Phonak and Advanced Bionics to Launch New Microphone Technology

​Phonak has partnered with Advanced Bionics to develop a new microphone technology, MultiBeam Technology, that will help people with hearing aids and cochlear implants hear better in noise. By utilizing multiple microphones in six directions, MultiBeam Technology captures speech from 360 degrees, which is then calculated and compared. The direction with the best signal-to-noise ratio is automatically selected. Phonak said the technological processing complexity is almost 10 times higher than its previous technology, and the power consumption was reduced more than one-third with MultiBeam Technology, which has been in development since 2009. In a study conducted at the University of Dallas involving 10 participants, speech understanding improved up to 61 percent in a group conversation in 75 dBA of noise compared with that when using hearing aids alone in the same setting. Linda Thibodeau, PhD, who led the research, said this new technology will allow people with hearing challenges who have resigned from attending social functions, family gatherings, and business meetings to experience significant improvements in speech recognition. "This could ultimately lead to improved quality of life as they confidently reconnect with others using discreet, convenient, and highly versatile technology," she said. 

Published: 3/9/2018 10:12:00 AM

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Phonak and Advanced Bionics to Launch New Microphone Technology

​Phonak has partnered with Advanced Bionics to develop a new microphone technology, MultiBeam Technology, that will help people with hearing aids and cochlear implants hear better in noise. By utilizing multiple microphones in six directions, MultiBeam Technology captures speech from 360 degrees, which is then calculated and compared. The direction with the best signal-to-noise ratio is automatically selected. Phonak said the technological processing complexity is almost 10 times higher than its previous technology, and the power consumption was reduced more than one-third with MultiBeam Technology, which has been in development since 2009. In a study conducted at the University of Dallas involving 10 participants, speech understanding improved up to 61 percent in a group conversation in 75 dBA of noise compared with that when using hearing aids alone in the same setting. Linda Thibodeau, PhD, who led the research, said this new technology will allow people with hearing challenges who have resigned from attending social functions, family gatherings, and business meetings to experience significant improvements in speech recognition. "This could ultimately lead to improved quality of life as they confidently reconnect with others using discreet, convenient, and highly versatile technology," she said. 

Published: 3/9/2018 10:12:00 AM

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via IFTTT

Phonak and Advanced Bionics to Launch New Microphone Technology

​Phonak has partnered with Advanced Bionics to develop a new microphone technology, MultiBeam Technology, that will help people with hearing aids and cochlear implants hear better in noise. By utilizing multiple microphones in six directions, MultiBeam Technology captures speech from 360 degrees, which is then calculated and compared. The direction with the best signal-to-noise ratio is automatically selected. Phonak said the technological processing complexity is almost 10 times higher than its previous technology, and the power consumption was reduced more than one-third with MultiBeam Technology, which has been in development since 2009. In a study conducted at the University of Dallas involving 10 participants, speech understanding improved up to 61 percent in a group conversation in 75 dBA of noise compared with that when using hearing aids alone in the same setting. Linda Thibodeau, PhD, who led the research, said this new technology will allow people with hearing challenges who have resigned from attending social functions, family gatherings, and business meetings to experience significant improvements in speech recognition. "This could ultimately lead to improved quality of life as they confidently reconnect with others using discreet, convenient, and highly versatile technology," she said. 

Published: 3/9/2018 10:12:00 AM

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Responses of neurons in the feline inferior colliculus to modulated electrical stimuli applied on and within the ventral cochlear nucleus; Implications for an advanced auditory brainstem implant

