Σάββατο 24 Φεβρουαρίου 2018

Tinnitus and Self-Harm Revisited



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Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer



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An Argument for Self-Report as a Reference Standard in Audiology



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Test‐Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training



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Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test



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Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss



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Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis



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Response to Drs. Iliadou and Eleftheriadis Regarding “Auditory Processing Disorder (APD) as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion”



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Response to the Letter from Dr. Vermiglio Regarding Iliadou and Eleftheriadis (2017): CAPD is Classified in ICD-10 as H93.25



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JAAA CEU Program



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Tinnitus and Self-Harm Revisited



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Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer



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An Argument for Self-Report as a Reference Standard in Audiology



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Test‐Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training



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Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test



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Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss



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Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis



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Response to Drs. Iliadou and Eleftheriadis Regarding “Auditory Processing Disorder (APD) as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion”



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Response to the Letter from Dr. Vermiglio Regarding Iliadou and Eleftheriadis (2017): CAPD is Classified in ICD-10 as H93.25



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JAAA CEU Program



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Tinnitus and Self-Harm Revisited



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Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer



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An Argument for Self-Report as a Reference Standard in Audiology



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Test‐Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training



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Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test



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Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss



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Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis



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Response to Drs. Iliadou and Eleftheriadis Regarding “Auditory Processing Disorder (APD) as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion”



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Response to the Letter from Dr. Vermiglio Regarding Iliadou and Eleftheriadis (2017): CAPD is Classified in ICD-10 as H93.25



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JAAA CEU Program



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Average middle ear frequency response curves with preservation of curve morphology characteristics

Publication date: Available online 24 February 2018
Source:Hearing Research
Author(s): Gladiné Kilian, Joris J.J. Dirckx
For the validation of modelling results or the comparison of middle ear interventions, such as prostheses placement, average responses of middle ear vibrations are needed. One such response is the amplitude and phase of the vibration of the stapes footplate as a function of frequency. Average responses and their standard deviation are commonly obtained by calculating the mean of a number of measured responses at each frequency. A typical middle ear magnitude response curve shows a number of distinct peaks, and the location of these peaks varies between ears. By simply taking an average along the magnitude or phase response axis, the typical fine structure of the response curve is flattened out, delivering an average curve which no longer has the typical morphology of an individual response curve. This paper introduces methods to avoid this problem by first aligning the typical curve features along the frequency axis prior to calculating the average along the magnitude or phase axis, resulting in average magnitude and phase curves which maintain the typical morphology of the curve obtained for an individual ear. In the method, landmark points on the response magnitude curves are defined and the frequencies at which these points occur are averaged. Next, these average frequencies are used to align the landmark points between curves, prior to averaging values along the magnitude or phase axes. Methods for semi-automatic and manual assignment of landmark points and curve alignment are presented. After alignment, the correspondence between the original landmark frequencies and aligned frequencies is obtained together with the warping function which maps each original magnitude curve to its aligned version. The phase curves are aligned using the warping functions determined from the corresponding magnitude curves. Finally, a method is proposed to compare the data set of an individual measurement or model result to an aligned average curve in terms of magnitude and frequency by applying the alignment procedure to the individual curve.



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Increased expression level of Hsp70 in the inner ears of mice by exposure to low frequency noise

Publication date: Available online 24 February 2018
Source:Hearing Research
Author(s): Hiromasa Ninomiya, Nobutaka Ohgami, Reina Oshino, Masashi Kato, Kyoko Ohgami, Xiang Li, Dandan Shen, Machiko Iida, Ichiro Yajima, Charalampos E. Angelidis, Hiroaki Adachi, Masahisa Katsuno, Gen Sobue, Masashi Kato
Previous studies showed that people in urban areas are possibly exposed to 60–110 dB of low frequency noise (LFN) defined as noise of ≤100 Hz in their daily life. Previous studies also showed increased health risks by exposure to high levels (130–140 dB) of LFN in animals. However, little is known about the health effects of exposure to an ordinary level of LFN. We biochemically and immunohistochemically assessed the effects of exposure to inaudible LFN for mice (12 h/day of 100 Hz LFN at 95 dB for 5 days), at a level to which people are possibly exposed in daily life, on a murine inner ear by targeting 9 stress-reactive molecules. There was more than a 5-fold increased transcript level of heat shock protein 70 (Hsp70) in the whole inner ear exposed to LFN. However, the transcript levels of the other 8 stress-reactive molecules including Hsp27 and Hsp90 were comparable in LFN-exposed and unexposed murine inner ears. Only the transcript level of Cebpβ among the previously reported 4 transcriptional activators for Hsp70 expression was more than 3-fold increased by LFN exposure. Hsp70 transcript expression levels in the inner ears 3 days after LFN exposure were comparable to those in unexposed inner ears. The protein level of Hsp70, but not the levels of Hsp27 and Hsp90, was also increased in the vestibule by LFN exposure. However, hearing levels as well as expression levels of Hsp70 protein in the cochleae were comparable in LFN-exposed mice and unexposed mice. Our results demonstrated that the inner ear might be one of the organs that is negatively affected by stress from inaudible LFN exposure. Moreover, LFN exposure might increase Hsp70 expression level via Cebpβ in the inner ear. Thus, Hsp70 and Cebpβ levels could be candidates of biomarkers for response to LFN exposure.



