Evaluating Hearing Aid Management: Development of the Hearing Aid Skills and Knowledge Inventory (HASKI)

Purpose

Although hearing health care clinicians provide training on hearing aid handling and management as part of the rehabilitation program, clinical studies suggest that the level of management skill demonstrated by hearing aid owners is low. In the absence of a comprehensive clinical survey to identify these shortfalls in clinical training, the objective of this study was to develop and report the psychometric properties of the Hearing Aid Skills and Knowledge Inventory (HASKI: a self-administered version and a clinician-administered version). The HASKI evaluates the knowledge and skills required for hearing aid management. A secondary aim was to report the prevalence of hearing aid management difficulties in an Australian population.

Method

The development of the HASKI and the investigation of its psychometric properties in a prospective convenience cohort of 518 adult hearing aid owners, ranging in age from 18 to 97 years (M = 71 years, SD = 14), 60% male, 38% female, and 2% undisclosed, recruited from 7 hearing clinics across Australia, were used.

Results

The HASKI (both the self-administered and clinician administered) demonstrated high internal consistency, interdimensional relationships, construct validity, test–retest reliability, interobserver reliability, and criterion validity. A range of aptitudes were observed from low to full competency, with 99% of participants indicating difficulty with at least 1 item on the survey.

Conclusions

The Hearing Aid Skills and Knowledge Inventories are valid and reliable measures of hearing aid handling and management skills with good potential for use in clinical settings. Hearing aid management is an area of difficulty for the majority of hearing aid owners, indicating the need for clinicians to improve the efficacy of hearing aid management training delivered.

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Evaluating Hearing Aid Management: Development of the Hearing Aid Skills and Knowledge Inventory (HASKI)

Purpose

Although hearing health care clinicians provide training on hearing aid handling and management as part of the rehabilitation program, clinical studies suggest that the level of management skill demonstrated by hearing aid owners is low. In the absence of a comprehensive clinical survey to identify these shortfalls in clinical training, the objective of this study was to develop and report the psychometric properties of the Hearing Aid Skills and Knowledge Inventory (HASKI: a self-administered version and a clinician-administered version). The HASKI evaluates the knowledge and skills required for hearing aid management. A secondary aim was to report the prevalence of hearing aid management difficulties in an Australian population.

Method

The development of the HASKI and the investigation of its psychometric properties in a prospective convenience cohort of 518 adult hearing aid owners, ranging in age from 18 to 97 years (M = 71 years, SD = 14), 60% male, 38% female, and 2% undisclosed, recruited from 7 hearing clinics across Australia, were used.

Results

The HASKI (both the self-administered and clinician administered) demonstrated high internal consistency, interdimensional relationships, construct validity, test–retest reliability, interobserver reliability, and criterion validity. A range of aptitudes were observed from low to full competency, with 99% of participants indicating difficulty with at least 1 item on the survey.

Conclusions

The Hearing Aid Skills and Knowledge Inventories are valid and reliable measures of hearing aid handling and management skills with good potential for use in clinical settings. Hearing aid management is an area of difficulty for the majority of hearing aid owners, indicating the need for clinicians to improve the efficacy of hearing aid management training delivered.

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A Potential Bias in Subjective Ratings of Mental Effort

Purpose

Subjective reports of listening effort are frequently inconsistent with behavioral and physiological findings. A potential explanation is that participants unwittingly substitute an easier question when faced with a judgment that requires computationally expensive analysis (i.e., heuristic response strategies). The purpose of this study was to investigate whether participants substitute the question “How did I perform?” when asked “How much effort did that take?”.

Method

Participants completed 2 sets of online surveys containing a text-based, multiple-choice synonym task. Expected performance and mental effort were manipulated across sets in 4 experiments, using a visual masking technique shown to correlate with speech-reception-testing in noise. Experiment 1 was designed to yield stable accuracy and differing effort across sets. Experiment 2 elicited differing accuracy and stable effort. Experiments 3 and 4 manipulated accuracy and performance in opposite directions. Participants included 273 adults (aged 19–68 years, M = 38.4 years).

Results

Experiment 1 revealed no influence of perceived performance on ratings of effort when accuracy was stable. Experiment 2 showed that ratings of effort differed inversely with ratings of performance (lower performance and increased effort). Experiments 3 and 4 also demonstrated that participants rated effort in a manner inversely related to performance, regardless of the effort inherent in the condition.

Conclusions

Participants likely substitute an easier question when asked to rate the multidimensional construct of mental effort. The results presented here suggest that perceived performance can serve as a ready heuristic and may explain the dissociation between subjective measures of listening effort and behavioral and physiological measures.

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A Phonetic Complexity-Based Approach For Intelligibility and Articulatory Precision Testing: A Preliminary Study on Talkers With Amyotrophic Lateral Sclerosis

Purpose

This study describes a phonetic complexity-based approach for speech intelligibility and articulatory precision testing using preliminary data from talkers with amyotrophic lateral sclerosis.

