent of CI candidates actually get the device, the study found.
 
"There is a lack of information and awareness of current guidelines for implantable solutions among the public as well as with primary care physicians," explained Blank. "The survey underscores the importance of the primary care physician in taking an active role in understanding the significant implications of hearing loss.It is extremely unfortunate that majority of people who could benefit from a CI are not directed to the proper avenues necessary to be evaluated."
 
But Loyola offers a different scene, being one of the busiest hearing centers in the Midwest. It is also one of the first centers to implant a hybrid system—a combination of a CI and a hearing aid.
 
"Loyola Medicine's successful CI program is directly related to the close relationship between our excellent audiology and neurotology team," Blank told The Hearing Journal. The 500^th CI surgery was done by John Leonetti, MD, one of Loyola's four otolaryngologists with expertise in this procedure. "Together we determine if someone is medically, audiologically, and holistically a candidate—even if the patient is 96 years old… We treat both the patient's body and soul."

Published: 3/30/2018 10:15:00 AM

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GeneReviews®

GeneReviews®

Book. 1993

Authors: Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Stephens K, Amemiya A

Abstract
CLINICAL CHARACTERISTICS: The spectrum of ASAH1-related disorders ranges from Farber disease (FD) to spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME). Classic FD is characterized by onset in the first weeks of life of painful, progressive deformity of the major joints; palpable subcutaneous nodules of joints and mechanical pressure points; and a hoarse cry resulting from granulomas of the larynx and epiglottis. Life expectancy is usually less than two years. In the other less common types of FD, onset, severity, and primary manifestations vary. SMA-PME is characterized by early-childhood-onset progressive lower motor neuron disease manifest typically between ages three and seven years as proximal lower-extremity weakness, followed by progressive myoclonic and atonic seizures, tremulousness/tremor, and sensorineural hearing loss. Myoclonic epilepsy typically begins in late childhood after the onset of weakness and can include jerking of the upper limbs, action myoclonus, myoclonic status, and eyelid myoclonus. Other findings include generalized tremor, and cognitive decline. The time from disease onset to death from respiratory complications is usually five to 15 years.
DIAGNOSIS/TESTING: The diagnosis of an ASAH1-related disorder is established in a proband with suggestive clinical findings by identification of biallelic pathogenic variants in ASAH1 and/or decreased activity of the enzyme acid ceramidase in peripheral blood leukocytes or cultured skin fibroblasts.
MANAGEMENT: Treatment of manifestations is symptomatic and multidisciplinary. For FD: Management may include gastrostomy tube placement, surgical removal of oral and airway granulomas, and treatment of seizures as per standard practice. Hematopoietic stem cell transplantation may be an option in affected individuals who do not have significant neurologic involvement. For SMA-PME: Management may include standard treatment for hearing loss, scoliosis, seizures, and tremor. Weakness can be mitigated with the use of orthotics, wheelchairs, or other assistive devices. Surveillance: For FD: At each visit assess growth with emphasis on feeding and nutritional status; airway, joint mobility, and developmental milestones. For SMA-PME: At each visit monitor growth with emphasis on feeding and nutritional status, pulmonary function, back for evidence of scoliosis, strength, seizure control, functional capacity (e.g., mobility, communication); assess hearing annually.
GENETIC COUNSELING: ASAH1-related disorders are inherited in an autosomal recessive manner. At conception, each sib of an affected individual has a 25% chance of being affected, a 50% chance of being an asymptomatic carrier, and a 25% chance of being unaffected and not a carrier. Sibs with the same two pathogenic variants would be expected to have the same (or very similar) phenotype. Once the ASAH1 pathogenic variants have been identified in an affected family member, carrier testing for at-risk relatives, prenatal testing for a pregnancy at increased risk, and preimplantation genetic diagnosis are possible.

PMID: 29595935

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Mutations in Diphosphoinositol-Pentakisphosphate Kinase PPIP5K2 are associated with hearing loss in human and mouse.

Mutations in Diphosphoinositol-Pentakisphosphate Kinase PPIP5K2 are associated with hearing loss in human and mouse.

