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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