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Average middle ear frequency response curves with preservation of curve morphology characteristics

Publication date: Available online 24 February 2018
Source:Hearing Research
Author(s): Gladiné Kilian, Joris J.J. Dirckx
For the validation of modelling results or the comparison of middle ear interventions, such as prostheses placement, average responses of middle ear vibrations are needed. One such response is the amplitude and phase of the vibration of the stapes footplate as a function of frequency. Average responses and their standard deviation are commonly obtained by calculating the mean of a number of measured responses at each frequency. A typical middle ear magnitude response curve shows a number of distinct peaks, and the location of these peaks varies between ears. By simply taking an average along the magnitude or phase response axis, the typical fine structure of the response curve is flattened out, delivering an average curve which no longer has the typical morphology of an individual response curve. This paper introduces methods to avoid this problem by first aligning the typical curve features along the frequency axis prior to calculating the average along the magnitude or phase axis, resulting in average magnitude and phase curves which maintain the typical morphology of the curve obtained for an individual ear. In the method, landmark points on the response magnitude curves are defined and the frequencies at which these points occur are averaged. Next, these average frequencies are used to align the landmark points between curves, prior to averaging values along the magnitude or phase axes. Methods for semi-automatic and manual assignment of landmark points and curve alignment are presented. After alignment, the correspondence between the original landmark frequencies and aligned frequencies is obtained together with the warping function which maps each original magnitude curve to its aligned version. The phase curves are aligned using the warping functions determined from the corresponding magnitude curves. Finally, a method is proposed to compare the data set of an individual measurement or model result to an aligned average curve in terms of magnitude and frequency by applying the alignment procedure to the individual curve.



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Increased expression level of Hsp70 in the inner ears of mice by exposure to low frequency noise

Publication date: Available online 24 February 2018
Source:Hearing Research
Author(s): Hiromasa Ninomiya, Nobutaka Ohgami, Reina Oshino, Masashi Kato, Kyoko Ohgami, Xiang Li, Dandan Shen, Machiko Iida, Ichiro Yajima, Charalampos E. Angelidis, Hiroaki Adachi, Masahisa Katsuno, Gen Sobue, Masashi Kato
Previous studies showed that people in urban areas are possibly exposed to 60–110 dB of low frequency noise (LFN) defined as noise of ≤100 Hz in their daily life. Previous studies also showed increased health risks by exposure to high levels (130–140 dB) of LFN in animals. However, little is known about the health effects of exposure to an ordinary level of LFN. We biochemically and immunohistochemically assessed the effects of exposure to inaudible LFN for mice (12 h/day of 100 Hz LFN at 95 dB for 5 days), at a level to which people are possibly exposed in daily life, on a murine inner ear by targeting 9 stress-reactive molecules. There was more than a 5-fold increased transcript level of heat shock protein 70 (Hsp70) in the whole inner ear exposed to LFN. However, the transcript levels of the other 8 stress-reactive molecules including Hsp27 and Hsp90 were comparable in LFN-exposed and unexposed murine inner ears. Only the transcript level of Cebpβ among the previously reported 4 transcriptional activators for Hsp70 expression was more than 3-fold increased by LFN exposure. Hsp70 transcript expression levels in the inner ears 3 days after LFN exposure were comparable to those in unexposed inner ears. The protein level of Hsp70, but not the levels of Hsp27 and Hsp90, was also increased in the vestibule by LFN exposure. However, hearing levels as well as expression levels of Hsp70 protein in the cochleae were comparable in LFN-exposed mice and unexposed mice. Our results demonstrated that the inner ear might be one of the organs that is negatively affected by stress from inaudible LFN exposure. Moreover, LFN exposure might increase Hsp70 expression level via Cebpβ in the inner ear. Thus, Hsp70 and Cebpβ levels could be candidates of biomarkers for response to LFN exposure.



