Vocal Biomarkers of Mild-to-Moderate Hearing Loss in Children and Adults: Voiceless Sibilants

Purpose

The purpose of this study was to determine if an objective measure of speech production could serve as a vocal biomarker for the effects of high-frequency hearing loss on speech perception. It was hypothesized that production of voiceless sibilants is governed sufficiently by auditory feedback that high-frequency hearing loss results in subtle but significant shifts in the spectral characteristics of these sibilants.

Method

Sibilant production was examined in individuals with mild to moderately severe congenital (22 children; 8–17 years old) and acquired (23 adults; 55–80 years old) hearing losses. Measures of hearing level (pure-tone average thresholds at 4 and 8 kHz), speech perception (detection of nonsense words within sentences), and speech production (spectral center of gravity [COG] for /s/ and /ʃ/) were obtained in unaided and aided conditions.

Results

For both children and adults, detection of nonsense words increased significantly as hearing thresholds improved. Spectral COG for /ʃ/ was unaffected by hearing loss in both listening conditions, whereas the spectral COG for /s/ significantly decreased as high-frequency hearing loss increased. The distance in spectral COG between /s/ and /ʃ/ decreased significantly with increasing hearing level. COG distance significantly predicted nonsense-word detection in children but not in adults.

Conclusions

At least one aspect of speech production (voiceless sibilants) is measurably affected by high-frequency hearing loss and is related to speech perception in children. Speech production did not predict speech perception in adults, suggesting a more complex relationship between auditory feedback and feedforward mechanisms with age. Even so, these results suggest that this vocal biomarker may be useful for identifying the presence of high-frequency hearing loss in adults and children and for predicting the impact of hearing loss in children.

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Relations Between Teacher Talk Characteristics and Child Language in Spoken Language, Deaf, and Hard-of-Hearing Classrooms

Purpose

The aim of this study was to examine relations between teachers' conversational techniques and language gains made by their deaf and hard-of-hearing students. Specifically, we considered teachers' reformulations of child utterances, language elicitations, explicit vocabulary and syntax instruction, and wait time.

Method

This was an observational, longitudinal study that examined the characteristics of teacher talk in 25 kindergarten through second-grade classrooms of 68 deaf and hard-of-hearing children who used spoken English. Standardized assessments provided measures of child vocabulary and morphosyntax in the fall and spring of a school year. Characteristics of teacher talk were coded from classroom video recordings during the winter of that year.

Results

Hierarchical linear modeling indicated that reformulating child statements and explicitly teaching vocabulary were significant predictors of child vocabulary gains across a school year. Explicitly teaching vocabulary also significantly predicted gains in morphosyntax abilities. There were wide individual differences in the teachers' use of these conversational techniques.

Conclusion

Reformulation and explicit vocabulary instruction may be areas where training can help teachers improve, and improvements in the teachers' talk may benefit their students.

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The Coexistence of Disabling Conditions in Children Who Stutter: Evidence From the National Health Interview Survey

Purpose

Stuttering is a disorder that has been associated with coexisting developmental disorders. To date, detailed descriptions of the coexistence of such conditions have not consistently emerged in the literature. Identifying and understanding these conditions can be important to the overall management of children who stutter (CWS). The objective of this study was to generate a profile of the existence of disabling developmental conditions among CWS using national data.

Method

Six years of data from the National Health Interview Survey (2010–2015) were analyzed for this project. The sample consisted of children whose respondents clearly indicated the presence or absence of stuttering. Chi-square tests of independence were used for comparing categorical variables; and independent-samples t tests, for comparing continuous variables. Multiple logistic regression analyses were used for determining the odds of having a coexisting disabling developmental condition.