Method

Eight talkers with amyotrophic lateral sclerosis and 8 healthy controls produced a list of 16 low and high complexity words. Sixty-four listeners judged the samples for intelligibility, and 2 trained listeners completed phoneme-level analysis to determine articulatory precision. To estimate percent intelligibility, listeners orthographically transcribed each word, and the transcriptions were scored as being either accurate or inaccurate. Percent articulatory precision was calculated based on the experienced listeners' judgments of phoneme distortions, deletions, additions, and/or substitutions for each word. Articulation errors were weighted based on the perceived impact on intelligibility to determine word-level precision.

Results

Between-groups differences in word intelligibility and articulatory precision were significant at lower levels of phonetic complexity as dysarthria severity increased. Specifically, more severely impaired talkers showed significant reductions in word intelligibility and precision at both complexity levels, whereas those with milder speech impairments displayed intelligibility reductions only for more complex words. Articulatory precision was less sensitive to mild dysarthria compared to speech intelligibility for the proposed complexity-based approach.

Conclusions

Considering phonetic complexity for dysarthria tests could result in more sensitive assessments for detecting and monitoring dysarthria progression.

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Reliability of Measures of N1 Peak Amplitude of the Compound Action Potential in Younger and Older Adults

Purpose

Human auditory nerve (AN) activity estimated from the amplitude of the first prominent negative peak (N1) of the compound action potential (CAP) is typically quantified using either a peak-to-peak measurement or a baseline-corrected measurement. However, the reliability of these 2 common measurement techniques has not been evaluated but is often assumed to be relatively poor, especially for older adults. To address this question, the current study (a) compared test–retest reliability of these 2 methods and (b) tested the extent to which measurement type affected the relationship between N1 amplitude and experimental factors related to the stimulus (higher and lower intensity levels) and participants (younger and older adults).

Method

Click-evoked CAPs were recorded in 24 younger (aged 18–30 years) and 20 older (aged 55–85 years) adults with clinically normal audiograms up to 3000 Hz. N1 peak amplitudes were estimated from peak-to-peak measurements (from N1 to P1) and baseline-corrected measurements for 2 stimulus levels (80 and 110 dB pSPL). Baseline-corrected measurements were made with 4 baseline windows. Each stimulus level was presented twice, and test–retest reliability of these 2 measures was assessed using the intraclass correlation coefficient. Linear mixed models were used to evaluate the extent to which age group and click level uniquely predicted N1 amplitude and whether the predictive relationships differed between N1 measurement techniques.

Results

Both peak-to-peak and baseline-corrected measurements of N1 amplitude were found to have good-to-excellent reliability, with intraclass correlation coefficient values > 0.60. As expected, N1 amplitudes were significantly larger for younger participants compared with older participants for both measurement types and were significantly larger in response to clicks presented at 110 dB pSPL than at 80 dB pSPL for both measurement types. Furthermore, the choice of baseline window had no significant effect on N1 amplitudes using the baseline-corrected method.

Conclusions

Our results suggest that measurements of AN activity can be robustly and reliably recorded in both younger and older adults using either peak-to-peak or baseline-corrected measurements of the N1 of the CAP. Peak-to-peak measurements yield larger N1 response amplitudes and are the default measurement type for many clinical systems, whereas baseline-corrected measurements are computationally simpler. Furthermore, the relationships between AN activity and stimulus- and participant-related variables were not affected by measurement technique, which suggests that these relationships can be compared across studies using different techniques for measuring the CAP N1.

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Morphosyntax Production of Preschool Children With Hearing Loss: An Evaluation of the Extended Optional Infinitive and Surface Accounts

Purpose

The first aim of this study was to explore differences in profiles of morphosyntax production of preschool children with hearing loss (CHL) relative to age- and language-matched comparison groups. The second aim was to explore the potential of extending 2 long-standing theoretical accounts of morphosyntax weakness in children with specific language impairment to preschool CHL.

Method

This study examined conversational language samples to describe the accuracy and type of inaccurate productions of Brown's grammatical morphemes in 18 preschool CHL as compared with an age-matched group (±3 months, n = 18) and a language-matched group (±1 raw score point on an expressive language subtest, n = 18). Age ranged from 45 to 62 months. Performance across groups was compared. In addition, production accuracy of CHL on morphemes that varied by tense and duration was compared to assess the validity of extending theoretical accounts of children with specific language impairment to CHL.

Results

CHL exhibited particular difficulty with morphosyntax relative to other aspects of language. In addition, differences across groups on accuracy and type of inaccurate productions were observed. Finally, a unified approach to explaining morphosyntax weakness in CHL was more appropriate than a linguistic- or perceptual-only approach.

Conclusions

Taken together, the findings of this study support a unified theoretical account of morphosyntax weakness in CHL in which both tense and duration of morphemes play a role in morphosyntax production accuracy, with a more robust role for tense than duration.

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The Impact of Exposure With No Training: Implications for Future Partner Training Research

Purpose

This research note reports on an unexpected negative finding related to behavior change in a controlled trial designed to test whether partner training improves the conversational skills of volunteers.

Method

The clinical trial involving training in “Supported Conversation for Adults with Aphasia” utilized a single-blind, randomized, controlled, pre–post design. Eighty participants making up 40 dyads of a volunteer conversation partner and an adult with aphasia were randomly allocated to either an experimental or control group of 20 dyads each. Descriptive statistics including exact 95% confidence intervals were calculated for the percentage of control group participants who got worse after exposure to individuals with aphasia.

