Interpersonal interactions for haptic guidance during balance exercises

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): S.M. Steinl, P.J. Sparto, C.G. Atkeson, M.S. Redfern, L. Johannsen

Abstract

Background

Caregiver–patient interaction relies on interpersonal coordination during support provided by a therapist to a patient with impaired control of body balance.

Research question

The purpose of this study was to investigate in a therapeutic context active and passive participant involvement during interpersonal support in balancing tasks of increasing sensorimotor difficulty.

Methods

Ten older adults stood in semi-tandem stance and received support from a physical therapist (PT) in two support conditions: 1) physical support provided by the PT to the participant’s back via an instrumented handle affixed to a harness worn by the participant (“passive” interpersonal touch; IPT) or 2) support by PT and participant jointly holding a handle instrumented with a force-torque transducer while facing each other (“active” IPT). The postural stability of both support conditions was measured using the root-mean-square (RMS) of the Centre-of-Pressure velocity (RMS dCOP) in the antero-posterior (AP) and medio-lateral (ML) directions. Interpersonal postural coordination (IPC) was characterized in terms of cross-correlations between both individuals’ sway fluctuations as well as the measured interaction forces.

Results

Active involvement of the participant decreased the participant’s postural variability to a greater extent, especially under challenging stance conditions, than receiving support passively. In the passive support condition, however, stronger in-phase IPC between both partners was observed in the antero-posterior direction, possibly caused by a more critical (visual or tactile) observation of participants’ body sway dynamics by the therapist. In-phase cross-correlation time lags indicated that the therapist tended to respond to participants’ body sway fluctuations in a reactive follower mode, which could indicate visual dominance affecting the therapist during the provision of haptic support.

Significance

Our paradigm implies that in balance rehabilitation more partnership-based methods promote greater postural steadiness. The implications of this finding with regard to motor learning and rehabilitation need to be investigated.

from #Audiology via ola Kala on Inoreader https://ift.tt/2mvUKpv
via IFTTT

Bilateral scapular kinematics, asymmetries and shoulder pain in wheelchair athletes

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): Barry S. Mason, Riemer J.K. Vegter, Thomas A.W. Paulson, Dylan Morrissey, Jan W. van der Scheer, Victoria L. Goosey-Tolfrey

Abstract

Background

Shoulder pain is the most common complaint for wheelchair athletes. Scapular orientation and dyskinesia are thought to be associated with shoulder pathology, yet no previous studies have examined the bilateral scapula kinematics of wheelchair athletes during propulsion.

Research question

To examine bilateral scapular kinematics of highly trained wheelchair rugby (WR) players and any associations with self-reported shoulder pain during everyday wheelchair propulsion.

Methods

Ten WR players (5 with shoulder pain, 5 without) performed 2 × 3-minute bouts of exercise in their everyday wheelchair on a wheelchair ergometer at two sub-maximal speeds (3 and 6 km∙h^-1). During the final minute, 3D kinematic data were collected at 100 Hz to describe scapulothoracic motion relative to each propulsion cycle. Instantaneous asymmetries in scapular orientation between dominant and non-dominant sides were also reported. Differences in scapular kinematics and propulsion asymmetries were compared across shoulders symptomatic and asymptomatic of pain.

Results

An internally rotated, upwardly rotated and anteriorly tilted scapula was common during wheelchair propulsion and asymmetries ≤ 14° did exist, yet minimal changes were observed across speeds. Participants with bilateral shoulder pain displayed a less upwardly rotated scapula during propulsion, however large inter-individual variability in scapular kinematics was noted.

Significance

Scapular asymmetries are exhibited by wheelchair athletes during wheelchair propulsion, yet these were not exacerbated by increased speed and had limited associations to shoulder pain. This suggests that propulsion kinematics of highly trained athletes may not be the primary cause of pain experienced by this population.

from #Audiology via ola Kala on Inoreader https://ift.tt/2zZZwVW
via IFTTT

Interpersonal interactions for haptic guidance during balance exercises

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): S.M. Steinl, P.J. Sparto, C.G. Atkeson, M.S. Redfern, L. Johannsen

Abstract

Background

Caregiver–patient interaction relies on interpersonal coordination during support provided by a therapist to a patient with impaired control of body balance.

Research question

The purpose of this study was to investigate in a therapeutic context active and passive participant involvement during interpersonal support in balancing tasks of increasing sensorimotor difficulty.

Methods

Ten older adults stood in semi-tandem stance and received support from a physical therapist (PT) in two support conditions: 1) physical support provided by the PT to the participant’s back via an instrumented handle affixed to a harness worn by the participant (“passive” interpersonal touch; IPT) or 2) support by PT and participant jointly holding a handle instrumented with a force-torque transducer while facing each other (“active” IPT). The postural stability of both support conditions was measured using the root-mean-square (RMS) of the Centre-of-Pressure velocity (RMS dCOP) in the antero-posterior (AP) and medio-lateral (ML) directions. Interpersonal postural coordination (IPC) was characterized in terms of cross-correlations between both individuals’ sway fluctuations as well as the measured interaction forces.

Results

Active involvement of the participant decreased the participant’s postural variability to a greater extent, especially under challenging stance conditions, than receiving support passively. In the passive support condition, however, stronger in-phase IPC between both partners was observed in the antero-posterior direction, possibly caused by a more critical (visual or tactile) observation of participants’ body sway dynamics by the therapist. In-phase cross-correlation time lags indicated that the therapist tended to respond to participants’ body sway fluctuations in a reactive follower mode, which could indicate visual dominance affecting the therapist during the provision of haptic support.