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Average middle ear frequency response curves with preservation of curve morphology characteristics

Publication date: Available online 24 February 2018
Source:Hearing Research
Author(s): Gladiné Kilian, Joris J.J. Dirckx
For the validation of modelling results or the comparison of middle ear interventions, such as prostheses placement, average responses of middle ear vibrations are needed. One such response is the amplitude and phase of the vibration of the stapes footplate as a function of frequency. Average responses and their standard deviation are commonly obtained by calculating the mean of a number of measured responses at each frequency. A typical middle ear magnitude response curve shows a number of distinct peaks, and the location of these peaks varies between ears. By simply taking an average along the magnitude or phase response axis, the typical fine structure of the response curve is flattened out, delivering an average curve which no longer has the typical morphology of an individual response curve. This paper introduces methods to avoid this problem by first aligning the typical curve features along the frequency axis prior to calculating the average along the magnitude or phase axis, resulting in average magnitude and phase curves which maintain the typical morphology of the curve obtained for an individual ear. In the method, landmark points on the response magnitude curves are defined and the frequencies at which these points occur are averaged. Next, these average frequencies are used to align the landmark points between curves, prior to averaging values along the magnitude or phase axes. Methods for semi-automatic and manual assignment of landmark points and curve alignment are presented. After alignment, the correspondence between the original landmark frequencies and aligned frequencies is obtained together with the warping function which maps each original magnitude curve to its aligned version. The phase curves are aligned using the warping functions determined from the corresponding magnitude curves. Finally, a method is proposed to compare the data set of an individual measurement or model result to an aligned average curve in terms of magnitude and frequency by applying the alignment procedure to the individual curve.



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Increased expression level of Hsp70 in the inner ears of mice by exposure to low frequency noise

Publication date: Available online 24 February 2018
Source:Hearing Research
Author(s): Hiromasa Ninomiya, Nobutaka Ohgami, Reina Oshino, Masashi Kato, Kyoko Ohgami, Xiang Li, Dandan Shen, Machiko Iida, Ichiro Yajima, Charalampos E. Angelidis, Hiroaki Adachi, Masahisa Katsuno, Gen Sobue, Masashi Kato
Previous studies showed that people in urban areas are possibly exposed to 60–110 dB of low frequency noise (LFN) defined as noise of ≤100 Hz in their daily life. Previous studies also showed increased health risks by exposure to high levels (130–140 dB) of LFN in animals. However, little is known about the health effects of exposure to an ordinary level of LFN. We biochemically and immunohistochemically assessed the effects of exposure to inaudible LFN for mice (12 h/day of 100 Hz LFN at 95 dB for 5 days), at a level to which people are possibly exposed in daily life, on a murine inner ear by targeting 9 stress-reactive molecules. There was more than a 5-fold increased transcript level of heat shock protein 70 (Hsp70) in the whole inner ear exposed to LFN. However, the transcript levels of the other 8 stress-reactive molecules including Hsp27 and Hsp90 were comparable in LFN-exposed and unexposed murine inner ears. Only the transcript level of Cebpβ among the previously reported 4 transcriptional activators for Hsp70 expression was more than 3-fold increased by LFN exposure. Hsp70 transcript expression levels in the inner ears 3 days after LFN exposure were comparable to those in unexposed inner ears. The protein level of Hsp70, but not the levels of Hsp27 and Hsp90, was also increased in the vestibule by LFN exposure. However, hearing levels as well as expression levels of Hsp70 protein in the cochleae were comparable in LFN-exposed mice and unexposed mice. Our results demonstrated that the inner ear might be one of the organs that is negatively affected by stress from inaudible LFN exposure. Moreover, LFN exposure might increase Hsp70 expression level via Cebpβ in the inner ear. Thus, Hsp70 and Cebpβ levels could be candidates of biomarkers for response to LFN exposure.



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The learning process of gait retraining using real-time feedback in patients with medial knee osteoarthritis

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Rosie Richards, Martin van der Esch, Josien C. van den Noort, Jaap Harlaar
The objective of this study was to investigate the learning process of knee osteoarthritis (KOA) patients learning to change their foot progression angle (FPA) over a six-week toe-in gait training program.Sixteen patients with medial KOA completed a six-week toe-in gait training program with real-time biofeedback. Patients walked on an instrumented treadmill while receiving real-time feedback on their foot progression angle (FPA) with reference to a target angle. The FPA difference (difference between target and actual FPA) was analyzed during i) natural walking, ii) walking with feedback, iii) walking without feedback and iv) walking with a dual-task at the start and end of the training program. Self-reported difficulty and abnormality and time spent walking and training were also analyzed.The FPA difference during natural walking was significantly decreased from median 6.9 to median 3.6° i.e. by 3.3° in week six (p < 0.001); adding feedback reduced FPA difference to almost zero. However the dual-task condition increased the FPA difference at week one compared to the feedback condition (median difference: 1.8°, p = 0.022), but after training this effect was minimized (median difference: 0.6°, p = 0.167). Self-reported abnormality and difficulty decreased from median 5 to 3 and from median 6 to 3 on the NRS respectively (p < 0.05).Patients with medial KOA could reduce the FPA difference during natural walking after the gait retraining program, with some evidence of a reduction in the cognitive demand needed to achieve this. Automation of adaptions might need support from more permanent feedback using wearable technologies.