Results

Positive outcomes of training in Supported Conversation for Adults with Aphasia for both the trained volunteers and their partners with aphasia were reported by Kagan, Black, Felson Duchan, Simmons-Mackie, and Square in 2001. However, post hoc data analysis revealed that almost one third of untrained control participants had a negative outcome rather than the anticipated neutral or slightly positive outcome.

Conclusions

If the results of this small study are in any way representative of what happens in real life, communication partner training in aphasia becomes even more important than indicated from the positive results of training studies. That is, it is possible that mere exposure to a communication disability such as aphasia could have negative impacts on communication and social interaction. This may be akin to what is known as a “nocebo” effect—something for partner training studies in aphasia to take into account.

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A Potential Bias in Subjective Ratings of Mental Effort

Purpose

Subjective reports of listening effort are frequently inconsistent with behavioral and physiological findings. A potential explanation is that participants unwittingly substitute an easier question when faced with a judgment that requires computationally expensive analysis (i.e., heuristic response strategies). The purpose of this study was to investigate whether participants substitute the question “How did I perform?” when asked “How much effort did that take?”.

Method

Participants completed 2 sets of online surveys containing a text-based, multiple-choice synonym task. Expected performance and mental effort were manipulated across sets in 4 experiments, using a visual masking technique shown to correlate with speech-reception-testing in noise. Experiment 1 was designed to yield stable accuracy and differing effort across sets. Experiment 2 elicited differing accuracy and stable effort. Experiments 3 and 4 manipulated accuracy and performance in opposite directions. Participants included 273 adults (aged 19–68 years, M = 38.4 years).

Results

Experiment 1 revealed no influence of perceived performance on ratings of effort when accuracy was stable. Experiment 2 showed that ratings of effort differed inversely with ratings of performance (lower performance and increased effort). Experiments 3 and 4 also demonstrated that participants rated effort in a manner inversely related to performance, regardless of the effort inherent in the condition.

Conclusions

Participants likely substitute an easier question when asked to rate the multidimensional construct of mental effort. The results presented here suggest that perceived performance can serve as a ready heuristic and may explain the dissociation between subjective measures of listening effort and behavioral and physiological measures.

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A Phonetic Complexity-Based Approach For Intelligibility and Articulatory Precision Testing: A Preliminary Study on Talkers With Amyotrophic Lateral Sclerosis

Purpose

This study describes a phonetic complexity-based approach for speech intelligibility and articulatory precision testing using preliminary data from talkers with amyotrophic lateral sclerosis.

Method

Eight talkers with amyotrophic lateral sclerosis and 8 healthy controls produced a list of 16 low and high complexity words. Sixty-four listeners judged the samples for intelligibility, and 2 trained listeners completed phoneme-level analysis to determine articulatory precision. To estimate percent intelligibility, listeners orthographically transcribed each word, and the transcriptions were scored as being either accurate or inaccurate. Percent articulatory precision was calculated based on the experienced listeners' judgments of phoneme distortions, deletions, additions, and/or substitutions for each word. Articulation errors were weighted based on the perceived impact on intelligibility to determine word-level precision.

Results

Between-groups differences in word intelligibility and articulatory precision were significant at lower levels of phonetic complexity as dysarthria severity increased. Specifically, more severely impaired talkers showed significant reductions in word intelligibility and precision at both complexity levels, whereas those with milder speech impairments displayed intelligibility reductions only for more complex words. Articulatory precision was less sensitive to mild dysarthria compared to speech intelligibility for the proposed complexity-based approach.

Conclusions

Considering phonetic complexity for dysarthria tests could result in more sensitive assessments for detecting and monitoring dysarthria progression.

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Reliability of Measures of N1 Peak Amplitude of the Compound Action Potential in Younger and Older Adults

Purpose

Human auditory nerve (AN) activity estimated from the amplitude of the first prominent negative peak (N1) of the compound action potential (CAP) is typically quantified using either a peak-to-peak measurement or a baseline-corrected measurement. However, the reliability of these 2 common measurement techniques has not been evaluated but is often assumed to be relatively poor, especially for older adults. To address this question, the current study (a) compared test–retest reliability of these 2 methods and (b) tested the extent to which measurement type affected the relationship between N1 amplitude and experimental factors related to the stimulus (higher and lower intensity levels) and participants (younger and older adults).

Method

Click-evoked CAPs were recorded in 24 younger (aged 18–30 years) and 20 older (aged 55–85 years) adults with clinically normal audiograms up to 3000 Hz. N1 peak amplitudes were estimated from peak-to-peak measurements (from N1 to P1) and baseline-corrected measurements for 2 stimulus levels (80 and 110 dB pSPL). Baseline-corrected measurements were made with 4 baseline windows. Each stimulus level was presented twice, and test–retest reliability of these 2 measures was assessed using the intraclass correlation coefficient. Linear mixed models were used to evaluate the extent to which age group and click level uniquely predicted N1 amplitude and whether the predictive relationships differed between N1 measurement techniques.