Results

This study sample included 62,450 children, of which 1,231 were CWS. Overall, the presence of at least 1 disabling developmental condition was 5.5 times higher in CWS when compared with children who do not stutter. The presence of stuttering was also associated with higher odds of each of the following coexisting developmental conditions: intellectual disability (odds ratio [OR] = 6.67, p < .001), learning disability (OR = 5.45, p < .001), attention-deficit hyperactivity disorder/attention-deficit disorder (OR = 3.09, p < .001), seizures (OR = 7.52, p < .001), autism/Asperger's/pervasive developmental disorder (OR = 5.48, p < .001), and any other developmental delay (OR = 7.10, p < .001).

Conclusion

Evidence from the National Health Interview Survey suggests a higher prevalence of coexisting developmental disabilities in CWS. The existence of coexisting disabling developmental conditions should be considered as part of an overall management plan for CWS.

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Vocal Biomarkers of Mild-to-Moderate Hearing Loss in Children and Adults: Voiceless Sibilants

Purpose

The purpose of this study was to determine if an objective measure of speech production could serve as a vocal biomarker for the effects of high-frequency hearing loss on speech perception. It was hypothesized that production of voiceless sibilants is governed sufficiently by auditory feedback that high-frequency hearing loss results in subtle but significant shifts in the spectral characteristics of these sibilants.

Method

Sibilant production was examined in individuals with mild to moderately severe congenital (22 children; 8–17 years old) and acquired (23 adults; 55–80 years old) hearing losses. Measures of hearing level (pure-tone average thresholds at 4 and 8 kHz), speech perception (detection of nonsense words within sentences), and speech production (spectral center of gravity [COG] for /s/ and /ʃ/) were obtained in unaided and aided conditions.

Results

For both children and adults, detection of nonsense words increased significantly as hearing thresholds improved. Spectral COG for /ʃ/ was unaffected by hearing loss in both listening conditions, whereas the spectral COG for /s/ significantly decreased as high-frequency hearing loss increased. The distance in spectral COG between /s/ and /ʃ/ decreased significantly with increasing hearing level. COG distance significantly predicted nonsense-word detection in children but not in adults.

Conclusions

At least one aspect of speech production (voiceless sibilants) is measurably affected by high-frequency hearing loss and is related to speech perception in children. Speech production did not predict speech perception in adults, suggesting a more complex relationship between auditory feedback and feedforward mechanisms with age. Even so, these results suggest that this vocal biomarker may be useful for identifying the presence of high-frequency hearing loss in adults and children and for predicting the impact of hearing loss in children.

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Relations Between Teacher Talk Characteristics and Child Language in Spoken Language, Deaf, and Hard-of-Hearing Classrooms

Purpose

The aim of this study was to examine relations between teachers' conversational techniques and language gains made by their deaf and hard-of-hearing students. Specifically, we considered teachers' reformulations of child utterances, language elicitations, explicit vocabulary and syntax instruction, and wait time.

Method

This was an observational, longitudinal study that examined the characteristics of teacher talk in 25 kindergarten through second-grade classrooms of 68 deaf and hard-of-hearing children who used spoken English. Standardized assessments provided measures of child vocabulary and morphosyntax in the fall and spring of a school year. Characteristics of teacher talk were coded from classroom video recordings during the winter of that year.

Results

Hierarchical linear modeling indicated that reformulating child statements and explicitly teaching vocabulary were significant predictors of child vocabulary gains across a school year. Explicitly teaching vocabulary also significantly predicted gains in morphosyntax abilities. There were wide individual differences in the teachers' use of these conversational techniques.

Conclusion

Reformulation and explicit vocabulary instruction may be areas where training can help teachers improve, and improvements in the teachers' talk may benefit their students.

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The Coexistence of Disabling Conditions in Children Who Stutter: Evidence From the National Health Interview Survey

Purpose

Stuttering is a disorder that has been associated with coexisting developmental disorders. To date, detailed descriptions of the coexistence of such conditions have not consistently emerged in the literature. Identifying and understanding these conditions can be important to the overall management of children who stutter (CWS). The objective of this study was to generate a profile of the existence of disabling developmental conditions among CWS using national data.