Significance

Our paradigm implies that in balance rehabilitation more partnership-based methods promote greater postural steadiness. The implications of this finding with regard to motor learning and rehabilitation need to be investigated.

from #Audiology via ola Kala on Inoreader https://ift.tt/2mvUKpv
via IFTTT

Bilateral scapular kinematics, asymmetries and shoulder pain in wheelchair athletes

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): Barry S. Mason, Riemer J.K. Vegter, Thomas A.W. Paulson, Dylan Morrissey, Jan W. van der Scheer, Victoria L. Goosey-Tolfrey

Abstract

Background

Shoulder pain is the most common complaint for wheelchair athletes. Scapular orientation and dyskinesia are thought to be associated with shoulder pathology, yet no previous studies have examined the bilateral scapula kinematics of wheelchair athletes during propulsion.

Research question

To examine bilateral scapular kinematics of highly trained wheelchair rugby (WR) players and any associations with self-reported shoulder pain during everyday wheelchair propulsion.

Methods

Ten WR players (5 with shoulder pain, 5 without) performed 2 × 3-minute bouts of exercise in their everyday wheelchair on a wheelchair ergometer at two sub-maximal speeds (3 and 6 km∙h^-1). During the final minute, 3D kinematic data were collected at 100 Hz to describe scapulothoracic motion relative to each propulsion cycle. Instantaneous asymmetries in scapular orientation between dominant and non-dominant sides were also reported. Differences in scapular kinematics and propulsion asymmetries were compared across shoulders symptomatic and asymptomatic of pain.

Results

An internally rotated, upwardly rotated and anteriorly tilted scapula was common during wheelchair propulsion and asymmetries ≤ 14° did exist, yet minimal changes were observed across speeds. Participants with bilateral shoulder pain displayed a less upwardly rotated scapula during propulsion, however large inter-individual variability in scapular kinematics was noted.

Significance

Scapular asymmetries are exhibited by wheelchair athletes during wheelchair propulsion, yet these were not exacerbated by increased speed and had limited associations to shoulder pain. This suggests that propulsion kinematics of highly trained athletes may not be the primary cause of pain experienced by this population.

from #Audiology via ola Kala on Inoreader https://ift.tt/2zZZwVW
via IFTTT

Oculomotor Assessment in Children

Semin Hear 2018; 39: 275-287
DOI: 10.1055/s-0038-1666818

Oculomotor evaluation as part of videonystagmography is an integral tool in the assessment of vestibular function providing a global assessment of the neurological pathways associated with oculomotor function. The value of an oculomotor evaluation for pediatric evaluation is well established; however, many questions can also arise with the application to the pediatric population. Oculomotor function is age dependent which can have a significant effect on the test results obtain in children. The underlying neural substrates and age effects are discussed across the literature with specific results from recent research using clinical oculomotor equipment and protocols. The evidence suggests there are several key differences in the pediatric population compared with adults. These include longer saccade latencies, reduced smooth pursuit gain, increased optokinetic asymmetry, increased variability in all responses, and increased artifact in saccade and smooth pursuit testing.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2uTIAKQ
via IFTTT

Vestibular Rehabilitation for Children

Semin Hear 2018; 39: 334-344
DOI: 10.1055/s-0038-1666822

This article focuses on vestibular rehabilitation (VR) for children. Reports of the presence of vestibular dysfunction in infants, young children, and adolescents have increased over the past decade. In addition to being a comorbidity of sensorineural hearing loss, vestibular dysfunction has been noted in children with cytomegalovirus, late prematurity, and concussion, to name a few. Despite ample evidence and reports of VR for adults, the selection and provision of exercises to be included in the VR protocol for children vary, depending on the nature of the lesion, impairments identified, age at the time of lesion, and developmental factors such as critical periods of development and intermodality interdependence. Unlike adults, children with loss of function or hypofunction of the vestibular apparatus since or shortly after birth present with a developmental delay that is progressive. Very young children may not be able to describe symptoms but rather only avoid activities or cry. This report provides a review of vestibular-related impairments in children, determinants of the symptoms and functional impairments of vestibular dysfunction, the mechanisms of recovery in children, the challenges of VR for children, and a summary of research on the efficacy for VR for children.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2mykiT9
via IFTTT

Self-Assessment Questions

Semin Hear 2018; 39: C1-C8
DOI: 10.1055/s-0038-1666854

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2zUEVSN
via IFTTT

Cochlear Implants and Children with Vestibular Impairments

Semin Hear 2018; 39: 305-320
DOI: 10.1055/s-0038-1666820

Sensorineural hearing loss (SNHL) in children occurs in 1 to 3% of live births and acquired hearing loss can additionally occur. This sensory deficit has far reaching consequences that have been shown to extend beyond speech and language development. Thankfully there are many therapeutic options that exist for these children with the aim of decreasing the morbidity of their hearing impairment. Of late, focus has shifted beyond speech and language outcomes to the overall performance of children with SNHL in real-world environments. To account for their residual deficits in such environments, clinicians must understand the extent of their sensory impairments. SNHL commonly coexists with other sensory deficits such as vestibular loss. Vestibular impairment is exceedingly common in children with SNHL with nearly half of children exhibiting vestibular end-organ dysfunction. These deficits naturally lead to impairments in balance and delay in motor milestones. However, this additional sensory deficit likely leads to further impairment in the performance of these children. This article focuses on the following:1. Defining the coexistence of vestibular impairment in children with SNHL and cochlear implants.2. Describing screening methods aimed at identifying vestibular dysfunction in children with SNHL.3. Understanding the functional implications of this dual-sensory impairment.4. Exploring possible rehabilitative strategies to minimize the impact of vestibular impairment in children with SNHL
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2mvnuyB
via IFTTT

RE: Important Information Regarding Continuing Education Units for Seminars in Hearing through AAA and ASHA