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Douglas McCreery, Kamal Yadev, Martin Han
Auditory brainstem implants (ABIs) can restore useful hearing to persons with deafness who cannot benefit from cochlear implants. However, the quality of hearing restored by ABIs rarely is comparable to that provided by cochlear implants in persons for whom those are appropriate. In an animal model, we evaluated elements of a prototype of an ABI in which the functions of macroelectrodes on the surface of the dorsal cochlear nucleus would be integrated with the function of multiple penetrating microelectrodes implanted into the ventral cochlear nucleus. The surface electrodes would convey most of the range of loudness percepts while the intranuclear microelectrodes would sharpen and focus pitch percepts. In the present study, stimulating electrodes were implanted chronically on the surface of the animal's dorsal cochlear nucleus (DCN) and also within their ventral cochlear nucleus (VCN). Recording microelectrodes were implanted into the central nucleus of the inferior colliculus (ICC). The electrical stimuli were sinusoidally modulated stimulus pulse trains applied on the DCN and within the VCN. Temporal encoding of neuronal responses was quantified as vector strength (VS) and as full-cycle rate of neuronal activity in the ICC. VS and full-cycle AP rate were measured for 4 stimulation modes; continuous and transient amplitude modulation of the stimulus pulse trains, each delivered via the macroelectrode on the surface of the DCN and then by the intranuclear penetrating microelectrodes. In the proposed clinical device the functions of the surface and intranuclear microelectrodes could best be integrated if there is minimal variation in the neuronal responses across the range of modulation depth, modulation frequencies, and across the four stimulation modes. In this study VS did vary as much as 34% across modulation frequency and modulation depth within a stimulation mode, and up to 40% between modulation modes. However, these intra- and inter-mode variances differed for different stimulation rates, and at 500 Hz the inter-mode differences in VS and across the range of modulation frequencies and modulation depths was<Roman> = </Roman>24% and the intra-modal differences were<Roman> = </Roman>15%. The findings were generally similar for rate encoding of modulation depth, although the depth of transient amplitude modulation delivered by the surface electrode was weakly encoded as full-cycle rate. Overall, our findings support the concept of a clinical ABI that employs surface stimulation and intranuclear microstimulation in an integrated manner.



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Controlled drug release to the inner ear: Concepts, materials, mechanisms, and performance

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Karsten Mäder, Eric Lehner, Arne Liebau, Stefan Plontke
Progress in drug delivery to the ear has been achieved over the last few years. This review illustrates the main mechanisms of controlled drug release and the resulting geometry- and size-dependent release kinetics. The potency, physicochemical properties, and stability of the drug molecules are key parameters for designing the most suitable drug delivery system. The most important drug delivery systems for the inner ear include solid foams, hydrogels, and different nanoscale drug delivery systems (e.g., nanoparticles, liposomes, lipid nanocapsules, polymersomes). Their main characteristics (i.e., general structure and materials) are discussed, with special attention given to underlining the link between the physicochemical properties (e.g., surface areas, glass transition temperature, microviscosity, size, and shape) and release kinetics. An appropriate characterization of the drug, the excipients used, and the formulated drug delivery systems is necessary to achieve a deeper understanding of the release process and decrease variability originating from the drug delivery system. This task cannot be solved by otologists alone. The interdisciplinary cooperation between otology/neurotology, pharmaceutics, physics, and other disciplines will result in improved drug delivery systems for the inner ear.



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Impaired speech perception in noise with a normal audiogram: No evidence for cochlear synaptopathy and no relation to lifetime noise exposure

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Hannah Guest, Kevin J. Munro, Garreth Prendergast, Rebecca Millman, Christopher J. Plack
In rodents, noise exposure can destroy synapses between inner hair cells and auditory nerve fibers (“cochlear synaptopathy”) without causing hair cell loss. Noise-induced cochlear synaptopathy usually leaves cochlear thresholds unaltered, but is associated with long-term reductions in auditory brainstem response (ABR) amplitudes at medium-to-high sound levels. This pathophysiology has been suggested to degrade speech perception in noise (SPiN), perhaps explaining why SPiN ability varies so widely among audiometrically normal humans. The present study is the first to test for evidence of cochlear synaptopathy in humans with significant SPiN impairment. Individuals were recruited on the basis of self-reported SPiN difficulties and normal pure tone audiometric thresholds. Performance on a listening task identified a subset with “verified” SPiN impairment. This group was matched with controls on the basis of age, sex, and audiometric thresholds up to 14 kHz. ABRs and envelope-following responses (EFRs) were recorded at high stimulus levels, yielding both raw amplitude measures and within-subject difference measures. Past exposure to high sound levels was assessed by detailed structured interview. Impaired SPiN was not associated with greater lifetime noise exposure, nor with any electrophysiological measure. It is conceivable that retrospective self-report cannot reliably capture noise exposure, and that ABRs and EFRs offer limited sensitivity to synaptopathy in humans. Nevertheless, the results do not support the notion that noise-induced synaptopathy is a significant etiology of SPiN impairment with normal audiometric thresholds. It may be that synaptopathy alone does not have significant perceptual consequences, or is not widespread in humans with normal audiograms.