Method

Six years of data from the National Health Interview Survey (2010–2015) were analyzed for this project. The sample consisted of children whose respondents clearly indicated the presence or absence of stuttering. Chi-square tests of independence were used for comparing categorical variables; and independent-samples t tests, for comparing continuous variables. Multiple logistic regression analyses were used for determining the odds of having a coexisting disabling developmental condition.

Results

This study sample included 62,450 children, of which 1,231 were CWS. Overall, the presence of at least 1 disabling developmental condition was 5.5 times higher in CWS when compared with children who do not stutter. The presence of stuttering was also associated with higher odds of each of the following coexisting developmental conditions: intellectual disability (odds ratio [OR] = 6.67, p < .001), learning disability (OR = 5.45, p < .001), attention-deficit hyperactivity disorder/attention-deficit disorder (OR = 3.09, p < .001), seizures (OR = 7.52, p < .001), autism/Asperger's/pervasive developmental disorder (OR = 5.48, p < .001), and any other developmental delay (OR = 7.10, p < .001).

Conclusion

Evidence from the National Health Interview Survey suggests a higher prevalence of coexisting developmental disabilities in CWS. The existence of coexisting disabling developmental conditions should be considered as part of an overall management plan for CWS.

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Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Related Articles

Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Int J Audiol. 2018 Oct;57(10):737-745

Authors: Marcrum SC, Picou EM, Bohr C, Steffens T

Abstract
OBJECTIVE: The primary purpose of this study was to update existing data on additional gain before feedback and maximum stable gain in commercially available, open-fit hearing instruments. A secondary purpose was to evaluate ratings of sound quality with feedback reduction systems active.
DESIGN: Additional gain before feedback, maximum stable gain and subjective sound quality ratings were obtained for six commercially available hearing instruments utilising modern feedback reduction systems.
STUDY SAMPLE: Twenty adults (22-46 years) with normal hearing participated in gain measurement testing. Thirty adults (22-39 years) with normal hearing provided ratings of sound quality.
RESULTS: Mean additional gain before feedback for 2000-4000 Hz ranged from 5 to 16 dB across manufacturers. Mean maximum stable gain in the same frequency region ranged from 25 to 35 dB across manufacturers. However, meaningful performance differences between participants within each given manufacturer were also identified. Sound quality ratings were not related to the type of feedback reduction algorithm.
CONCLUSIONS: AGBF and MSG continue to vary significantly both across manufacturers as well as individual ears within a given manufacturer. User satisfaction and performance with hearing aids might be improved by identifying the feedback reduction system optimal for the individual patient.

PMID: 30394158 [PubMed - in process]

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A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Related Articles

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Int J Audiol. 2018 Oct;57(10):721-729

Authors: Maidment DW, Barker AB, Xia J, Ferguson MA

Abstract
Recent technological advances have led to a rapid increase in alternative listening devices to conventional hearing aids. The aim was to systematically review the existing evidence to assess the effectiveness of alternative listening devices in adults with mild and moderate hearing loss. A systematic search strategy of the scientific literature was employed, reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist. Eleven studies met eligibility for inclusion: two studies evaluated personal sound amplification products, and nine studies assessed remote microphone systems (frequency modulation, Bluetooth, wireless). The evidence in this review suggests that alternative listening devices improve behavioural measures of speech intelligibility relative to unaided and/or aided conditions. Evidence for whether alternative listening devices improve self-reported outcomes is inconsistent. The evidence was judged to be of poor to good quality and subject to bias due to limitations in study design. Our overall recommendation is that high-quality evidence (i.e. randomised controlled trials) is required to demonstrate the effectiveness of alternative listening devices. Such evidence is not currently available and is necessary to guide healthcare commissioners and policymakers when considering new service delivery models for adults with hearing loss. Review registration: Prospective Register of Systematic Reviews (PROSPERO), CRD42015029582.