Results

Both peak-to-peak and baseline-corrected measurements of N1 amplitude were found to have good-to-excellent reliability, with intraclass correlation coefficient values > 0.60. As expected, N1 amplitudes were significantly larger for younger participants compared with older participants for both measurement types and were significantly larger in response to clicks presented at 110 dB pSPL than at 80 dB pSPL for both measurement types. Furthermore, the choice of baseline window had no significant effect on N1 amplitudes using the baseline-corrected method.

Conclusions

Our results suggest that measurements of AN activity can be robustly and reliably recorded in both younger and older adults using either peak-to-peak or baseline-corrected measurements of the N1 of the CAP. Peak-to-peak measurements yield larger N1 response amplitudes and are the default measurement type for many clinical systems, whereas baseline-corrected measurements are computationally simpler. Furthermore, the relationships between AN activity and stimulus- and participant-related variables were not affected by measurement technique, which suggests that these relationships can be compared across studies using different techniques for measuring the CAP N1.

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Morphosyntax Production of Preschool Children With Hearing Loss: An Evaluation of the Extended Optional Infinitive and Surface Accounts

Purpose

The first aim of this study was to explore differences in profiles of morphosyntax production of preschool children with hearing loss (CHL) relative to age- and language-matched comparison groups. The second aim was to explore the potential of extending 2 long-standing theoretical accounts of morphosyntax weakness in children with specific language impairment to preschool CHL.

Method

This study examined conversational language samples to describe the accuracy and type of inaccurate productions of Brown's grammatical morphemes in 18 preschool CHL as compared with an age-matched group (±3 months, n = 18) and a language-matched group (±1 raw score point on an expressive language subtest, n = 18). Age ranged from 45 to 62 months. Performance across groups was compared. In addition, production accuracy of CHL on morphemes that varied by tense and duration was compared to assess the validity of extending theoretical accounts of children with specific language impairment to CHL.

Results

CHL exhibited particular difficulty with morphosyntax relative to other aspects of language. In addition, differences across groups on accuracy and type of inaccurate productions were observed. Finally, a unified approach to explaining morphosyntax weakness in CHL was more appropriate than a linguistic- or perceptual-only approach.

Conclusions

Taken together, the findings of this study support a unified theoretical account of morphosyntax weakness in CHL in which both tense and duration of morphemes play a role in morphosyntax production accuracy, with a more robust role for tense than duration.

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The Impact of Exposure With No Training: Implications for Future Partner Training Research

Purpose

This research note reports on an unexpected negative finding related to behavior change in a controlled trial designed to test whether partner training improves the conversational skills of volunteers.

Method

The clinical trial involving training in “Supported Conversation for Adults with Aphasia” utilized a single-blind, randomized, controlled, pre–post design. Eighty participants making up 40 dyads of a volunteer conversation partner and an adult with aphasia were randomly allocated to either an experimental or control group of 20 dyads each. Descriptive statistics including exact 95% confidence intervals were calculated for the percentage of control group participants who got worse after exposure to individuals with aphasia.

Results

Positive outcomes of training in Supported Conversation for Adults with Aphasia for both the trained volunteers and their partners with aphasia were reported by Kagan, Black, Felson Duchan, Simmons-Mackie, and Square in 2001. However, post hoc data analysis revealed that almost one third of untrained control participants had a negative outcome rather than the anticipated neutral or slightly positive outcome.

Conclusions

If the results of this small study are in any way representative of what happens in real life, communication partner training in aphasia becomes even more important than indicated from the positive results of training studies. That is, it is possible that mere exposure to a communication disability such as aphasia could have negative impacts on communication and social interaction. This may be akin to what is known as a “nocebo” effect—something for partner training studies in aphasia to take into account.

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The Effects of Dynamic-range Automatic Gain Control on Sentence Intelligibility With a Speech Masker in Simulated Cochlear Implant Listening