Semin Hear 2018; 39: 227-228
DOI: 10.1055/s-0038-1666836

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2uTIoLC
via IFTTT

Quantitative Vestibular Function Testing in the Pediatric Population

Semin Hear 2018; 39: 257-274
DOI: 10.1055/s-0038-1666817

Quantitative tests of vestibular function include the caloric test, cervical and ocular vestibular evoked myogenic potential (VEMP), rotary chair, and head impulse test, either at the bedside or utilizing video head impulse test (vHIT). The purpose of this article is to provide an overview of how to perform these tests in children, including which tests are recommended based on the child's age and any modifications or considerations that can be made. A variety of clinical measures have been recommended as screening measures for vestibular loss, which will be reviewed. Symptom questionnaires designed to assess the functional impact of dizziness and vestibular loss in children will also be discussed. If a child complains of dizziness or if vestibular loss is suspected (either by case history or positive screening measure), vestibular function testing is warranted. For vestibular function testing, children aged 0 to 2 years typically receive rotary chair, cervical VEMP, and vHIT if a remote system is available. For children aged 3 to 7 years, vHIT, cervical VEMP, and ocular VEMP are completed, and for children aged 8+ years, vHIT, caloric testing if vHIT is normal, and cervical and ocular VEMP are completed. For all children, modifications to testing can be made, as needed.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2myGIUk
via IFTTT

Epidemiology of Vestibular Impairments in a Pediatric Population

Semin Hear 2018; 39: 229-242
DOI: 10.1055/s-0038-1666815

The purpose of this study was to report the prevalence of vestibular impairment (VI) in children (n = 2,528) referred for complete vestibular testing because of balance disorders (BD) or hearing loss (H). A VI was shown in 51.5% of the children tested (1,304/2,528). For BD (e.g., vertigo, dizziness, instability, delay in posturomotor development), VI was found in 36.5% (n = 379/1,037). The most frequent causes of BD with VI included inner ear malformation (13.5%), delay in posturomotor development (13.4%), hearing loss revealed with vertigo (3.9%), trauma (3.9%), vestibular neuritis (3.3%), meningitis (2.5%), Meniere-like syndrome (1.1%), BPPV posttrauma (1%), labyrinthitis (0.4%), and unknown etiology (19.6%). Normal responses to the complete battery of tests (n = 658, 63.5%) excluded a vestibular origin to BD, leading to other diagnoses: principally migraine (15.6%), ophthalmological disorders (15.1%), neurological disorders (including delay in posturomotor development; 14.4%), orthostatic hypotension, or somatoform dizziness (<1%). Of the children referred for hearing loss (n = 1,491), 68.5% were tested without cochlear implantation (CI; n = 1,022). In this group, 54.5% presented with VI (n = 557). This was mostly found in cytomegalovirus infection, inner ear malformation, and genetic syndromes. Profound hearing loss candidates for cochlear implants had complete bilateral vestibular loss in 20% and delay in posturomotor development, and 80% had partial or normal vestibular function and normal posturomotor development. VI was found after CI in 50% on the side of the implant (partial in 41% and complete in 9%). VI is present in 36.5% of children referred to our center for BDs and 54.5% for hearing loss. Vestibular testing permits ruling out peripheral VI and hence seeking other causes for BDs such as migraine and ophthalmological disorders and also helps lower the risk of inducing bilateral complete vestibular loss in CI protocols.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2zTf0Lg
via IFTTT

Vestibular and Oculomotor Function in Children with Cerebral Palsy: A Scoping Review

Semin Hear 2018; 39: 288-304
DOI: 10.1055/s-0038-1666819

Cerebral palsy (CP) is a nonprogressive permanent brain injury that causes an impairment of movement and posture. This scoping review aimed to answer the following questions: (1) “What is the status of oculomotor function in children with CP?” (2) “What is the status of vestibular function (i.e., gaze stability, perception of vertical, vestibular-related balance abilities) in children with CP?” Using Arksey's and O'Malley's five-stage framework, we searched six online databases for relevant articles. The inclusion criteria were: (1) participants of the studies included individuals with CP; (2) a primary outcome in the studies was measurement of oculomotor, vestibular, and/or balance; (3) studies were published within the past 20 years; and (4) the participants in the studies were between 0 and 21 years of age. Twenty-one articles were found that described impairments in oculomotor function (n = 9), vestibular function (n = 1), and oculomotor and vestibular integration (n = 11) in children with CP. The evidence suggests that children with CP may have altered saccadic and smooth pursuit eye movements, abnormal saccular function, poor eye–hand coordination, and abnormal use of vestibular information for balance. Future studies should explore peripheral and central vestibular function using reliable and valid methods for this population. This scoping review demonstrated a paucity of rigorous and objective research to describe the status of oculomotor and vestibular function in children with CP. However, preliminary studies suggest that more research is warranted.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2murjnU
via IFTTT

Development of a Pediatric Balance Center: A Multidisciplinary Approach

Semin Hear 2018; 39: 243-256
DOI: 10.1055/s-0038-1666816

The growing evidence of the need for pediatric vestibular evaluation, as well as the availability of successful treatment options for children, is attracting the attention of many professionals and sparking much interest in the development of pediatric balance centers in North America. Complete balance function assessment and rehabilitation in children requires specialized knowledge and practices of professionals in multiple disciplines. While individual specialists provide useful test information and recommendations for patients, the collaboration of specialists working in a multidisciplinary fashion allows the information to become more powerful, providing the patients and their families with a comprehensive plan. Currently, there are only a handful of pediatric balance centers in North America and most of the centers have been in existence less than 10 years. Thus, this new initiative is in its infancy. Educating oneself, administrators, referral sources, and interdisciplinary colleagues is crucial for gathering support for the enormous endeavor of developing such a center. There are many resources one can draw from, including the works found in this issue. Our hope is that this special Seminars in Hearing may serve as a companion guide to anyone interested in performing pediatric vestibular evaluations and/or developing a multidisciplinary pediatric balance center.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2uSrBZh
via IFTTT

Announcement

Semin Hear 2018; 39: A1-A2
DOI: 10.1055/s-0038-1667188

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2mzg3GU
via IFTTT

Considerations for Testing and Treating Children with Central Vestibular Impairments