PMID: 30388942 [PubMed - in process]

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Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Related Articles

Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Int J Audiol. 2018 Oct;57(10):784-790

Authors: Pryce H, Hall A, Shaw R, Culhane BA, Swift S, Straus J, Claesen B

Abstract
In order to identify patient preferences in care for tinnitus an in depth grounded theory study was conducted. This consisted of interviews with 41 patients who had sought help for tinnitus across a range of locations and tinnitus services in England. Preferences for outcomes were for both the removal of the tinnitus and for improved coping and management of the tinnitus. Preferences for treatment were for individualized care, tailored information and for treatment to assist with psychological adjustment and auditory distraction. Adoption of treatments to manage tinnitus were based on a trial and error approach. Patients? preferences for individual treatments varied but were informed by the information they received. Information plays an important role in care for people with tinnitus. Patients hold individual preferences and require engagement in shared decision making.

PMID: 30388941 [PubMed - in process]

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Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Related Articles

Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Int J Audiol. 2018 Oct;57(10):737-745

Authors: Marcrum SC, Picou EM, Bohr C, Steffens T

Abstract
OBJECTIVE: The primary purpose of this study was to update existing data on additional gain before feedback and maximum stable gain in commercially available, open-fit hearing instruments. A secondary purpose was to evaluate ratings of sound quality with feedback reduction systems active.
DESIGN: Additional gain before feedback, maximum stable gain and subjective sound quality ratings were obtained for six commercially available hearing instruments utilising modern feedback reduction systems.
STUDY SAMPLE: Twenty adults (22-46 years) with normal hearing participated in gain measurement testing. Thirty adults (22-39 years) with normal hearing provided ratings of sound quality.
RESULTS: Mean additional gain before feedback for 2000-4000 Hz ranged from 5 to 16 dB across manufacturers. Mean maximum stable gain in the same frequency region ranged from 25 to 35 dB across manufacturers. However, meaningful performance differences between participants within each given manufacturer were also identified. Sound quality ratings were not related to the type of feedback reduction algorithm.
CONCLUSIONS: AGBF and MSG continue to vary significantly both across manufacturers as well as individual ears within a given manufacturer. User satisfaction and performance with hearing aids might be improved by identifying the feedback reduction system optimal for the individual patient.

PMID: 30394158 [PubMed - in process]

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A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Related Articles

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Int J Audiol. 2018 Oct;57(10):721-729

Authors: Maidment DW, Barker AB, Xia J, Ferguson MA

Abstract
Recent technological advances have led to a rapid increase in alternative listening devices to conventional hearing aids. The aim was to systematically review the existing evidence to assess the effectiveness of alternative listening devices in adults with mild and moderate hearing loss. A systematic search strategy of the scientific literature was employed, reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist. Eleven studies met eligibility for inclusion: two studies evaluated personal sound amplification products, and nine studies assessed remote microphone systems (frequency modulation, Bluetooth, wireless). The evidence in this review suggests that alternative listening devices improve behavioural measures of speech intelligibility relative to unaided and/or aided conditions. Evidence for whether alternative listening devices improve self-reported outcomes is inconsistent. The evidence was judged to be of poor to good quality and subject to bias due to limitations in study design. Our overall recommendation is that high-quality evidence (i.e. randomised controlled trials) is required to demonstrate the effectiveness of alternative listening devices. Such evidence is not currently available and is necessary to guide healthcare commissioners and policymakers when considering new service delivery models for adults with hearing loss. Review registration: Prospective Register of Systematic Reviews (PROSPERO), CRD42015029582.