Objectives: “Channel-linked” and “multi-band” front-end automatic gain control (AGC) were examined as alternatives to single-band, channel-unlinked AGC in simulated bilateral cochlear implant (CI) processing. In channel-linked AGC, the same gain control signal was applied to the input signals to both of the two CIs (“channels”). In multi-band AGC, gain control acted independently on each of a number of narrow frequency regions per channel. Design: Speech intelligibility performance was measured with a single target (to the left, at –15 or –30º) and a single, symmetrically-opposed masker (to the right) at a signal-to-noise ratio (SNR) of –2 decibels. Binaural sentence intelligibility was measured as a function of whether channel linking was present and of the number of AGC bands. Analysis of variance was performed to assess condition effects on percent correct across the two spatial arrangements, both at a high and a low AGC threshold. Acoustic analysis was conducted to compare postcompressed better-ear SNR, interaural differences, and monaural within-band envelope levels across processing conditions. Results: Analyses of variance indicated significant main effects of both channel linking and number of bands at low threshold, and of channel linking at high threshold. These improvements were accompanied by several acoustic changes. Linked AGC produced a more favorable better-ear SNR and better preserved broadband interaural level difference statistics, but did not reduce dynamic range as much as unlinked AGC. Multi-band AGC sometimes improved better-ear SNR statistics and always improved broadband interaural level difference statistics whenever the AGC channels were unlinked. Multi-band AGC produced output envelope levels that were higher than single-band AGC. Conclusions: These results favor strategies that incorporate channel-linked AGC and multi-band AGC for bilateral CIs. Linked AGC aids speech intelligibility in spatially separated speech, but reduces the degree to which dynamic range is compressed. Combining multi-band and channel-linked AGC offsets the potential impact of diminished dynamic range with linked AGC without sacrificing the intelligibility gains observed with linked AGC. ACKNOWLEDGMENTS: The authors thank Bernhard U. Seeber for providing the automatic gain control algorithm on which our implementation was based, and Joshua S. Stohl for his helpful feedback on this article. The authors also thank Katrina Killian and Lauren Dubyne for their work in coordinating data collection. This work was supported by NIDCD (Brown R-01 DC008329) and University of Pittsburgh T-32 Training Grant (T32-DC011499). The authors have no conflicts of interest or finance to disclose. Address for correspondence: Nathaniel J. Spencer, Department of Communication Sciences and Disorders, University of Pittsburgh, 5056 Forbes Tower, 3600 Forbes at Atwood, Pittsburgh, PA 15213, USA. E-mail: nathaniel.spencer.1.ctr@us.af.mil Received March 24, 2016; accepted July 16, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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The Effects of Dynamic-range Automatic Gain Control on Sentence Intelligibility With a Speech Masker in Simulated Cochlear Implant Listening

Objectives: “Channel-linked” and “multi-band” front-end automatic gain control (AGC) were examined as alternatives to single-band, channel-unlinked AGC in simulated bilateral cochlear implant (CI) processing. In channel-linked AGC, the same gain control signal was applied to the input signals to both of the two CIs (“channels”). In multi-band AGC, gain control acted independently on each of a number of narrow frequency regions per channel. Design: Speech intelligibility performance was measured with a single target (to the left, at –15 or –30º) and a single, symmetrically-opposed masker (to the right) at a signal-to-noise ratio (SNR) of –2 decibels. Binaural sentence intelligibility was measured as a function of whether channel linking was present and of the number of AGC bands. Analysis of variance was performed to assess condition effects on percent correct across the two spatial arrangements, both at a high and a low AGC threshold. Acoustic analysis was conducted to compare postcompressed better-ear SNR, interaural differences, and monaural within-band envelope levels across processing conditions. Results: Analyses of variance indicated significant main effects of both channel linking and number of bands at low threshold, and of channel linking at high threshold. These improvements were accompanied by several acoustic changes. Linked AGC produced a more favorable better-ear SNR and better preserved broadband interaural level difference statistics, but did not reduce dynamic range as much as unlinked AGC. Multi-band AGC sometimes improved better-ear SNR statistics and always improved broadband interaural level difference statistics whenever the AGC channels were unlinked. Multi-band AGC produced output envelope levels that were higher than single-band AGC. Conclusions: These results favor strategies that incorporate channel-linked AGC and multi-band AGC for bilateral CIs. Linked AGC aids speech intelligibility in spatially separated speech, but reduces the degree to which dynamic range is compressed. Combining multi-band and channel-linked AGC offsets the potential impact of diminished dynamic range with linked AGC without sacrificing the intelligibility gains observed with linked AGC. ACKNOWLEDGMENTS: The authors thank Bernhard U. Seeber for providing the automatic gain control algorithm on which our implementation was based, and Joshua S. Stohl for his helpful feedback on this article. The authors also thank Katrina Killian and Lauren Dubyne for their work in coordinating data collection. This work was supported by NIDCD (Brown R-01 DC008329) and University of Pittsburgh T-32 Training Grant (T32-DC011499). The authors have no conflicts of interest or finance to disclose. Address for correspondence: Nathaniel J. Spencer, Department of Communication Sciences and Disorders, University of Pittsburgh, 5056 Forbes Tower, 3600 Forbes at Atwood, Pittsburgh, PA 15213, USA. E-mail: nathaniel.spencer.1.ctr@us.af.mil Received March 24, 2016; accepted July 16, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Necesidad de una evaluación e intervención en esclerosis lateral amiotrófica

Publication date: Available online 10 September 2018

Source: Revista de Logopedia, Foniatría y Audiología

Author(s): Andrea Belén Sánchez Sánchez, Elena María Planells del Pozo

Resumen

Antecedentes

La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa rara y de rápido progreso que causa un deterioro en las motoneuronas de la corteza cerebral, tronco encefálico (bulbo) y la médula espinal. Entre las alteraciones más comunes se encuentra la disartria y otros problemas logopédicos que requieren de una intervención de la que actualmente no existen protocolos.

Objetivo

El objetivo de este estudio es crear un protocolo de evaluación de disartria en pacientes con esclerosis lateral amiotrófica en español, que evalúe la respiración, fonación, articulación, resonancia en estos pacientes, para obtener con exactitud los aspectos afectados de cada paciente y elaborar un tratamiento que se adapte al paciente.