Semin Hear 2018; 39: 321-333
DOI: 10.1055/s-0038-1666821

This perspective explores common pediatric diagnoses that could present with central vestibular pathway dysfunction, leading to delays in motor development and postural control, and gaze instability. Specifically, the following diagnoses are considered: cerebral palsy, myelomeningocele, vestibular migraine, attention-deficit hyperactivity disorder, developmental coordination disorder, concussion, childhood cancer, congenital muscular torticollis, adolescent idiopathic scoliosis, and autism. Suggestions for clinical screening, vestibular function testing, and vestibular rehabilitation for children with these diagnoses are based on evidence for the efficacy of testing and interventions for children with peripheral vestibular hypofunction. More research is needed to explore peripheral and central vestibular function in children with these diagnoses. Testing and intervention methods may need to be modified to accommodate for the specific behavior and motor challenges that some children might present. Researchers should develop technology so that gaze stabilization exercises can be delivered in a fun, functional, and effective way.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2A3Q17Y
via IFTTT

Oculomotor Assessment in Children

Semin Hear 2018; 39: 275-287
DOI: 10.1055/s-0038-1666818

Oculomotor evaluation as part of videonystagmography is an integral tool in the assessment of vestibular function providing a global assessment of the neurological pathways associated with oculomotor function. The value of an oculomotor evaluation for pediatric evaluation is well established; however, many questions can also arise with the application to the pediatric population. Oculomotor function is age dependent which can have a significant effect on the test results obtain in children. The underlying neural substrates and age effects are discussed across the literature with specific results from recent research using clinical oculomotor equipment and protocols. The evidence suggests there are several key differences in the pediatric population compared with adults. These include longer saccade latencies, reduced smooth pursuit gain, increased optokinetic asymmetry, increased variability in all responses, and increased artifact in saccade and smooth pursuit testing.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2uTIAKQ
via IFTTT

Vestibular Rehabilitation for Children

Semin Hear 2018; 39: 334-344
DOI: 10.1055/s-0038-1666822

This article focuses on vestibular rehabilitation (VR) for children. Reports of the presence of vestibular dysfunction in infants, young children, and adolescents have increased over the past decade. In addition to being a comorbidity of sensorineural hearing loss, vestibular dysfunction has been noted in children with cytomegalovirus, late prematurity, and concussion, to name a few. Despite ample evidence and reports of VR for adults, the selection and provision of exercises to be included in the VR protocol for children vary, depending on the nature of the lesion, impairments identified, age at the time of lesion, and developmental factors such as critical periods of development and intermodality interdependence. Unlike adults, children with loss of function or hypofunction of the vestibular apparatus since or shortly after birth present with a developmental delay that is progressive. Very young children may not be able to describe symptoms but rather only avoid activities or cry. This report provides a review of vestibular-related impairments in children, determinants of the symptoms and functional impairments of vestibular dysfunction, the mechanisms of recovery in children, the challenges of VR for children, and a summary of research on the efficacy for VR for children.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2mykiT9
via IFTTT

Self-Assessment Questions

Semin Hear 2018; 39: C1-C8
DOI: 10.1055/s-0038-1666854

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2zUEVSN
via IFTTT

Cochlear Implants and Children with Vestibular Impairments

Semin Hear 2018; 39: 305-320
DOI: 10.1055/s-0038-1666820

Sensorineural hearing loss (SNHL) in children occurs in 1 to 3% of live births and acquired hearing loss can additionally occur. This sensory deficit has far reaching consequences that have been shown to extend beyond speech and language development. Thankfully there are many therapeutic options that exist for these children with the aim of decreasing the morbidity of their hearing impairment. Of late, focus has shifted beyond speech and language outcomes to the overall performance of children with SNHL in real-world environments. To account for their residual deficits in such environments, clinicians must understand the extent of their sensory impairments. SNHL commonly coexists with other sensory deficits such as vestibular loss. Vestibular impairment is exceedingly common in children with SNHL with nearly half of children exhibiting vestibular end-organ dysfunction. These deficits naturally lead to impairments in balance and delay in motor milestones. However, this additional sensory deficit likely leads to further impairment in the performance of these children. This article focuses on the following:1. Defining the coexistence of vestibular impairment in children with SNHL and cochlear implants.2. Describing screening methods aimed at identifying vestibular dysfunction in children with SNHL.3. Understanding the functional implications of this dual-sensory impairment.4. Exploring possible rehabilitative strategies to minimize the impact of vestibular impairment in children with SNHL
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2mvnuyB
via IFTTT

RE: Important Information Regarding Continuing Education Units for Seminars in Hearing through AAA and ASHA

Semin Hear 2018; 39: 227-228
DOI: 10.1055/s-0038-1666836

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2uTIoLC
via IFTTT

Quantitative Vestibular Function Testing in the Pediatric Population

Semin Hear 2018; 39: 257-274
DOI: 10.1055/s-0038-1666817

Quantitative tests of vestibular function include the caloric test, cervical and ocular vestibular evoked myogenic potential (VEMP), rotary chair, and head impulse test, either at the bedside or utilizing video head impulse test (vHIT). The purpose of this article is to provide an overview of how to perform these tests in children, including which tests are recommended based on the child's age and any modifications or considerations that can be made. A variety of clinical measures have been recommended as screening measures for vestibular loss, which will be reviewed. Symptom questionnaires designed to assess the functional impact of dizziness and vestibular loss in children will also be discussed. If a child complains of dizziness or if vestibular loss is suspected (either by case history or positive screening measure), vestibular function testing is warranted. For vestibular function testing, children aged 0 to 2 years typically receive rotary chair, cervical VEMP, and vHIT if a remote system is available. For children aged 3 to 7 years, vHIT, cervical VEMP, and ocular VEMP are completed, and for children aged 8+ years, vHIT, caloric testing if vHIT is normal, and cervical and ocular VEMP are completed. For all children, modifications to testing can be made, as needed.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2myGIUk
via IFTTT