PMID: 30388942 [PubMed - in process]

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Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Related Articles

Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Int J Audiol. 2018 Oct;57(10):784-790

Authors: Pryce H, Hall A, Shaw R, Culhane BA, Swift S, Straus J, Claesen B

Abstract
In order to identify patient preferences in care for tinnitus an in depth grounded theory study was conducted. This consisted of interviews with 41 patients who had sought help for tinnitus across a range of locations and tinnitus services in England. Preferences for outcomes were for both the removal of the tinnitus and for improved coping and management of the tinnitus. Preferences for treatment were for individualized care, tailored information and for treatment to assist with psychological adjustment and auditory distraction. Adoption of treatments to manage tinnitus were based on a trial and error approach. Patients? preferences for individual treatments varied but were informed by the information they received. Information plays an important role in care for people with tinnitus. Patients hold individual preferences and require engagement in shared decision making.

PMID: 30388941 [PubMed - in process]

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via IFTTT

Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Int J Audiol. 2018 Oct;57(10):737-745

Authors: Marcrum SC, Picou EM, Bohr C, Steffens T

Abstract
OBJECTIVE: The primary purpose of this study was to update existing data on additional gain before feedback and maximum stable gain in commercially available, open-fit hearing instruments. A secondary purpose was to evaluate ratings of sound quality with feedback reduction systems active.
DESIGN: Additional gain before feedback, maximum stable gain and subjective sound quality ratings were obtained for six commercially available hearing instruments utilising modern feedback reduction systems.
STUDY SAMPLE: Twenty adults (22-46 years) with normal hearing participated in gain measurement testing. Thirty adults (22-39 years) with normal hearing provided ratings of sound quality.
RESULTS: Mean additional gain before feedback for 2000-4000 Hz ranged from 5 to 16 dB across manufacturers. Mean maximum stable gain in the same frequency region ranged from 25 to 35 dB across manufacturers. However, meaningful performance differences between participants within each given manufacturer were also identified. Sound quality ratings were not related to the type of feedback reduction algorithm.
CONCLUSIONS: AGBF and MSG continue to vary significantly both across manufacturers as well as individual ears within a given manufacturer. User satisfaction and performance with hearing aids might be improved by identifying the feedback reduction system optimal for the individual patient.

PMID: 30394158 [PubMed - in process]

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via IFTTT

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Related Articles

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Int J Audiol. 2018 Oct;57(10):721-729

Authors: Maidment DW, Barker AB, Xia J, Ferguson MA

Abstract
Recent technological advances have led to a rapid increase in alternative listening devices to conventional hearing aids. The aim was to systematically review the existing evidence to assess the effectiveness of alternative listening devices in adults with mild and moderate hearing loss. A systematic search strategy of the scientific literature was employed, reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist. Eleven studies met eligibility for inclusion: two studies evaluated personal sound amplification products, and nine studies assessed remote microphone systems (frequency modulation, Bluetooth, wireless). The evidence in this review suggests that alternative listening devices improve behavioural measures of speech intelligibility relative to unaided and/or aided conditions. Evidence for whether alternative listening devices improve self-reported outcomes is inconsistent. The evidence was judged to be of poor to good quality and subject to bias due to limitations in study design. Our overall recommendation is that high-quality evidence (i.e. randomised controlled trials) is required to demonstrate the effectiveness of alternative listening devices. Such evidence is not currently available and is necessary to guide healthcare commissioners and policymakers when considering new service delivery models for adults with hearing loss. Review registration: Prospective Register of Systematic Reviews (PROSPERO), CRD42015029582.

PMID: 30388942 [PubMed - in process]

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Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Related Articles

Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Int J Audiol. 2018 Oct;57(10):784-790

Authors: Pryce H, Hall A, Shaw R, Culhane BA, Swift S, Straus J, Claesen B

Abstract
In order to identify patient preferences in care for tinnitus an in depth grounded theory study was conducted. This consisted of interviews with 41 patients who had sought help for tinnitus across a range of locations and tinnitus services in England. Preferences for outcomes were for both the removal of the tinnitus and for improved coping and management of the tinnitus. Preferences for treatment were for individualized care, tailored information and for treatment to assist with psychological adjustment and auditory distraction. Adoption of treatments to manage tinnitus were based on a trial and error approach. Patients? preferences for individual treatments varied but were informed by the information they received. Information plays an important role in care for people with tinnitus. Patients hold individual preferences and require engagement in shared decision making.