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Gait assessment of the expectant mothers – Systematic review

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Wanda Forczek, Yury P. Ivanenko, Joanna Bielatowicz, Karolina Wacławik
IntroductionSince pregnant women may have potentially greater difficulty maintaining balance, their stability has been investigated by some researchers. However, there is no consensus considering the results. The purpose of our investigation was to compare all the experimental studies focusing on the analysis of gait that have been conducted over the last years to assess their methodological issues and changes induced by pregnancy.MethodsThe PRISMA Guidelines incorporating a risk of bias and strength of recommendations were used as a methodological template for this review. Literature searches were conducted using the following databases: PubMed, Embase, SPORTDiscus, Scopus. After limiting the search to meet the inclusion criteria, 25 articles remained in the final analysis.ResultsSome authors emphasised that adaptations due to pregnancy are recognised to provide safety and stability. Thus, they consistently reported reduced walking velocity as a result of lower frequency and smaller length of the steps. Longer contact times were reflected by the shortened peak forces. Plantar loads were redistributed from the rearfoot (decrease) to the midfoot and forefoot (increase) throughout pregnancy. Another adjustment was an increase of base of support to improve lateral gait stability which allows to compensate increased medio-lateral ground reaction force. During the course of pregnancy the increase of anterior body mass and hormonal changes enhance some realignments of the pelvis and lumbar spine. Methodological approaches varied across the included studies. The critical appraisal identified some areas of weaknesses that should be considered for designing the future investigations.ConclusionsSince many gait parameters are interrelated, in order to understand the cause-and-effect relationships an integrative and complete analysis of multiple factors is required.



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The relationship between foot posture and plantar pressure during walking in adults: a systematic review

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Andrew K. Buldt, Jamie J. Allan, Karl B. Landorf, Hylton B. Menz
BackgroundFoot posture is a risk factor for some lower limb injuries, however the underlying mechanism is not well understood. Plantar pressure analysis is one technique to investigate the interaction between foot posture and biomechanical function of the lower limb.Research questionThe aim of this review was to investigate the relationship between foot posture and plantar pressure during walking.MethodsA systematic database search was conducted using MEDLINE, CINAHL, SPORTDiscus and Embase to identify studies that have assessed the relationship between foot posture and plantar pressure during walking. Included studies were assessed for methodological quality. Meta-analysis was not conducted due to heterogeneity between studies. Inconsistencies included foot posture classification techniques, gait analysis protocols, selection of plantar pressure parameters and statistical analysis approaches.ResultsOf the 4,213 citations identified for title and abstract review, sixteen studies were included and underwent quality assessment; all were of moderate methodological quality. There was some evidence that planus feet display higher peak pressure, pressure-time integral, maximum force, force-time integral and contact area predominantly in the medial arch, central forefoot and hallux, while these variables are lower in the lateral and medial forefoot. In contrast, cavus feet display higher peak pressure and pressure-time integral in the heel and lateral forefoot, while pressure-time integral, maximum force, force-time integral and contact area are lower for the midfoot and hallux. Centre of pressure was more laterally deviated in cavus feet and more medially deviated in planus feet. Overall, effect sizes were moderate, but regression models could only explain a small amount of variance in plantar pressure variables.SignificanceDespite these significant findings, future research would benefit from greater methodological rigour, particularly in relation to the use of valid foot posture measurement techniques, gait analysis protocols, and standardised approaches for analysis and reporting of plantar pressure variables.