Epidemiology of Vestibular Impairments in a Pediatric Population

Semin Hear 2018; 39: 229-242
DOI: 10.1055/s-0038-1666815

The purpose of this study was to report the prevalence of vestibular impairment (VI) in children (n = 2,528) referred for complete vestibular testing because of balance disorders (BD) or hearing loss (H). A VI was shown in 51.5% of the children tested (1,304/2,528). For BD (e.g., vertigo, dizziness, instability, delay in posturomotor development), VI was found in 36.5% (n = 379/1,037). The most frequent causes of BD with VI included inner ear malformation (13.5%), delay in posturomotor development (13.4%), hearing loss revealed with vertigo (3.9%), trauma (3.9%), vestibular neuritis (3.3%), meningitis (2.5%), Meniere-like syndrome (1.1%), BPPV posttrauma (1%), labyrinthitis (0.4%), and unknown etiology (19.6%). Normal responses to the complete battery of tests (n = 658, 63.5%) excluded a vestibular origin to BD, leading to other diagnoses: principally migraine (15.6%), ophthalmological disorders (15.1%), neurological disorders (including delay in posturomotor development; 14.4%), orthostatic hypotension, or somatoform dizziness (<1%). Of the children referred for hearing loss (n = 1,491), 68.5% were tested without cochlear implantation (CI; n = 1,022). In this group, 54.5% presented with VI (n = 557). This was mostly found in cytomegalovirus infection, inner ear malformation, and genetic syndromes. Profound hearing loss candidates for cochlear implants had complete bilateral vestibular loss in 20% and delay in posturomotor development, and 80% had partial or normal vestibular function and normal posturomotor development. VI was found after CI in 50% on the side of the implant (partial in 41% and complete in 9%). VI is present in 36.5% of children referred to our center for BDs and 54.5% for hearing loss. Vestibular testing permits ruling out peripheral VI and hence seeking other causes for BDs such as migraine and ophthalmological disorders and also helps lower the risk of inducing bilateral complete vestibular loss in CI protocols.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2zTf0Lg
via IFTTT

Vestibular and Oculomotor Function in Children with Cerebral Palsy: A Scoping Review

Semin Hear 2018; 39: 288-304
DOI: 10.1055/s-0038-1666819

Cerebral palsy (CP) is a nonprogressive permanent brain injury that causes an impairment of movement and posture. This scoping review aimed to answer the following questions: (1) “What is the status of oculomotor function in children with CP?” (2) “What is the status of vestibular function (i.e., gaze stability, perception of vertical, vestibular-related balance abilities) in children with CP?” Using Arksey's and O'Malley's five-stage framework, we searched six online databases for relevant articles. The inclusion criteria were: (1) participants of the studies included individuals with CP; (2) a primary outcome in the studies was measurement of oculomotor, vestibular, and/or balance; (3) studies were published within the past 20 years; and (4) the participants in the studies were between 0 and 21 years of age. Twenty-one articles were found that described impairments in oculomotor function (n = 9), vestibular function (n = 1), and oculomotor and vestibular integration (n = 11) in children with CP. The evidence suggests that children with CP may have altered saccadic and smooth pursuit eye movements, abnormal saccular function, poor eye–hand coordination, and abnormal use of vestibular information for balance. Future studies should explore peripheral and central vestibular function using reliable and valid methods for this population. This scoping review demonstrated a paucity of rigorous and objective research to describe the status of oculomotor and vestibular function in children with CP. However, preliminary studies suggest that more research is warranted.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2murjnU
via IFTTT

Development of a Pediatric Balance Center: A Multidisciplinary Approach

Semin Hear 2018; 39: 243-256
DOI: 10.1055/s-0038-1666816

The growing evidence of the need for pediatric vestibular evaluation, as well as the availability of successful treatment options for children, is attracting the attention of many professionals and sparking much interest in the development of pediatric balance centers in North America. Complete balance function assessment and rehabilitation in children requires specialized knowledge and practices of professionals in multiple disciplines. While individual specialists provide useful test information and recommendations for patients, the collaboration of specialists working in a multidisciplinary fashion allows the information to become more powerful, providing the patients and their families with a comprehensive plan. Currently, there are only a handful of pediatric balance centers in North America and most of the centers have been in existence less than 10 years. Thus, this new initiative is in its infancy. Educating oneself, administrators, referral sources, and interdisciplinary colleagues is crucial for gathering support for the enormous endeavor of developing such a center. There are many resources one can draw from, including the works found in this issue. Our hope is that this special Seminars in Hearing may serve as a companion guide to anyone interested in performing pediatric vestibular evaluations and/or developing a multidisciplinary pediatric balance center.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2uSrBZh
via IFTTT

Announcement

Semin Hear 2018; 39: A1-A2
DOI: 10.1055/s-0038-1667188

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2mzg3GU
via IFTTT

Considerations for Testing and Treating Children with Central Vestibular Impairments

Semin Hear 2018; 39: 321-333
DOI: 10.1055/s-0038-1666821

This perspective explores common pediatric diagnoses that could present with central vestibular pathway dysfunction, leading to delays in motor development and postural control, and gaze instability. Specifically, the following diagnoses are considered: cerebral palsy, myelomeningocele, vestibular migraine, attention-deficit hyperactivity disorder, developmental coordination disorder, concussion, childhood cancer, congenital muscular torticollis, adolescent idiopathic scoliosis, and autism. Suggestions for clinical screening, vestibular function testing, and vestibular rehabilitation for children with these diagnoses are based on evidence for the efficacy of testing and interventions for children with peripheral vestibular hypofunction. More research is needed to explore peripheral and central vestibular function in children with these diagnoses. Testing and intervention methods may need to be modified to accommodate for the specific behavior and motor challenges that some children might present. Researchers should develop technology so that gaze stabilization exercises can be delivered in a fun, functional, and effective way.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader https://ift.tt/2A3Q17Y
via IFTTT

P 145 – Comparison of the results of primary versus repeat hamstrings surgical lengthening in cerebral palsy

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): M.C. De Morais Filho, F. Blumetti, C. Kawamura, M. Matias, M. Fujino, J.A. Lopes, D. Neves

from #Audiology via ola Kala on Inoreader https://ift.tt/2LbUquL
via IFTTT

P 145 – Comparison of the results of primary versus repeat hamstrings surgical lengthening in cerebral palsy

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): M.C. De Morais Filho, F. Blumetti, C. Kawamura, M. Matias, M. Fujino, J.A. Lopes, D. Neves

from #Audiology via ola Kala on Inoreader https://ift.tt/2LbUquL
via IFTTT

Evaluating the effectiveness and reliability of the Vibrant Soundbridge and Bonebridge auditory implants in clinical practice: Study design and methods for a multi-centre longitudinal observational study.