PMID: 30388941 [PubMed - in process]

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via IFTTT

Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Int J Audiol. 2018 Oct;57(10):737-745

Authors: Marcrum SC, Picou EM, Bohr C, Steffens T

Abstract
OBJECTIVE: The primary purpose of this study was to update existing data on additional gain before feedback and maximum stable gain in commercially available, open-fit hearing instruments. A secondary purpose was to evaluate ratings of sound quality with feedback reduction systems active.
DESIGN: Additional gain before feedback, maximum stable gain and subjective sound quality ratings were obtained for six commercially available hearing instruments utilising modern feedback reduction systems.
STUDY SAMPLE: Twenty adults (22-46 years) with normal hearing participated in gain measurement testing. Thirty adults (22-39 years) with normal hearing provided ratings of sound quality.
RESULTS: Mean additional gain before feedback for 2000-4000 Hz ranged from 5 to 16 dB across manufacturers. Mean maximum stable gain in the same frequency region ranged from 25 to 35 dB across manufacturers. However, meaningful performance differences between participants within each given manufacturer were also identified. Sound quality ratings were not related to the type of feedback reduction algorithm.
CONCLUSIONS: AGBF and MSG continue to vary significantly both across manufacturers as well as individual ears within a given manufacturer. User satisfaction and performance with hearing aids might be improved by identifying the feedback reduction system optimal for the individual patient.

PMID: 30394158 [PubMed - in process]

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via IFTTT

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Related Articles

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss.

Int J Audiol. 2018 Oct;57(10):721-729

Authors: Maidment DW, Barker AB, Xia J, Ferguson MA

Abstract
Recent technological advances have led to a rapid increase in alternative listening devices to conventional hearing aids. The aim was to systematically review the existing evidence to assess the effectiveness of alternative listening devices in adults with mild and moderate hearing loss. A systematic search strategy of the scientific literature was employed, reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist. Eleven studies met eligibility for inclusion: two studies evaluated personal sound amplification products, and nine studies assessed remote microphone systems (frequency modulation, Bluetooth, wireless). The evidence in this review suggests that alternative listening devices improve behavioural measures of speech intelligibility relative to unaided and/or aided conditions. Evidence for whether alternative listening devices improve self-reported outcomes is inconsistent. The evidence was judged to be of poor to good quality and subject to bias due to limitations in study design. Our overall recommendation is that high-quality evidence (i.e. randomised controlled trials) is required to demonstrate the effectiveness of alternative listening devices. Such evidence is not currently available and is necessary to guide healthcare commissioners and policymakers when considering new service delivery models for adults with hearing loss. Review registration: Prospective Register of Systematic Reviews (PROSPERO), CRD42015029582.

PMID: 30388942 [PubMed - in process]

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Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Related Articles

Patient preferences in tinnitus outcomes and treatments: a qualitative study.

Int J Audiol. 2018 Oct;57(10):784-790

Authors: Pryce H, Hall A, Shaw R, Culhane BA, Swift S, Straus J, Claesen B

Abstract
In order to identify patient preferences in care for tinnitus an in depth grounded theory study was conducted. This consisted of interviews with 41 patients who had sought help for tinnitus across a range of locations and tinnitus services in England. Preferences for outcomes were for both the removal of the tinnitus and for improved coping and management of the tinnitus. Preferences for treatment were for individualized care, tailored information and for treatment to assist with psychological adjustment and auditory distraction. Adoption of treatments to manage tinnitus were based on a trial and error approach. Patients? preferences for individual treatments varied but were informed by the information they received. Information plays an important role in care for people with tinnitus. Patients hold individual preferences and require engagement in shared decision making.