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Responses of neurons in the feline inferior colliculus to modulated electrical stimuli applied on and within the ventral cochlear nucleus; Implications for an advanced auditory brainstem implant

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Douglas McCreery, Kamal Yadev, Martin Han
Auditory brainstem implants (ABIs) can restore useful hearing to persons with deafness who cannot benefit from cochlear implants. However, the quality of hearing restored by ABIs rarely is comparable to that provided by cochlear implants in persons for whom those are appropriate. In an animal model, we evaluated elements of a prototype of an ABI in which the functions of macroelectrodes on the surface of the dorsal cochlear nucleus would be integrated with the function of multiple penetrating microelectrodes implanted into the ventral cochlear nucleus. The surface electrodes would convey most of the range of loudness percepts while the intranuclear microelectrodes would sharpen and focus pitch percepts. In the present study, stimulating electrodes were implanted chronically on the surface of the animal's dorsal cochlear nucleus (DCN) and also within their ventral cochlear nucleus (VCN). Recording microelectrodes were implanted into the central nucleus of the inferior colliculus (ICC). The electrical stimuli were sinusoidally modulated stimulus pulse trains applied on the DCN and within the VCN. Temporal encoding of neuronal responses was quantified as vector strength (VS) and as full-cycle rate of neuronal activity in the ICC. VS and full-cycle AP rate were measured for 4 stimulation modes; continuous and transient amplitude modulation of the stimulus pulse trains, each delivered via the macroelectrode on the surface of the DCN and then by the intranuclear penetrating microelectrodes. In the proposed clinical device the functions of the surface and intranuclear microelectrodes could best be integrated if there is minimal variation in the neuronal responses across the range of modulation depth, modulation frequencies, and across the four stimulation modes. In this study VS did vary as much as 34% across modulation frequency and modulation depth within a stimulation mode, and up to 40% between modulation modes. However, these intra- and inter-mode variances differed for different stimulation rates, and at 500 Hz the inter-mode differences in VS and across the range of modulation frequencies and modulation depths was<Roman> = </Roman>24% and the intra-modal differences were<Roman> = </Roman>15%. The findings were generally similar for rate encoding of modulation depth, although the depth of transient amplitude modulation delivered by the surface electrode was weakly encoded as full-cycle rate. Overall, our findings support the concept of a clinical ABI that employs surface stimulation and intranuclear microstimulation in an integrated manner.



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Controlled drug release to the inner ear: Concepts, materials, mechanisms, and performance

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Karsten Mäder, Eric Lehner, Arne Liebau, Stefan Plontke
Progress in drug delivery to the ear has been achieved over the last few years. This review illustrates the main mechanisms of controlled drug release and the resulting geometry- and size-dependent release kinetics. The potency, physicochemical properties, and stability of the drug molecules are key parameters for designing the most suitable drug delivery system. The most important drug delivery systems for the inner ear include solid foams, hydrogels, and different nanoscale drug delivery systems (e.g., nanoparticles, liposomes, lipid nanocapsules, polymersomes). Their main characteristics (i.e., general structure and materials) are discussed, with special attention given to underlining the link between the physicochemical properties (e.g., surface areas, glass transition temperature, microviscosity, size, and shape) and release kinetics. An appropriate characterization of the drug, the excipients used, and the formulated drug delivery systems is necessary to achieve a deeper understanding of the release process and decrease variability originating from the drug delivery system. This task cannot be solved by otologists alone. The interdisciplinary cooperation between otology/neurotology, pharmaceutics, physics, and other disciplines will result in improved drug delivery systems for the inner ear.



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Impaired speech perception in noise with a normal audiogram: No evidence for cochlear synaptopathy and no relation to lifetime noise exposure

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Hannah Guest, Kevin J. Munro, Garreth Prendergast, Rebecca Millman, Christopher J. Plack
In rodents, noise exposure can destroy synapses between inner hair cells and auditory nerve fibers (“cochlear synaptopathy”) without causing hair cell loss. Noise-induced cochlear synaptopathy usually leaves cochlear thresholds unaltered, but is associated with long-term reductions in auditory brainstem response (ABR) amplitudes at medium-to-high sound levels. This pathophysiology has been suggested to degrade speech perception in noise (SPiN), perhaps explaining why SPiN ability varies so widely among audiometrically normal humans. The present study is the first to test for evidence of cochlear synaptopathy in humans with significant SPiN impairment. Individuals were recruited on the basis of self-reported SPiN difficulties and normal pure tone audiometric thresholds. Performance on a listening task identified a subset with “verified” SPiN impairment. This group was matched with controls on the basis of age, sex, and audiometric thresholds up to 14 kHz. ABRs and envelope-following responses (EFRs) were recorded at high stimulus levels, yielding both raw amplitude measures and within-subject difference measures. Past exposure to high sound levels was assessed by detailed structured interview. Impaired SPiN was not associated with greater lifetime noise exposure, nor with any electrophysiological measure. It is conceivable that retrospective self-report cannot reliably capture noise exposure, and that ABRs and EFRs offer limited sensitivity to synaptopathy in humans. Nevertheless, the results do not support the notion that noise-induced synaptopathy is a significant etiology of SPiN impairment with normal audiometric thresholds. It may be that synaptopathy alone does not have significant perceptual consequences, or is not widespread in humans with normal audiograms.