Evaluating the effectiveness and reliability of the Vibrant Soundbridge and Bonebridge auditory implants in clinical practice: Study design and methods for a multi-centre longitudinal observational study.

Contemp Clin Trials Commun. 2018 Jun;10:137-140

Authors: Vickers D, Canas A, Degun A, Briggs J, Bingham M, Toner J, Cooper H, Rogers S, Cooper S, Irving R, Spielman P, Batty S, Jones S, Asher A, Chung M, Donnelly N, Skibinska A, Gardner R, Raine C, Andrew R, Green K, Ghulam H, Nunn T, Jiang D, Fürhapter S, Urban M, Hanvey K, Flynn S, Lovegrove D, Saeed S

Abstract
Background: The Vibrant Soundbridge middle ear implant and the Bonebridge bone conducting hearing device are hearing implants that use radio frequency transmission to send information from the sound processor to the internal transducer. This reduces the risk of skin problems and infection but requires a more involved surgical procedure than competitor skin penetrating devices. It is not known whether more complex surgery will lead to additional complications. There is little information available on the reliability of these systems and adverse medical or surgical events. The primary research question is to determine the reliability and complication rate for the Vibrant Soundbridge and Bonebridge. The secondary research question explores changes in quality of life following implantation of the devices. The tertiary research question looks at effectiveness via changes in auditory performance.
Method: The study was designed based on a combination of a literature search, two clinician focus groups and expert review.A multi-centre longitudinal observational study was designed. There are three study groups, two will have been implanted prior to the start of the study and one group, the prospective group, will be implanted after initiation of the study. Outcomes are surgical questionnaires, measures of quality of life, user satisfaction and speech perception tests in quiet and in noise.
Conclusion: This is the first multi-centre study to look at these interventions and includes follow up over time to understand effectiveness, reliability, quality of life and complications.

PMID: 30023447 [PubMed]

from #Audiology via ola Kala on Inoreader https://ift.tt/2uAF6h4
via IFTTT

Influence of hearing on vestibulospinal control in healthy subjects.

Related Articles

Influence of hearing on vestibulospinal control in healthy subjects.

HNO. 2018 Jul 18;:

Authors: Seiwerth I, Jonen J, Rahne T, Schwesig R, Lauenroth A, Hullar TE, Plontke SK

Abstract
BACKGROUND: Balance control is based on multisensory interaction. In addition to vestibular, proprioceptive and visual information, it seems that auditory input also plays an important role.
OBJECTIVES: The aim of the study was to investigate the effect of hearing on vestibulospinal coordination and to obtain deeper knowledge about mechanisms of audiovestibular interaction.
MATERIALS AND METHODS: In normal hearing, healthy subjects who performed the Unterberger (Fukuda) stepping test with and without frontal presentation of noise, the distance of displacement, the angle of displacement and the angle of rotation were measured by means of ultrasound based cranio-corpo-graphy (CCG). Additionally, subjective estimation of the effect of auditory input was compared to objective test results.
RESULTS: In the noise condition, there was a significant improvement in the distance of displacement (mean with noise 66.9 cm± 33.5 standard deviation, SD, mean without noise 77.0 cm±32.7 SD, p< 0.001) and in the angle of rotation (mean with noise 14.2°± 10.1 SD, mean without noise 28.3°± 20.2 SD, p< 0.001), while no difference was found within the conditions regarding the angle of displacement (mean with noise 29.1°± 33.5 SD, mean without noise 30.0°± 34.0 SD, p= 0.641). Side-specific analysis revealed a positive correlation between angle of displacement and angle of rotation in the condition without noise (Spearman r = 0.441, p< 0.001). The rate of agreement between subjective estimation of noise influence and objective test results ranged between only 43% and 63%, depending on the question and endpoint.
CONCLUSION: Hearing had a clearly beneficial effect of auditory inputs on vestibulospinal coordination, especially for distance of displacement and angle of rotation.

PMID: 30022257 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2NrE2TN
via IFTTT

Losartan Prevents Maladaptive Auditory-Somatosensory Plasticity After Hearing Loss via Transforming Growth Factor-β Signaling Suppression.

Related Articles

Losartan Prevents Maladaptive Auditory-Somatosensory Plasticity After Hearing Loss via Transforming Growth Factor-β Signaling Suppression.

Clin Exp Otorhinolaryngol. 2018 Jul 20;:

Authors: Mun SK, Han KH, Baek JT, Ahn SW, Cho HS, Chang MY

Abstract
Objectives: Hearing loss disrupts the balance of auditory-somatosensory inputs in the cochlear nucleus (CN) of the brainstem, which has been suggested to be a mechanism of tinnitus. This disruption.
Results.: from maladaptive auditory-somatosensory plasticity, which is a form of axonal sprouting. Axonal sprouting is promoted by transforming growth factor (TGF)-β signaling, which can be inhibited by losartan. We investigated whether losartan prevents maladaptive auditory-somatosensory plasticity after hearing loss.
Methods: The study consisted of two stages: determining the time course of auditory-somatosensory plasticity following hearing loss and preventing auditory-somatosensory plasticity using losartan. In the first stage, rats were randomly divided into two groups: a control group that underwent a sham operation and a deaf group that underwent cochlea ablation on the left side. CNs were harvested 1 and 2 weeks after surgery. In the second stage, rats were randomly divided into either a saline group that underwent cochlear ablation on the left side and received normal saline or a losartan group that underwent cochlear ablation on the left side and received losartan. CNs were harvested 2 weeks after surgery. Hearing was estimated with auditory brainstem responses (ABRs). Western blotting was performed for vesicular glutamate transporter 1 (VGLUT1), reflecting auditory input; vesicular glutamate transporter 2 (VGLUT2), reflecting somatosensory input; growth-associated protein 43 (GAP-43), reflecting axonal sprouting; and p-Smad2/3.
Results: Baseline ABR thresholds before surgery ranged from 20 to 35 dB sound pressure level. After cochlear ablation, ABR thresholds were higher than 80 dB. In the first experiment, VGLUT2/VGLUT1 ratios did not differ significantly between the control and deaf groups 1 week after surgery. At 2 weeks after surgery, the deaf group had a significantly higher VGLUT2/VGLUT1 ratio compared to the control group. In the second experiment, the losartan group had a significantly lower VGLUT2/VGLUT1 ratio along with significantly lower p-Smad3 and GAP-43 levels compared to the saline group.
Conclusion: Losartan might prevent axonal sprouting after hearing loss by blocking TGF-β signaling thereby preventing maladaptive auditory-somatosensory plasticity.

PMID: 30021416 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2O3HgOr
via IFTTT

Evaluating the effectiveness and reliability of the Vibrant Soundbridge and Bonebridge auditory implants in clinical practice: Study design and methods for a multi-centre longitudinal observational study.

Evaluating the effectiveness and reliability of the Vibrant Soundbridge and Bonebridge auditory implants in clinical practice: Study design and methods for a multi-centre longitudinal observational study.

Contemp Clin Trials Commun. 2018 Jun;10:137-140

Authors: Vickers D, Canas A, Degun A, Briggs J, Bingham M, Toner J, Cooper H, Rogers S, Cooper S, Irving R, Spielman P, Batty S, Jones S, Asher A, Chung M, Donnelly N, Skibinska A, Gardner R, Raine C, Andrew R, Green K, Ghulam H, Nunn T, Jiang D, Fürhapter S, Urban M, Hanvey K, Flynn S, Lovegrove D, Saeed S

Abstract
Background: The Vibrant Soundbridge middle ear implant and the Bonebridge bone conducting hearing device are hearing implants that use radio frequency transmission to send information from the sound processor to the internal transducer. This reduces the risk of skin problems and infection but requires a more involved surgical procedure than competitor skin penetrating devices. It is not known whether more complex surgery will lead to additional complications. There is little information available on the reliability of these systems and adverse medical or surgical events. The primary research question is to determine the reliability and complication rate for the Vibrant Soundbridge and Bonebridge. The secondary research question explores changes in quality of life following implantation of the devices. The tertiary research question looks at effectiveness via changes in auditory performance.
Method: The study was designed based on a combination of a literature search, two clinician focus groups and expert review.A multi-centre longitudinal observational study was designed. There are three study groups, two will have been implanted prior to the start of the study and one group, the prospective group, will be implanted after initiation of the study. Outcomes are surgical questionnaires, measures of quality of life, user satisfaction and speech perception tests in quiet and in noise.
Conclusion: This is the first multi-centre study to look at these interventions and includes follow up over time to understand effectiveness, reliability, quality of life and complications.

PMID: 30023447 [PubMed]

from #Audiology via ola Kala on Inoreader https://ift.tt/2uAF6h4
via IFTTT

Influence of hearing on vestibulospinal control in healthy subjects.

Related Articles

Influence of hearing on vestibulospinal control in healthy subjects.

HNO. 2018 Jul 18;:

Authors: Seiwerth I, Jonen J, Rahne T, Schwesig R, Lauenroth A, Hullar TE, Plontke SK

Abstract
BACKGROUND: Balance control is based on multisensory interaction. In addition to vestibular, proprioceptive and visual information, it seems that auditory input also plays an important role.
OBJECTIVES: The aim of the study was to investigate the effect of hearing on vestibulospinal coordination and to obtain deeper knowledge about mechanisms of audiovestibular interaction.
MATERIALS AND METHODS: In normal hearing, healthy subjects who performed the Unterberger (Fukuda) stepping test with and without frontal presentation of noise, the distance of displacement, the angle of displacement and the angle of rotation were measured by means of ultrasound based cranio-corpo-graphy (CCG). Additionally, subjective estimation of the effect of auditory input was compared to objective test results.
RESULTS: In the noise condition, there was a significant improvement in the distance of displacement (mean with noise 66.9 cm± 33.5 standard deviation, SD, mean without noise 77.0 cm±32.7 SD, p< 0.001) and in the angle of rotation (mean with noise 14.2°± 10.1 SD, mean without noise 28.3°± 20.2 SD, p< 0.001), while no difference was found within the conditions regarding the angle of displacement (mean with noise 29.1°± 33.5 SD, mean without noise 30.0°± 34.0 SD, p= 0.641). Side-specific analysis revealed a positive correlation between angle of displacement and angle of rotation in the condition without noise (Spearman r = 0.441, p< 0.001). The rate of agreement between subjective estimation of noise influence and objective test results ranged between only 43% and 63%, depending on the question and endpoint.
CONCLUSION: Hearing had a clearly beneficial effect of auditory inputs on vestibulospinal coordination, especially for distance of displacement and angle of rotation.

PMID: 30022257 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2NrE2TN
via IFTTT

Losartan Prevents Maladaptive Auditory-Somatosensory Plasticity After Hearing Loss via Transforming Growth Factor-β Signaling Suppression.

Related Articles

Losartan Prevents Maladaptive Auditory-Somatosensory Plasticity After Hearing Loss via Transforming Growth Factor-β Signaling Suppression.