PMID: 30388941 [PubMed - in process]

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Defining the Minimal Clinically Important Difference for Patients With Vestibular Schwannoma: Are all Quality-of-Life Scores Significant?

Defining the Minimal Clinically Important Difference for Patients With Vestibular Schwannoma: Are all Quality-of-Life Scores Significant?

Neurosurgery. 2018 Nov 05;:

Authors: Kerezoudis P, Yost KJ, Tombers NM, Celda MP, Carlson ML, Link MJ

Abstract
BACKGROUND: The diagnosis of vestibular schwannomas (VS) is associated with reduced patient quality of life (QOL). Minimal clinically important difference (MCID) was introduced as the lowest improvement in a patient-reported outcome (PRO) score discerned as significant by the patient. We formerly presented an MCID for the Penn Acoustic Neuroma QOL (PANQOL) battery based on cross-sectional data from 2 tertiary referral centers.
OBJECTIVE: To validate the PANQOL MCID values using prospective data.
METHODS: A prospective registry capturing QOL was queried, comprising patients treated at the authors' institution and Acoustic Neuroma Association members. Anchor- and distribution-based techniques were utilized to determine the MCID for domain and total scores. We only included anchors with Spearman's correlation coefficient larger than 0.3 in the MCID threshold calculations. Most domains had multiple anchors with which to estimate the MCID.
RESULTS: A total of 1254 patients (mean age: 57.4 yr, 65% females) were analyzed. Anchor-based methods produced a span of MCID values (median, 25th-75th percentile) for each PANQOL domain and the total score: hearing (13.1, 13-16 points), balance (14, 14-19 points), pain (21, 20-28 points), face (25, 16-36 points), energy (16, 15-18 points), anxiety (16 [1 estimate]), general (13 [1 estimate]), and total (12.5, 10-15 points).
CONCLUSION: Current findings corroborate our formerly shared experience using multi-institutional, cross-sectional information. These MCID thresholds can serve as a pertinent outcome when deciphering the clinical magnitude of VS QOL endpoints in cross-sectional and longitudinal studies.

PMID: 30395303 [PubMed - as supplied by publisher]

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ACR Appropriateness Criteria® Hearing Loss and/or Vertigo.

Related Articles

ACR Appropriateness Criteria® Hearing Loss and/or Vertigo.

J Am Coll Radiol. 2018 Nov;15(11S):S321-S331

Authors: Expert Panel on Neurologic Imaging:, Sharma A, Kirsch CFE, Aulino JM, Chakraborty S, Choudhri AF, Germano IM, Kendi AT, Kim HJ, Lee RK, Liebeskind DS, Luttrull MD, Moritani T, Murad GJA, Shah LM, Shih RY, Symko SC, Bykowski J

Abstract
This article presents guidelines for imaging utilization in patients presenting with hearing loss or vertigo, symptoms that sometimes occur concurrently due to proximity of receptors and neural pathways responsible for hearing and balance. These guidelines take into account the superiority of CT in providing bony details and better soft-tissue resolution offered by MRI. It should be noted that a dedicated temporal bone CT rather than a head CT best achieves delineation of disease in many of these patients. Similarly, optimal assessment often requires a dedicated high-resolution protocol designed to assess temporal bone and internal auditory canals even though such a study will be requested and billed as a brain MRI. Angiographic techniques are helpful in some patients, especially in the setting of vertigo. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

PMID: 30392601 [PubMed - in process]

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The effect of simultaneously and sequentially delivered cognitive and aerobic training on mobility among older adults with hearing loss.

Related Articles

The effect of simultaneously and sequentially delivered cognitive and aerobic training on mobility among older adults with hearing loss.