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Responses of neurons in the feline inferior colliculus to modulated electrical stimuli applied on and within the ventral cochlear nucleus; Implications for an advanced auditory brainstem implant

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Douglas McCreery, Kamal Yadev, Martin Han
Auditory brainstem implants (ABIs) can restore useful hearing to persons with deafness who cannot benefit from cochlear implants. However, the quality of hearing restored by ABIs rarely is comparable to that provided by cochlear implants in persons for whom those are appropriate. In an animal model, we evaluated elements of a prototype of an ABI in which the functions of macroelectrodes on the surface of the dorsal cochlear nucleus would be integrated with the function of multiple penetrating microelectrodes implanted into the ventral cochlear nucleus. The surface electrodes would convey most of the range of loudness percepts while the intranuclear microelectrodes would sharpen and focus pitch percepts. In the present study, stimulating electrodes were implanted chronically on the surface of the animal's dorsal cochlear nucleus (DCN) and also within their ventral cochlear nucleus (VCN). Recording microelectrodes were implanted into the central nucleus of the inferior colliculus (ICC). The electrical stimuli were sinusoidally modulated stimulus pulse trains applied on the DCN and within the VCN. Temporal encoding of neuronal responses was quantified as vector strength (VS) and as full-cycle rate of neuronal activity in the ICC. VS and full-cycle AP rate were measured for 4 stimulation modes; continuous and transient amplitude modulation of the stimulus pulse trains, each delivered via the macroelectrode on the surface of the DCN and then by the intranuclear penetrating microelectrodes. In the proposed clinical device the functions of the surface and intranuclear microelectrodes could best be integrated if there is minimal variation in the neuronal responses across the range of modulation depth, modulation frequencies, and across the four stimulation modes. In this study VS did vary as much as 34% across modulation frequency and modulation depth within a stimulation mode, and up to 40% between modulation modes. However, these intra- and inter-mode variances differed for different stimulation rates, and at 500 Hz the inter-mode differences in VS and across the range of modulation frequencies and modulation depths was<Roman> = </Roman>24% and the intra-modal differences were<Roman> = </Roman>15%. The findings were generally similar for rate encoding of modulation depth, although the depth of transient amplitude modulation delivered by the surface electrode was weakly encoded as full-cycle rate. Overall, our findings support the concept of a clinical ABI that employs surface stimulation and intranuclear microstimulation in an integrated manner.



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Controlled drug release to the inner ear: Concepts, materials, mechanisms, and performance

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Karsten Mäder, Eric Lehner, Arne Liebau, Stefan Plontke
Progress in drug delivery to the ear has been achieved over the last few years. This review illustrates the main mechanisms of controlled drug release and the resulting geometry- and size-dependent release kinetics. The potency, physicochemical properties, and stability of the drug molecules are key parameters for designing the most suitable drug delivery system. The most important drug delivery systems for the inner ear include solid foams, hydrogels, and different nanoscale drug delivery systems (e.g., nanoparticles, liposomes, lipid nanocapsules, polymersomes). Their main characteristics (i.e., general structure and materials) are discussed, with special attention given to underlining the link between the physicochemical properties (e.g., surface areas, glass transition temperature, microviscosity, size, and shape) and release kinetics. An appropriate characterization of the drug, the excipients used, and the formulated drug delivery systems is necessary to achieve a deeper understanding of the release process and decrease variability originating from the drug delivery system. This task cannot be solved by otologists alone. The interdisciplinary cooperation between otology/neurotology, pharmaceutics, physics, and other disciplines will result in improved drug delivery systems for the inner ear.