Clin Exp Otorhinolaryngol. 2018 Jul 20;:

Authors: Mun SK, Han KH, Baek JT, Ahn SW, Cho HS, Chang MY

Abstract
Objectives: Hearing loss disrupts the balance of auditory-somatosensory inputs in the cochlear nucleus (CN) of the brainstem, which has been suggested to be a mechanism of tinnitus. This disruption.
Results.: from maladaptive auditory-somatosensory plasticity, which is a form of axonal sprouting. Axonal sprouting is promoted by transforming growth factor (TGF)-β signaling, which can be inhibited by losartan. We investigated whether losartan prevents maladaptive auditory-somatosensory plasticity after hearing loss.
Methods: The study consisted of two stages: determining the time course of auditory-somatosensory plasticity following hearing loss and preventing auditory-somatosensory plasticity using losartan. In the first stage, rats were randomly divided into two groups: a control group that underwent a sham operation and a deaf group that underwent cochlea ablation on the left side. CNs were harvested 1 and 2 weeks after surgery. In the second stage, rats were randomly divided into either a saline group that underwent cochlear ablation on the left side and received normal saline or a losartan group that underwent cochlear ablation on the left side and received losartan. CNs were harvested 2 weeks after surgery. Hearing was estimated with auditory brainstem responses (ABRs). Western blotting was performed for vesicular glutamate transporter 1 (VGLUT1), reflecting auditory input; vesicular glutamate transporter 2 (VGLUT2), reflecting somatosensory input; growth-associated protein 43 (GAP-43), reflecting axonal sprouting; and p-Smad2/3.
Results: Baseline ABR thresholds before surgery ranged from 20 to 35 dB sound pressure level. After cochlear ablation, ABR thresholds were higher than 80 dB. In the first experiment, VGLUT2/VGLUT1 ratios did not differ significantly between the control and deaf groups 1 week after surgery. At 2 weeks after surgery, the deaf group had a significantly higher VGLUT2/VGLUT1 ratio compared to the control group. In the second experiment, the losartan group had a significantly lower VGLUT2/VGLUT1 ratio along with significantly lower p-Smad3 and GAP-43 levels compared to the saline group.
Conclusion: Losartan might prevent axonal sprouting after hearing loss by blocking TGF-β signaling thereby preventing maladaptive auditory-somatosensory plasticity.

PMID: 30021416 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2O3HgOr
via IFTTT

Neither total muscle activation nor co-activation explains the youthful walking economy of older runners

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): Owen N. Beck, Alena M. Grabowski, Justus D. Ortega

Abstract

Background

Older adults (≥65 years) exhibited greater metabolic rates during walking (worse walking economy) compared to young adults. Yet, previous research suggests that habitual running, but not habitual walking, exercise mitigates the age-related deterioration of walking economy.

Research Question

Does total leg muscle activation and/or agonist-antagonist co-activation explain the superior walking economy of older runners versus older walkers? Methods: We quantified metabolic power, leg muscle activation, and co-activation in older walkers and older runners during walking at 0.75, 1.25, and 1.75 m/s.

Results

Neither total stride (each speed p ≥ 0.024), stance- (each speed p ≥ 0.217), nor swing- (each speed p ≥ 0.170) phase EMG amplitude differed between older walkers and older runners at 0.75, 1.25, or 1.75 m/s. Stride averaged medial gastrocnemius and biceps femoris activation were less in older runners than older walkers at 1.25 and 1.75 m/s (all p ≤ 0.025). We also calculated shank, thigh, and overall (shank and thigh) agonist-antagonist leg muscle co-activation over each stride phase and the only difference between groups was a greater shank co-activation in older runners at 0.75 m/s (p = 0.024). Across groups, stride, stance-, and swing-phase total muscle activation positively correlated with gross metabolic power (R² = 0.58-0.66; all p < 0.001). Paradoxically, across groups, stride, stance-, and swing-phase muscle co-activation indices were negatively correlated with gross metabolic power (R² = 0.08-0.29; all p ≤ 0.007).

Significance

Neither total leg muscle activation nor co-activation explains the superior walking economy of older runners versus older walkers.

from #Audiology via ola Kala on Inoreader https://ift.tt/2mtfrCm
via IFTTT

Neither total muscle activation nor co-activation explains the youthful walking economy of older runners

Publication date: Available online 20 July 2018

Source: Gait & Posture

Author(s): Owen N. Beck, Alena M. Grabowski, Justus D. Ortega

Abstract

Background

Older adults (≥65 years) exhibited greater metabolic rates during walking (worse walking economy) compared to young adults. Yet, previous research suggests that habitual running, but not habitual walking, exercise mitigates the age-related deterioration of walking economy.

Research Question

Does total leg muscle activation and/or agonist-antagonist co-activation explain the superior walking economy of older runners versus older walkers? Methods: We quantified metabolic power, leg muscle activation, and co-activation in older walkers and older runners during walking at 0.75, 1.25, and 1.75 m/s.

Results

Neither total stride (each speed p ≥ 0.024), stance- (each speed p ≥ 0.217), nor swing- (each speed p ≥ 0.170) phase EMG amplitude differed between older walkers and older runners at 0.75, 1.25, or 1.75 m/s. Stride averaged medial gastrocnemius and biceps femoris activation were less in older runners than older walkers at 1.25 and 1.75 m/s (all p ≤ 0.025). We also calculated shank, thigh, and overall (shank and thigh) agonist-antagonist leg muscle co-activation over each stride phase and the only difference between groups was a greater shank co-activation in older runners at 0.75 m/s (p = 0.024). Across groups, stride, stance-, and swing-phase total muscle activation positively correlated with gross metabolic power (R² = 0.58-0.66; all p < 0.001). Paradoxically, across groups, stride, stance-, and swing-phase muscle co-activation indices were negatively correlated with gross metabolic power (R² = 0.08-0.29; all p ≤ 0.007).

Significance

Neither total leg muscle activation nor co-activation explains the superior walking economy of older runners versus older walkers.

from #Audiology via ola Kala on Inoreader https://ift.tt/2mtfrCm
via IFTTT