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The learning process of gait retraining using real-time feedback in patients with medial knee osteoarthritis

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Rosie Richards, Martin van der Esch, Josien C. van den Noort, Jaap Harlaar
The objective of this study was to investigate the learning process of knee osteoarthritis (KOA) patients learning to change their foot progression angle (FPA) over a six-week toe-in gait training program.Sixteen patients with medial KOA completed a six-week toe-in gait training program with real-time biofeedback. Patients walked on an instrumented treadmill while receiving real-time feedback on their foot progression angle (FPA) with reference to a target angle. The FPA difference (difference between target and actual FPA) was analyzed during i) natural walking, ii) walking with feedback, iii) walking without feedback and iv) walking with a dual-task at the start and end of the training program. Self-reported difficulty and abnormality and time spent walking and training were also analyzed.The FPA difference during natural walking was significantly decreased from median 6.9 to median 3.6° i.e. by 3.3° in week six (p < 0.001); adding feedback reduced FPA difference to almost zero. However the dual-task condition increased the FPA difference at week one compared to the feedback condition (median difference: 1.8°, p = 0.022), but after training this effect was minimized (median difference: 0.6°, p = 0.167). Self-reported abnormality and difficulty decreased from median 5 to 3 and from median 6 to 3 on the NRS respectively (p < 0.05).Patients with medial KOA could reduce the FPA difference during natural walking after the gait retraining program, with some evidence of a reduction in the cognitive demand needed to achieve this. Automation of adaptions might need support from more permanent feedback using wearable technologies.



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Gait assessment of the expectant mothers – Systematic review

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Wanda Forczek, Yury P. Ivanenko, Joanna Bielatowicz, Karolina Wacławik
IntroductionSince pregnant women may have potentially greater difficulty maintaining balance, their stability has been investigated by some researchers. However, there is no consensus considering the results. The purpose of our investigation was to compare all the experimental studies focusing on the analysis of gait that have been conducted over the last years to assess their methodological issues and changes induced by pregnancy.MethodsThe PRISMA Guidelines incorporating a risk of bias and strength of recommendations were used as a methodological template for this review. Literature searches were conducted using the following databases: PubMed, Embase, SPORTDiscus, Scopus. After limiting the search to meet the inclusion criteria, 25 articles remained in the final analysis.ResultsSome authors emphasised that adaptations due to pregnancy are recognised to provide safety and stability. Thus, they consistently reported reduced walking velocity as a result of lower frequency and smaller length of the steps. Longer contact times were reflected by the shortened peak forces. Plantar loads were redistributed from the rearfoot (decrease) to the midfoot and forefoot (increase) throughout pregnancy. Another adjustment was an increase of base of support to improve lateral gait stability which allows to compensate increased medio-lateral ground reaction force. During the course of pregnancy the increase of anterior body mass and hormonal changes enhance some realignments of the pelvis and lumbar spine. Methodological approaches varied across the included studies. The critical appraisal identified some areas of weaknesses that should be considered for designing the future investigations.ConclusionsSince many gait parameters are interrelated, in order to understand the cause-and-effect relationships an integrative and complete analysis of multiple factors is required.



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The relationship between foot posture and plantar pressure during walking in adults: a systematic review

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Andrew K. Buldt, Jamie J. Allan, Karl B. Landorf, Hylton B. Menz
BackgroundFoot posture is a risk factor for some lower limb injuries, however the underlying mechanism is not well understood. Plantar pressure analysis is one technique to investigate the interaction between foot posture and biomechanical function of the lower limb.Research questionThe aim of this review was to investigate the relationship between foot posture and plantar pressure during walking.MethodsA systematic database search was conducted using MEDLINE, CINAHL, SPORTDiscus and Embase to identify studies that have assessed the relationship between foot posture and plantar pressure during walking. Included studies were assessed for methodological quality. Meta-analysis was not conducted due to heterogeneity between studies. Inconsistencies included foot posture classification techniques, gait analysis protocols, selection of plantar pressure parameters and statistical analysis approaches.ResultsOf the 4,213 citations identified for title and abstract review, sixteen studies were included and underwent quality assessment; all were of moderate methodological quality. There was some evidence that planus feet display higher peak pressure, pressure-time integral, maximum force, force-time integral and contact area predominantly in the medial arch, central forefoot and hallux, while these variables are lower in the lateral and medial forefoot. In contrast, cavus feet display higher peak pressure and pressure-time integral in the heel and lateral forefoot, while pressure-time integral, maximum force, force-time integral and contact area are lower for the midfoot and hallux. Centre of pressure was more laterally deviated in cavus feet and more medially deviated in planus feet. Overall, effect sizes were moderate, but regression models could only explain a small amount of variance in plantar pressure variables.SignificanceDespite these significant findings, future research would benefit from greater methodological rigour, particularly in relation to the use of valid foot posture measurement techniques, gait analysis protocols, and standardised approaches for analysis and reporting of plantar pressure variables.