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Impaired speech perception in noise with a normal audiogram: No evidence for cochlear synaptopathy and no relation to lifetime noise exposure

Publication date: Available online 9 March 2018
Source:Hearing Research
Author(s): Hannah Guest, Kevin J. Munro, Garreth Prendergast, Rebecca Millman, Christopher J. Plack
In rodents, noise exposure can destroy synapses between inner hair cells and auditory nerve fibers (“cochlear synaptopathy”) without causing hair cell loss. Noise-induced cochlear synaptopathy usually leaves cochlear thresholds unaltered, but is associated with long-term reductions in auditory brainstem response (ABR) amplitudes at medium-to-high sound levels. This pathophysiology has been suggested to degrade speech perception in noise (SPiN), perhaps explaining why SPiN ability varies so widely among audiometrically normal humans. The present study is the first to test for evidence of cochlear synaptopathy in humans with significant SPiN impairment. Individuals were recruited on the basis of self-reported SPiN difficulties and normal pure tone audiometric thresholds. Performance on a listening task identified a subset with “verified” SPiN impairment. This group was matched with controls on the basis of age, sex, and audiometric thresholds up to 14 kHz. ABRs and envelope-following responses (EFRs) were recorded at high stimulus levels, yielding both raw amplitude measures and within-subject difference measures. Past exposure to high sound levels was assessed by detailed structured interview. Impaired SPiN was not associated with greater lifetime noise exposure, nor with any electrophysiological measure. It is conceivable that retrospective self-report cannot reliably capture noise exposure, and that ABRs and EFRs offer limited sensitivity to synaptopathy in humans. Nevertheless, the results do not support the notion that noise-induced synaptopathy is a significant etiology of SPiN impairment with normal audiometric thresholds. It may be that synaptopathy alone does not have significant perceptual consequences, or is not widespread in humans with normal audiograms.



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Detecting Gait Abnormalities After Concussion or Mild Traumatic Brain Injury: A Systematic Review of Single-Task, Dual-Task, and Complex Gait

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Peter C. Fino, Lucy Parrington, Will Pitt, Douglas N. Martini, James C. Chesnutt, Li-Shan Chou, Laurie A. King
BackgroundWhile a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear.Research QuestionThis review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion.MethodsData sources included MEDLINE/PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) accessed on March 14, 2017. Original research articles reporting gait outcomes in people with concussion or mTBI were included. Studies of moderate, severe, or unspecified TBI, and studies without a comparator were excluded.ResultsAfter screening 233 articles, 38 studies were included and assigned to one or more sections based on the protocol and reported outcomes. Twenty-six articles reported single-task simple gait outcomes, 24 reported dual-task simple gait outcomes, 21 reported single-task complex gait outcomes, and 10 reported dual-task complex gait outcomes.SignificanceOverall, this review provides evidence for two conclusions: 1) gait is abnormal acutely after concussion/mTBI but generally resolves over time; and 2) the inconsistency of findings, small sample sizes, and small number of studies examining homogenous measures at the same time-period post-concussion highlight the need for replication across independent populations and investigators. Future research should concentrate on dual-task and complex gait tasks, as they showed promise for detecting abnormal locomotor function outside of the acute timeframe. Additionally, studies should provide detailed demographic and clinical characteristics to enable more refined comparisons across studies.



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Real time non-instrumented clinical gait analysis as part of a clinical musculoskeletal assessment in the treatment of lower limb symptoms in adults: A systematic review

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Paul Harradine, Lucy Gates, Catherine Bowen
BackgroundThe aim of this review was to evaluate and summarise the current evidence on non-computerised or non-recorded real time adult gait assessment conducted within the clinical musculoskeletal setting. It was hoped a protocol for best practice and a framework for further research could be developed from this search.Research QuestionCan a protocol for best practice and a framework for further research be established from previous literature relating to non-computerised or non-recorded real time adult gait analysis in a musculoskeletal clinical setting.MethodsA literature review with no limitation on date of publication was conducted on the 18th February 2017.ResultsThe review found no significantly informative papers relating to the searchSignificanceThe lack of research on the accuracy, reliability and therefore worth of this highly recommended area of musculoskeletal assessment raises concerns over current assessment and treatment pathways. Further work to develop a method by which gait analysis can be routinely employed in musculoskeletal clinics as a diagnostic tool is required, with any new approach undertaking robust methodological testing.