Materiales y métodos

El estudio se realiza con 3 pacientes de esclerosis lateral amiotrófica bulbar con un estado leve-moderado de la enfermedad. Para la evaluación se utilizaron un protocolo breve de evaluación de la disartria y el protocolo de evaluación de la disartria elaborado para este trabajo.

Resultados

Tras la evaluación final se comprobó una mejoría en todos los apartados evaluados tras la intervención. Con el protocolo mejorado, se obtuvieron mejores resultados en los distintos apartados.

Conclusiones

Los resultados obtenidos han sido óptimos debido a la utilización del protocolo adaptado a las necesidades y a la aplicación de tratamientos específicos que producen una evolución positiva de la enfermedad.

Abstract

Background

Amyotrophic lateral sclerosis is a rare, rapidly progressing neurodegenerative disease that causes deterioration in the motor neurons of the cerebral cortex, brainstem, and spinal cord. Among the most common disorders are dysarthria and other logopaedic problems that require intervention for which there are currently no protocols.

Objective

The objective of this study is to create a protocol for the evaluation of patients with amyotrophic lateral sclerosis in Spanish, which evaluates respiration, phonation, articulation, and resonance in these patients, in order to accurately obtain the symptoms of each patient and a develop a treatment adapted to the patient.

Materials and methods

The study was carried out with 3 patients with bulbar amyotrophic lateral sclerosis with a mild-moderate state of the disease. For evaluation, a short protocol to assess dysarthria and the protocol for evaluating dysarthria prepared for this study were used.

Results

After the final evaluation, an improvement was observed in all the sections evaluated after the intervention. With the improved protocol, better results were obtained in the different sections.

Conclusions

The results were optimal due to the use of the protocol adapted to needs and the application of specific treatments that have a positive effect on the outcome of the disease.

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Necesidad de una evaluación e intervención en esclerosis lateral amiotrófica

Publication date: Available online 10 September 2018

Source: Revista de Logopedia, Foniatría y Audiología

Author(s): Andrea Belén Sánchez Sánchez, Elena María Planells del Pozo

Resumen

Antecedentes

La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa rara y de rápido progreso que causa un deterioro en las motoneuronas de la corteza cerebral, tronco encefálico (bulbo) y la médula espinal. Entre las alteraciones más comunes se encuentra la disartria y otros problemas logopédicos que requieren de una intervención de la que actualmente no existen protocolos.

Objetivo

El objetivo de este estudio es crear un protocolo de evaluación de disartria en pacientes con esclerosis lateral amiotrófica en español, que evalúe la respiración, fonación, articulación, resonancia en estos pacientes, para obtener con exactitud los aspectos afectados de cada paciente y elaborar un tratamiento que se adapte al paciente.

Materiales y métodos

El estudio se realiza con 3 pacientes de esclerosis lateral amiotrófica bulbar con un estado leve-moderado de la enfermedad. Para la evaluación se utilizaron un protocolo breve de evaluación de la disartria y el protocolo de evaluación de la disartria elaborado para este trabajo.

Resultados

Tras la evaluación final se comprobó una mejoría en todos los apartados evaluados tras la intervención. Con el protocolo mejorado, se obtuvieron mejores resultados en los distintos apartados.

Conclusiones

Los resultados obtenidos han sido óptimos debido a la utilización del protocolo adaptado a las necesidades y a la aplicación de tratamientos específicos que producen una evolución positiva de la enfermedad.

Abstract

Background

Amyotrophic lateral sclerosis is a rare, rapidly progressing neurodegenerative disease that causes deterioration in the motor neurons of the cerebral cortex, brainstem, and spinal cord. Among the most common disorders are dysarthria and other logopaedic problems that require intervention for which there are currently no protocols.

Objective

The objective of this study is to create a protocol for the evaluation of patients with amyotrophic lateral sclerosis in Spanish, which evaluates respiration, phonation, articulation, and resonance in these patients, in order to accurately obtain the symptoms of each patient and a develop a treatment adapted to the patient.

Materials and methods

The study was carried out with 3 patients with bulbar amyotrophic lateral sclerosis with a mild-moderate state of the disease. For evaluation, a short protocol to assess dysarthria and the protocol for evaluating dysarthria prepared for this study were used.

Results

After the final evaluation, an improvement was observed in all the sections evaluated after the intervention. With the improved protocol, better results were obtained in the different sections.

Conclusions

The results were optimal due to the use of the protocol adapted to needs and the application of specific treatments that have a positive effect on the outcome of the disease.

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TRAINING HISTORY CONSTRAINS POSTURAL SWAY DYNAMICS: A STUDY OF BALANCE IN COLLEGIATE ICE HOCKEY PLAYERS

Publication date: Available online 11 September 2018

Source: Gait & Posture

Author(s): Mark Walsh, Eric Slattery, Arden McMath, Ronald Cox, Joshua Haworth

ABSTRACT

Background

Balance and postural control are integral to training and sport performance. Demands on posture are contextual and vary in different ways depending on the specific physical activity.

Research Question

The purpose of this study was to examine the possibility that sustained exposure to environmental constraints, through specific sport participation, might lead to a persistent modification of postural control.