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The learning process of gait retraining using real-time feedback in patients with medial knee osteoarthritis

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Rosie Richards, Martin van der Esch, Josien C. van den Noort, Jaap Harlaar
The objective of this study was to investigate the learning process of knee osteoarthritis (KOA) patients learning to change their foot progression angle (FPA) over a six-week toe-in gait training program.Sixteen patients with medial KOA completed a six-week toe-in gait training program with real-time biofeedback. Patients walked on an instrumented treadmill while receiving real-time feedback on their foot progression angle (FPA) with reference to a target angle. The FPA difference (difference between target and actual FPA) was analyzed during i) natural walking, ii) walking with feedback, iii) walking without feedback and iv) walking with a dual-task at the start and end of the training program. Self-reported difficulty and abnormality and time spent walking and training were also analyzed.The FPA difference during natural walking was significantly decreased from median 6.9 to median 3.6° i.e. by 3.3° in week six (p < 0.001); adding feedback reduced FPA difference to almost zero. However the dual-task condition increased the FPA difference at week one compared to the feedback condition (median difference: 1.8°, p = 0.022), but after training this effect was minimized (median difference: 0.6°, p = 0.167). Self-reported abnormality and difficulty decreased from median 5 to 3 and from median 6 to 3 on the NRS respectively (p < 0.05).Patients with medial KOA could reduce the FPA difference during natural walking after the gait retraining program, with some evidence of a reduction in the cognitive demand needed to achieve this. Automation of adaptions might need support from more permanent feedback using wearable technologies.



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Gait assessment of the expectant mothers – Systematic review

S09666362.gif

Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Wanda Forczek, Yury P. Ivanenko, Joanna Bielatowicz, Karolina Wacławik
IntroductionSince pregnant women may have potentially greater difficulty maintaining balance, their stability has been investigated by some researchers. However, there is no consensus considering the results. The purpose of our investigation was to compare all the experimental studies focusing on the analysis of gait that have been conducted over the last years to assess their methodological issues and changes induced by pregnancy.MethodsThe PRISMA Guidelines incorporating a risk of bias and strength of recommendations were used as a methodological template for this review. Literature searches were conducted using the following databases: PubMed, Embase, SPORTDiscus, Scopus. After limiting the search to meet the inclusion criteria, 25 articles remained in the final analysis.ResultsSome authors emphasised that adaptations due to pregnancy are recognised to provide safety and stability. Thus, they consistently reported reduced walking velocity as a result of lower frequency and smaller length of the steps. Longer contact times were reflected by the shortened peak forces. Plantar loads were redistributed from the rearfoot (decrease) to the midfoot and forefoot (increase) throughout pregnancy. Another adjustment was an increase of base of support to improve lateral gait stability which allows to compensate increased medio-lateral ground reaction force. During the course of pregnancy the increase of anterior body mass and hormonal changes enhance some realignments of the pelvis and lumbar spine. Methodological approaches varied across the included studies. The critical appraisal identified some areas of weaknesses that should be considered for designing the future investigations.ConclusionsSince many gait parameters are interrelated, in order to understand the cause-and-effect relationships an integrative and complete analysis of multiple factors is required.



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The relationship between foot posture and plantar pressure during walking in adults: a systematic review

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Publication date: Available online 23 February 2018
Source:Gait & Posture
Author(s): Andrew K. Buldt, Jamie J. Allan, Karl B. Landorf, Hylton B. Menz
BackgroundFoot posture is a risk factor for some lower limb injuries, however the underlying mechanism is not well understood. Plantar pressure analysis is one technique to investigate the interaction between foot posture and biomechanical function of the lower limb.Research questionThe aim of this review was to investigate the relationship between foot posture and plantar pressure during walking.MethodsA systematic database search was conducted using MEDLINE, CINAHL, SPORTDiscus and Embase to identify studies that have assessed the relationship between foot posture and plantar pressure during walking. Included studies were assessed for methodological quality. Meta-analysis was not conducted due to heterogeneity between studies. Inconsistencies included foot posture classification techniques, gait analysis protocols, selection of plantar pressure parameters and statistical analysis approaches.ResultsOf the 4,213 citations identified for title and abstract review, sixteen studies were included and underwent quality assessment; all were of moderate methodological quality. There was some evidence that planus feet display higher peak pressure, pressure-time integral, maximum force, force-time integral and contact area predominantly in the medial arch, central forefoot and hallux, while these variables are lower in the lateral and medial forefoot. In contrast, cavus feet display higher peak pressure and pressure-time integral in the heel and lateral forefoot, while pressure-time integral, maximum force, force-time integral and contact area are lower for the midfoot and hallux. Centre of pressure was more laterally deviated in cavus feet and more medially deviated in planus feet. Overall, effect sizes were moderate, but regression models could only explain a small amount of variance in plantar pressure variables.SignificanceDespite these significant findings, future research would benefit from greater methodological rigour, particularly in relation to the use of valid foot posture measurement techniques, gait analysis protocols, and standardised approaches for analysis and reporting of plantar pressure variables.