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Detecting Gait Abnormalities After Concussion or Mild Traumatic Brain Injury: A Systematic Review of Single-Task, Dual-Task, and Complex Gait

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Peter C. Fino, Lucy Parrington, Will Pitt, Douglas N. Martini, James C. Chesnutt, Li-Shan Chou, Laurie A. King
BackgroundWhile a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear.Research QuestionThis review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion.MethodsData sources included MEDLINE/PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) accessed on March 14, 2017. Original research articles reporting gait outcomes in people with concussion or mTBI were included. Studies of moderate, severe, or unspecified TBI, and studies without a comparator were excluded.ResultsAfter screening 233 articles, 38 studies were included and assigned to one or more sections based on the protocol and reported outcomes. Twenty-six articles reported single-task simple gait outcomes, 24 reported dual-task simple gait outcomes, 21 reported single-task complex gait outcomes, and 10 reported dual-task complex gait outcomes.SignificanceOverall, this review provides evidence for two conclusions: 1) gait is abnormal acutely after concussion/mTBI but generally resolves over time; and 2) the inconsistency of findings, small sample sizes, and small number of studies examining homogenous measures at the same time-period post-concussion highlight the need for replication across independent populations and investigators. Future research should concentrate on dual-task and complex gait tasks, as they showed promise for detecting abnormal locomotor function outside of the acute timeframe. Additionally, studies should provide detailed demographic and clinical characteristics to enable more refined comparisons across studies.



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Real time non-instrumented clinical gait analysis as part of a clinical musculoskeletal assessment in the treatment of lower limb symptoms in adults: A systematic review

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Paul Harradine, Lucy Gates, Catherine Bowen
BackgroundThe aim of this review was to evaluate and summarise the current evidence on non-computerised or non-recorded real time adult gait assessment conducted within the clinical musculoskeletal setting. It was hoped a protocol for best practice and a framework for further research could be developed from this search.Research QuestionCan a protocol for best practice and a framework for further research be established from previous literature relating to non-computerised or non-recorded real time adult gait analysis in a musculoskeletal clinical setting.MethodsA literature review with no limitation on date of publication was conducted on the 18th February 2017.ResultsThe review found no significantly informative papers relating to the searchSignificanceThe lack of research on the accuracy, reliability and therefore worth of this highly recommended area of musculoskeletal assessment raises concerns over current assessment and treatment pathways. Further work to develop a method by which gait analysis can be routinely employed in musculoskeletal clinics as a diagnostic tool is required, with any new approach undertaking robust methodological testing.



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Detecting Gait Abnormalities After Concussion or Mild Traumatic Brain Injury: A Systematic Review of Single-Task, Dual-Task, and Complex Gait

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Peter C. Fino, Lucy Parrington, Will Pitt, Douglas N. Martini, James C. Chesnutt, Li-Shan Chou, Laurie A. King
BackgroundWhile a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear.Research QuestionThis review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion.MethodsData sources included MEDLINE/PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) accessed on March 14, 2017. Original research articles reporting gait outcomes in people with concussion or mTBI were included. Studies of moderate, severe, or unspecified TBI, and studies without a comparator were excluded.ResultsAfter screening 233 articles, 38 studies were included and assigned to one or more sections based on the protocol and reported outcomes. Twenty-six articles reported single-task simple gait outcomes, 24 reported dual-task simple gait outcomes, 21 reported single-task complex gait outcomes, and 10 reported dual-task complex gait outcomes.SignificanceOverall, this review provides evidence for two conclusions: 1) gait is abnormal acutely after concussion/mTBI but generally resolves over time; and 2) the inconsistency of findings, small sample sizes, and small number of studies examining homogenous measures at the same time-period post-concussion highlight the need for replication across independent populations and investigators. Future research should concentrate on dual-task and complex gait tasks, as they showed promise for detecting abnormal locomotor function outside of the acute timeframe. Additionally, studies should provide detailed demographic and clinical characteristics to enable more refined comparisons across studies.



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Real time non-instrumented clinical gait analysis as part of a clinical musculoskeletal assessment in the treatment of lower limb symptoms in adults: A systematic review

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Paul Harradine, Lucy Gates, Catherine Bowen
BackgroundThe aim of this review was to evaluate and summarise the current evidence on non-computerised or non-recorded real time adult gait assessment conducted within the clinical musculoskeletal setting. It was hoped a protocol for best practice and a framework for further research could be developed from this search.Research QuestionCan a protocol for best practice and a framework for further research be established from previous literature relating to non-computerised or non-recorded real time adult gait analysis in a musculoskeletal clinical setting.MethodsA literature review with no limitation on date of publication was conducted on the 18th February 2017.ResultsThe review found no significantly informative papers relating to the searchSignificanceThe lack of research on the accuracy, reliability and therefore worth of this highly recommended area of musculoskeletal assessment raises concerns over current assessment and treatment pathways. Further work to develop a method by which gait analysis can be routinely employed in musculoskeletal clinics as a diagnostic tool is required, with any new approach undertaking robust methodological testing.



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