Methods

Double and single-leg postural sway were compared between ice hockey players, American football players and physically active college students. Data from 30 second trials were analyzed using traditional postural sway measures of range and pathlength of the center of pressure, as well as with Sample Entropy (SEn), in both mediolateral (ML) and anteroposterior (AP) directions.

Results

Each group displayed unique postural sway characteristics. During single-leg stance, ice hockey players show significantly different ML pathlength and ML and AP SEn from the physically active college students (all p < 0.05), and significantly different ML and AP pathlength and AP SEn from the American football players (all p < 0.05). The American football players and the physically active college students differed for all single-legged conditions (all p < 0.05).

Significance

This suggests that the organization and development of postural sway is not only context dependent but also influenced by training history; supporting the idea that balance training for sport should be designed with regards to sport specific conditions.

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Reliability of scapular kinematics estimated with three-dimensional motion analysis during shoulder elevation and flexion

Publication date: Available online 10 September 2018

Source: Gait & Posture

Author(s): Nathalie Alexander, Regina Wegener, Vilijam Zdravkovic, David North, Tom Gawliczek, Bernhard Jost

Abstract

Background

Knowing the reliability of three-dimensional motion analysis to evaluate scapular kinematics during upper limb movements is essential to plan further research dedicated to understanding scapulothoracic joint movements relative to the global shoulder motion.

Research question

The aim of this study was to assess the intra-subject as well as intra- and interrater reliability of scapulothoracic joint angles during shoulder elevation in scapular plane and shoulder flexion.

Methods

Twenty healthy participants (26.6 ± 3.5 years) were asked to perform maximum shoulder elevation in scapular plane as well as shoulder flexion. Reliability was assessed using the intraclass correlation coefficient (ICC) and its 95% confidence interval of scapular kinematics (rotation, tilting, pro-retraction) at each degree of global motion (shoulder elevation or shoulder flexion) between 0° to 150°.

Results

ICCs above 0.60 were accepted as good indicators for reliability. Intra-subject reliability was found to be very high (> 0.9 for most part) for all scapulothoracic joint angles during both movements. Intra- and interrater reliability also showed good reliability being above 0.60 for the most part (except scapula tilting during shoulder elevation). Scapular kinematics showed low reliability during the respective first 10° and 20° of shoulder elevation and shoulder flexion. Furthermore, decreasing reliability was found above 120° of shoulder elevation or flexion.

Significance

This study generally showed good to high levels of reliability in the range of interest (20-120°) in evaluating scapula kinematics in healthy adults during shoulder elevation and flexion; these results are important for future research providing a better understanding of scapular kinematics.

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The Validity and reliability of the Swaymeter for postural sway measurement in typically developing children aged between 7-12 years

Publication date: Available online 10 September 2018

Source: Gait & Posture

Author(s): Arisa Parameyong, Sirinun Boripuntakul, Teerawat Kamnardsiri, Jitapa Chawawisuttikool

Abstract

Background

The Swaymeter is a simple device for measuring postural sway. It consists of a 40-cm-long rod with a vertically mounted pen at the end of the rod that measures the displacement of the body at waist level.

Research question

This device could be an effective tool for measuring postural sway in children. However, the validity and reliability of the Swaymeter in children has not been evaluated. In this study, we aimed to evaluate the validity and reliability of the Swaymeter in typically developing children aged 7-12 years.

Method

The Swaymeter procedure was randomly measured in quiet bipedal stance under 4 conditions: eyes open and eyes closed on the floor, eyes open and eyes closed on foam, 30 seconds were performed in each condition. There were 15 children participated in the validity study. The postural sway was measured concurrently with the motion capture system with two reflective markers on the top of the pen and 12th thoracic vertebra level in three trials with four testing conditions. Additionally, 36 children participated in test-retest reliability. Three measurements were performed on the same day and one week later.

Results

Swaymeter had a moderate to good correlation with motion capture system(r=0.637-0.979). The test-retest reliability of the Swaymeter showed moderate to good reliability for immediate test-retest (ICC=0.51-0.87). However, inter-session reliability revealed moderate to good reliability except for the AP variable that showed low reliability. Good to excellent reliability was found in sway area variable (ICCs between 0.74-0.92) for all measurements.

Significance

Postural sway measure by Swaymeter was valid and reliable in typically developing children aged 7 to 12 years and suitable for applying to assess postural sway in typically developing children.

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Changes to Gait Speed and the Walk Ratio with Rhythmic Auditory Cuing

Publication date: Available online 10 September 2018

Source: Gait & Posture

Author(s): Scott W. Ducharme, Colleen J. Sands, Christopher C. Moore, Elroy J. Aguiar, Joseph Hamill, Catrine Tudor-Locke

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TRAINING HISTORY CONSTRAINS POSTURAL SWAY DYNAMICS: A STUDY OF BALANCE IN COLLEGIATE ICE HOCKEY PLAYERS

Publication date: Available online 11 September 2018

Source: Gait & Posture

Author(s): Mark Walsh, Eric Slattery, Arden McMath, Ronald Cox, Joshua Haworth

ABSTRACT

Background

Balance and postural control are integral to training and sport performance. Demands on posture are contextual and vary in different ways depending on the specific physical activity.