PLoS Genet. 2018 Mar 28;14(3):e1007297

Authors: Yousaf R, Gu C, Ahmed ZM, Khan SN, Friedman TB, Riazuddin S, Shears SB, Riazuddin S

Abstract
Autosomal recessive nonsyndromic hearing loss is a genetically heterogeneous disorder. Here, we report a severe-to-profound sensorineural hearing loss locus, DFNB100 on chromosome 5q13.2-q23.2. Exome enrichment followed by massive parallel sequencing revealed a c.2510G>A transition variant in PPIP5K2 that segregated with DFNB100-associated hearing loss in two large apparently unrelated Pakistani families. PPIP5Ks enzymes interconvert 5-IP7 and IP8, two key members of the inositol pyrophosphate (PP-IP) cell-signaling family. Their actions at the interface of cell signaling and bioenergetic homeostasis can impact many biological processes. The c.2510G>A transition variant is predicted to substitute a highly invariant arginine residue with histidine (p.Arg837His) in the phosphatase domain of PPIP5K2. Biochemical studies revealed that the p.Arg837His variant reduces the phosphatase activity of PPIP5K2 and elevates its kinase activity. We found that in mouse inner ear, PPIP5K2 is expressed in the cochlear and vestibular sensory hair cells, supporting cells and spiral ganglion neurons. Mice homozygous for a targeted deletion of the Ppip5k2 phosphatase domain exhibit degeneration of cochlear outer hair cells and elevated hearing thresholds. Our demonstration that PPIP5K2 has a role in hearing in humans indicates that PP-IP signaling is important to hair cell maintenance and function within inner ear.

PMID: 29590114 [PubMed - as supplied by publisher]

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Comparison of Subjective and Objective Measures of Hearing, Auditory Processing, and Cognition Among Older Adults With and Without Mild Cognitive Impairment

Purpose

The aims of the study were to compare the Cognitive Self-Report Questionnaire (CSRQ; Spina, Ruff, & Mahncke, 2006) Hearing and Cognitive subscale ratings among older adults with and without probable mild cognitive impairment (MCI) and to examine whether self-report, as measured by the CSRQ, is associated with objective measures of hearing, auditory processing, and cognition.

Method

Data analyses included 97 older adults of ages 61–91 years. Participants completed the CSRQ self-report measure as well as a battery of objective measures, including pure-tone audiometry, degraded speech understanding, temporal processing, and memory.

Results

Older adults with probable MCI rated their cognitive abilities more poorly than those without MCI (p = .002), but ratings of hearing and auditory abilities did not differ between the two groups (p = .912). Age and CSRQ Hearing subscale ratings explained a significant proportion of variance in objective measures of hearing and degraded speech understanding (R ² = .39, p < .001). Age, sex, mental status, and CSRQ Cognition subscale ratings explained a significant proportion of variance in objective memory performance (R ² = .55, p < .001).

Conclusions

Taken together, these results suggest that the CSRQ is an appropriate self-report measure of hearing, cognition, and some aspects of auditory processing for older adults with and without probable MCI.

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Comparison of Subjective and Objective Measures of Hearing, Auditory Processing, and Cognition Among Older Adults With and Without Mild Cognitive Impairment

Purpose

The aims of the study were to compare the Cognitive Self-Report Questionnaire (CSRQ; Spina, Ruff, & Mahncke, 2006) Hearing and Cognitive subscale ratings among older adults with and without probable mild cognitive impairment (MCI) and to examine whether self-report, as measured by the CSRQ, is associated with objective measures of hearing, auditory processing, and cognition.

Method

Data analyses included 97 older adults of ages 61–91 years. Participants completed the CSRQ self-report measure as well as a battery of objective measures, including pure-tone audiometry, degraded speech understanding, temporal processing, and memory.

Results

Older adults with probable MCI rated their cognitive abilities more poorly than those without MCI (p = .002), but ratings of hearing and auditory abilities did not differ between the two groups (p = .912). Age and CSRQ Hearing subscale ratings explained a significant proportion of variance in objective measures of hearing and degraded speech understanding (R ² = .39, p < .001). Age, sex, mental status, and CSRQ Cognition subscale ratings explained a significant proportion of variance in objective memory performance (R ² = .55, p < .001).

Conclusions

Taken together, these results suggest that the CSRQ is an appropriate self-report measure of hearing, cognition, and some aspects of auditory processing for older adults with and without probable MCI.