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Oticon Improves Internet-Connected Hearing Aids with New ConnectClip

Oticon.jpgOticon (https://www.oticon.com/) has introduced ConnectClip, which turns Oticon's internet-connected hearing aids into wireless headsets for hands-free calls and listening to music or podcasts in stereo. It works with any smartphone, music player, or computer, and it serves as a remote control for Oticon's Opn hearing aids to adjust volume and change programs. Sound from mobile phones is streamed directly to the hearing aids via 2.4GHz Bluetooth Low Energy, and ConnectClip's directional microphones pick up the wearer's voice. ConnectClip can also function as a remote or partner microphone, providing improved intelligibility of the speaker wearing it at a distance of up to 65 feet, in very noisy environments, or a combination of both. ConnectClip can be paired with or connected directly to a computer's built-in Bluetooth or used with the BTD 800 USB dongle. 

Published: 2/23/2018 12:55:00 PM


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Poor Nutrition in Early Childhood May Lead to Hearing Loss

A newly published study in the American Journal of Clinical Nutrition reports that undernutrition during early childhood is a risk factor for hearing loss in early adulthood.

From 2006-2008, researchers from Johns Hopkins Bloomberg School of Public Health carried out a study in Sarlahi, Nepal as a follow-up health and nutritional status assessment to an earlier project called Nepal Nutrition Intervention Project-1 (NNPIS-1), which was a cluster-randomized vitamin A supplementation trial for pre-school age children conducted between 1989 and 1991.

When asked about the reason behind the study, lead author Susan Emmett, MD, MPH said, "There are over a billion people living with hearing loss worldwide, and 80 percent are in low- and middle-income countries. With the tremendous lifelong impact of hearing loss on school achievement, economic outcomes, and overall health, it is essential to better understand why hearing loss is more common in low resource settings and what we can do to prevent it from happening in the first place."

The participants of the 2006-2008 research were 2193 young adults, with age range from 16 to 23, who were former participants of NNPIS-1. The results reveal that of the total number of participants, 5.93 percent exhibited hearing loss.

According to the paper titled "Early Childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal," early childhood malnutrition—wasting, stunting, being underweight—are associated with hearing loss. Participants who were malnourished during their early childhood were at higher risk for hearing impairment in their young adulthood. These undernutrition-hearing loss associations remained relevant even with research adjustments for age, sex, and multiple indicators of socioeconomic status, for abnormal tympanometry, and for cerumen impaction. The authors suggest that the association between preschool undernutrition and early adulthood hearing loss may have been a result of utero nutritional exposures or malnutrition that extends from fetal life through the preschool years.

“This study describes a new pathway for hearing loss prevention,” Emmett told The Hearing Journal. “We have identified nutritional risk factors and a window of opportunity, from fetal development through early childhood, to reduce the risk of later-life hearing loss. The results have implications for much of the Gangetic floodplain of South Asia, home to nearly 1 billion people and a region where undernutrition continues to be a problem.”

Published: 2/20/2018 8:11:00 AM


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Oticon Improves Internet-Connected Hearing Aids with New ConnectClip

Oticon.jpgOticon (https://www.oticon.com/) has introduced ConnectClip, which turns Oticon's internet-connected hearing aids into wireless headsets for hands-free calls and listening to music or podcasts in stereo. It works with any smartphone, music player, or computer, and it serves as a remote control for Oticon's Opn hearing aids to adjust volume and change programs. Sound from mobile phones is streamed directly to the hearing aids via 2.4GHz Bluetooth Low Energy, and ConnectClip's directional microphones pick up the wearer's voice. ConnectClip can also function as a remote or partner microphone, providing improved intelligibility of the speaker wearing it at a distance of up to 65 feet, in very noisy environments, or a combination of both. ConnectClip can be paired with or connected directly to a computer's built-in Bluetooth or used with the BTD 800 USB dongle. 

Published: 2/23/2018 12:55:00 PM


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Poor Nutrition in Early Childhood May Lead to Hearing Loss

A newly published study in the American Journal of Clinical Nutrition reports that undernutrition during early childhood is a risk factor for hearing loss in early adulthood.

From 2006-2008, researchers from Johns Hopkins Bloomberg School of Public Health carried out a study in Sarlahi, Nepal as a follow-up health and nutritional status assessment to an earlier project called Nepal Nutrition Intervention Project-1 (NNPIS-1), which was a cluster-randomized vitamin A supplementation trial for pre-school age children conducted between 1989 and 1991.