Research Question

The purpose of this study was to examine the possibility that sustained exposure to environmental constraints, through specific sport participation, might lead to a persistent modification of postural control.

Methods

Double and single-leg postural sway were compared between ice hockey players, American football players and physically active college students. Data from 30 second trials were analyzed using traditional postural sway measures of range and pathlength of the center of pressure, as well as with Sample Entropy (SEn), in both mediolateral (ML) and anteroposterior (AP) directions.

Results

Each group displayed unique postural sway characteristics. During single-leg stance, ice hockey players show significantly different ML pathlength and ML and AP SEn from the physically active college students (all p < 0.05), and significantly different ML and AP pathlength and AP SEn from the American football players (all p < 0.05). The American football players and the physically active college students differed for all single-legged conditions (all p < 0.05).

Significance

This suggests that the organization and development of postural sway is not only context dependent but also influenced by training history; supporting the idea that balance training for sport should be designed with regards to sport specific conditions.

from #Audiology via ola Kala on Inoreader https://ift.tt/2MjAL7W
via IFTTT

Reliability of scapular kinematics estimated with three-dimensional motion analysis during shoulder elevation and flexion

Publication date: Available online 10 September 2018

Source: Gait & Posture

Author(s): Nathalie Alexander, Regina Wegener, Vilijam Zdravkovic, David North, Tom Gawliczek, Bernhard Jost

Abstract

Background

Knowing the reliability of three-dimensional motion analysis to evaluate scapular kinematics during upper limb movements is essential to plan further research dedicated to understanding scapulothoracic joint movements relative to the global shoulder motion.

Research question

The aim of this study was to assess the intra-subject as well as intra- and interrater reliability of scapulothoracic joint angles during shoulder elevation in scapular plane and shoulder flexion.

Methods

Twenty healthy participants (26.6 ± 3.5 years) were asked to perform maximum shoulder elevation in scapular plane as well as shoulder flexion. Reliability was assessed using the intraclass correlation coefficient (ICC) and its 95% confidence interval of scapular kinematics (rotation, tilting, pro-retraction) at each degree of global motion (shoulder elevation or shoulder flexion) between 0° to 150°.

Results

ICCs above 0.60 were accepted as good indicators for reliability. Intra-subject reliability was found to be very high (> 0.9 for most part) for all scapulothoracic joint angles during both movements. Intra- and interrater reliability also showed good reliability being above 0.60 for the most part (except scapula tilting during shoulder elevation). Scapular kinematics showed low reliability during the respective first 10° and 20° of shoulder elevation and shoulder flexion. Furthermore, decreasing reliability was found above 120° of shoulder elevation or flexion.

Significance

This study generally showed good to high levels of reliability in the range of interest (20-120°) in evaluating scapula kinematics in healthy adults during shoulder elevation and flexion; these results are important for future research providing a better understanding of scapular kinematics.

from #Audiology via ola Kala on Inoreader https://ift.tt/2oYtz7Z
via IFTTT

The Validity and reliability of the Swaymeter for postural sway measurement in typically developing children aged between 7-12 years

Publication date: Available online 10 September 2018

Source: Gait & Posture

Author(s): Arisa Parameyong, Sirinun Boripuntakul, Teerawat Kamnardsiri, Jitapa Chawawisuttikool

Abstract

Background

The Swaymeter is a simple device for measuring postural sway. It consists of a 40-cm-long rod with a vertically mounted pen at the end of the rod that measures the displacement of the body at waist level.

Research question

This device could be an effective tool for measuring postural sway in children. However, the validity and reliability of the Swaymeter in children has not been evaluated. In this study, we aimed to evaluate the validity and reliability of the Swaymeter in typically developing children aged 7-12 years.

Method

The Swaymeter procedure was randomly measured in quiet bipedal stance under 4 conditions: eyes open and eyes closed on the floor, eyes open and eyes closed on foam, 30 seconds were performed in each condition. There were 15 children participated in the validity study. The postural sway was measured concurrently with the motion capture system with two reflective markers on the top of the pen and 12th thoracic vertebra level in three trials with four testing conditions. Additionally, 36 children participated in test-retest reliability. Three measurements were performed on the same day and one week later.

Results

Swaymeter had a moderate to good correlation with motion capture system(r=0.637-0.979). The test-retest reliability of the Swaymeter showed moderate to good reliability for immediate test-retest (ICC=0.51-0.87). However, inter-session reliability revealed moderate to good reliability except for the AP variable that showed low reliability. Good to excellent reliability was found in sway area variable (ICCs between 0.74-0.92) for all measurements.

Significance

Postural sway measure by Swaymeter was valid and reliable in typically developing children aged 7 to 12 years and suitable for applying to assess postural sway in typically developing children.

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via IFTTT

Changes to Gait Speed and the Walk Ratio with Rhythmic Auditory Cuing

Publication date: Available online 10 September 2018

Source: Gait & Posture

Author(s): Scott W. Ducharme, Colleen J. Sands, Christopher C. Moore, Elroy J. Aguiar, Joseph Hamill, Catrine Tudor-Locke

from #Audiology via ola Kala on Inoreader https://ift.tt/2oY2a64
via IFTTT