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Comparison of Subjective and Objective Measures of Hearing, Auditory Processing, and Cognition Among Older Adults With and Without Mild Cognitive Impairment

Purpose

The aims of the study were to compare the Cognitive Self-Report Questionnaire (CSRQ; Spina, Ruff, & Mahncke, 2006) Hearing and Cognitive subscale ratings among older adults with and without probable mild cognitive impairment (MCI) and to examine whether self-report, as measured by the CSRQ, is associated with objective measures of hearing, auditory processing, and cognition.

Method

Data analyses included 97 older adults of ages 61–91 years. Participants completed the CSRQ self-report measure as well as a battery of objective measures, including pure-tone audiometry, degraded speech understanding, temporal processing, and memory.

Results

Older adults with probable MCI rated their cognitive abilities more poorly than those without MCI (p = .002), but ratings of hearing and auditory abilities did not differ between the two groups (p = .912). Age and CSRQ Hearing subscale ratings explained a significant proportion of variance in objective measures of hearing and degraded speech understanding (R ² = .39, p < .001). Age, sex, mental status, and CSRQ Cognition subscale ratings explained a significant proportion of variance in objective memory performance (R ² = .55, p < .001).

Conclusions

Taken together, these results suggest that the CSRQ is an appropriate self-report measure of hearing, cognition, and some aspects of auditory processing for older adults with and without probable MCI.

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tACS-mediated modulation of the auditory steady-state response as seen with MEG

Publication date: Available online 28 March 2018
Source:Hearing Research
Author(s): Petteri Hyvärinen, Dawoon Choi, Gianpaolo Demarchi, Antti A. Aarnisalo, Nathan Weisz
BackgroundPrevious studies have shown that transcranial electrical stimulation can be successfully applied during simultaneous MEG measurements. In particular, using beamforming they have established that changes of stimulus induced as well as evoked activity can be inspected during transcranial alternating current stimulation (tACS).Objective/Hypothesis: We studied tACS-mediated changes of the auditory steady-state response (ASSR), hypothesizing that—due to the putatively inhibitory role of alpha oscillations—these evoked responses would be diminished.MethodsWe compared ASSRs in conditions with and without 12-Hz and 6.5-Hz sinusoidal 1.5 mA tACS, applied bilaterally over temporal areas. Source-level activity was estimated using a linearly constrained minimum variance beamformer and compared across tACS conditions using paired t-tests following a condition-internal normalization procedure.ConclusionsBy separating the electrical and auditory stimulation to non-overlapping parts of the frequency spectrum, we were able to compare auditory-evoked steady-state activity across tACS conditions. We observed a significant decrease in normalized ASSR power in the 12-Hz tACS condition, illustrating that tACS could induce immediate changes in auditory evoked activity. This study sets a methodology to further interrogate the causal roles of oscillatory dynamics in auditory cortices, as well as suggests perspectives for employing tACS in clinical contexts.



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tACS-mediated modulation of the auditory steady-state response as seen with MEG

Publication date: Available online 28 March 2018
Source:Hearing Research
Author(s): Petteri Hyvärinen, Dawoon Choi, Gianpaolo Demarchi, Antti A. Aarnisalo, Nathan Weisz
BackgroundPrevious studies have shown that transcranial electrical stimulation can be successfully applied during simultaneous MEG measurements. In particular, using beamforming they have established that changes of stimulus induced as well as evoked activity can be inspected during transcranial alternating current stimulation (tACS).Objective/Hypothesis: We studied tACS-mediated changes of the auditory steady-state response (ASSR), hypothesizing that—due to the putatively inhibitory role of alpha oscillations—these evoked responses would be diminished.MethodsWe compared ASSRs in conditions with and without 12-Hz and 6.5-Hz sinusoidal 1.5 mA tACS, applied bilaterally over temporal areas. Source-level activity was estimated using a linearly constrained minimum variance beamformer and compared across tACS conditions using paired t-tests following a condition-internal normalization procedure.ConclusionsBy separating the electrical and auditory stimulation to non-overlapping parts of the frequency spectrum, we were able to compare auditory-evoked steady-state activity across tACS conditions. We observed a significant decrease in normalized ASSR power in the 12-Hz tACS condition, illustrating that tACS could induce immediate changes in auditory evoked activity. This study sets a methodology to further interrogate the causal roles of oscillatory dynamics in auditory cortices, as well as suggests perspectives for employing tACS in clinical contexts.



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