When asked about the reason behind the study, lead author Susan Emmett, MD, MPH said, "There are over a billion people living with hearing loss worldwide, and 80 percent are in low- and middle-income countries. With the tremendous lifelong impact of hearing loss on school achievement, economic outcomes, and overall health, it is essential to better understand why hearing loss is more common in low resource settings and what we can do to prevent it from happening in the first place."

The participants of the 2006-2008 research were 2193 young adults, with age range from 16 to 23, who were former participants of NNPIS-1. The results reveal that of the total number of participants, 5.93 percent exhibited hearing loss.

According to the paper titled "Early Childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal," early childhood malnutrition—wasting, stunting, being underweight—are associated with hearing loss. Participants who were malnourished during their early childhood were at higher risk for hearing impairment in their young adulthood. These undernutrition-hearing loss associations remained relevant even with research adjustments for age, sex, and multiple indicators of socioeconomic status, for abnormal tympanometry, and for cerumen impaction. The authors suggest that the association between preschool undernutrition and early adulthood hearing loss may have been a result of utero nutritional exposures or malnutrition that extends from fetal life through the preschool years.

“This study describes a new pathway for hearing loss prevention,” Emmett told The Hearing Journal. “We have identified nutritional risk factors and a window of opportunity, from fetal development through early childhood, to reduce the risk of later-life hearing loss. The results have implications for much of the Gangetic floodplain of South Asia, home to nearly 1 billion people and a region where undernutrition continues to be a problem.”

Published: 2/20/2018 8:11:00 AM


from #Audiology via ola Kala on Inoreader http://ift.tt/2GFHI0V
via IFTTT

Oticon Improves Internet-Connected Hearing Aids with New ConnectClip

Oticon.jpgOticon (https://www.oticon.com/) has introduced ConnectClip, which turns Oticon's internet-connected hearing aids into wireless headsets for hands-free calls and listening to music or podcasts in stereo. It works with any smartphone, music player, or computer, and it serves as a remote control for Oticon's Opn hearing aids to adjust volume and change programs. Sound from mobile phones is streamed directly to the hearing aids via 2.4GHz Bluetooth Low Energy, and ConnectClip's directional microphones pick up the wearer's voice. ConnectClip can also function as a remote or partner microphone, providing improved intelligibility of the speaker wearing it at a distance of up to 65 feet, in very noisy environments, or a combination of both. ConnectClip can be paired with or connected directly to a computer's built-in Bluetooth or used with the BTD 800 USB dongle. 

Published: 2/23/2018 12:55:00 PM


from #Audiology via ola Kala on Inoreader http://ift.tt/2HK6RsC
via IFTTT

Poor Nutrition in Early Childhood May Lead to Hearing Loss

A newly published study in the American Journal of Clinical Nutrition reports that undernutrition during early childhood is a risk factor for hearing loss in early adulthood.

From 2006-2008, researchers from Johns Hopkins Bloomberg School of Public Health carried out a study in Sarlahi, Nepal as a follow-up health and nutritional status assessment to an earlier project called Nepal Nutrition Intervention Project-1 (NNPIS-1), which was a cluster-randomized vitamin A supplementation trial for pre-school age children conducted between 1989 and 1991.

When asked about the reason behind the study, lead author Susan Emmett, MD, MPH said, "There are over a billion people living with hearing loss worldwide, and 80 percent are in low- and middle-income countries. With the tremendous lifelong impact of hearing loss on school achievement, economic outcomes, and overall health, it is essential to better understand why hearing loss is more common in low resource settings and what we can do to prevent it from happening in the first place."

The participants of the 2006-2008 research were 2193 young adults, with age range from 16 to 23, who were former participants of NNPIS-1. The results reveal that of the total number of participants, 5.93 percent exhibited hearing loss.

According to the paper titled "Early Childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal," early childhood malnutrition—wasting, stunting, being underweight—are associated with hearing loss. Participants who were malnourished during their early childhood were at higher risk for hearing impairment in their young adulthood. These undernutrition-hearing loss associations remained relevant even with research adjustments for age, sex, and multiple indicators of socioeconomic status, for abnormal tympanometry, and for cerumen impaction. The authors suggest that the association between preschool undernutrition and early adulthood hearing loss may have been a result of utero nutritional exposures or malnutrition that extends from fetal life through the preschool years.

“This study describes a new pathway for hearing loss prevention,” Emmett told The Hearing Journal. “We have identified nutritional risk factors and a window of opportunity, from fetal development through early childhood, to reduce the risk of later-life hearing loss. The results have implications for much of the Gangetic floodplain of South Asia, home to nearly 1 billion people and a region where undernutrition continues to be a problem.”

Published: 2/20/2018 8:11:00 AM


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