Gait Posture. 2018 Oct 23;67:262-268

Authors: Bruce H, Lai L, Bherer L, Lussier M, St-Onge N, Li KZH

Abstract
BACKGROUND: Older adults exhibit declines in auditory and motor functioning, which are compensated for through the recruitment of cognitive resources. Cognitive or physical training alone has been shown to improve cognitive functioning and transfer to motor tasks, but results are mixed when these are combined in studies of healthy older adults, and few studies have included those with age-related hearing loss (ARHL), who are at a higher risk of falls.
RESEARCH QUESTION: To examine format effects in mixed training, we used a repeated measures intervention design to compare the efficacy of Simultaneous and Sequential multimodal training formats.
METHODS: 42 older adults (Mage = 68.05, SDage = 4.65, females = 26) with (ARHL) and without hearing loss (OAH) completed an intervention study consisting of 12 sessions of multimodal training (computerized cognitive dual-task and recumbent aerobic cycling). Participants were randomly assigned to either the Simultaneous (concurrent cognitive and aerobic) or Sequential training group (cognitive followed by aerobic) and completed assessments of single- and dual-task mobility concurrent with an auditory working memory task. Training gains were assessed with repeated measures ANOVAs using magnitude of improvement from pre- to post-training on primary outcome measures as the dependent variable.
RESULTS: Gains in auditory working memory were greater in the Sequential group than Simultaneous particularly among OAH. ARHL participants were unaffected by format. While all participants improved on a measure of chair rises, there was no benefit to standing balance. The results demonstrate an advantage to Sequential training, suggesting a benefit to focusing on each task in isolation.
SIGNIFICANCE: The gains noted in the ARHL indicate the potential benefit of incorporating cognitive remediation into traditional audiological rehabilitation. Moreover, it is important to consider the cost of dividing attention when combining training.

PMID: 30390596 [PubMed - as supplied by publisher]

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Defining the Minimal Clinically Important Difference for Patients With Vestibular Schwannoma: Are all Quality-of-Life Scores Significant?

Defining the Minimal Clinically Important Difference for Patients With Vestibular Schwannoma: Are all Quality-of-Life Scores Significant?

Neurosurgery. 2018 Nov 05;:

Authors: Kerezoudis P, Yost KJ, Tombers NM, Celda MP, Carlson ML, Link MJ

Abstract
BACKGROUND: The diagnosis of vestibular schwannomas (VS) is associated with reduced patient quality of life (QOL). Minimal clinically important difference (MCID) was introduced as the lowest improvement in a patient-reported outcome (PRO) score discerned as significant by the patient. We formerly presented an MCID for the Penn Acoustic Neuroma QOL (PANQOL) battery based on cross-sectional data from 2 tertiary referral centers.
OBJECTIVE: To validate the PANQOL MCID values using prospective data.
METHODS: A prospective registry capturing QOL was queried, comprising patients treated at the authors' institution and Acoustic Neuroma Association members. Anchor- and distribution-based techniques were utilized to determine the MCID for domain and total scores. We only included anchors with Spearman's correlation coefficient larger than 0.3 in the MCID threshold calculations. Most domains had multiple anchors with which to estimate the MCID.
RESULTS: A total of 1254 patients (mean age: 57.4 yr, 65% females) were analyzed. Anchor-based methods produced a span of MCID values (median, 25th-75th percentile) for each PANQOL domain and the total score: hearing (13.1, 13-16 points), balance (14, 14-19 points), pain (21, 20-28 points), face (25, 16-36 points), energy (16, 15-18 points), anxiety (16 [1 estimate]), general (13 [1 estimate]), and total (12.5, 10-15 points).
CONCLUSION: Current findings corroborate our formerly shared experience using multi-institutional, cross-sectional information. These MCID thresholds can serve as a pertinent outcome when deciphering the clinical magnitude of VS QOL endpoints in cross-sectional and longitudinal studies.

PMID: 30395303 [PubMed - as supplied by publisher]

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ACR Appropriateness Criteria® Hearing Loss and/or Vertigo.

Related Articles

ACR Appropriateness Criteria® Hearing Loss and/or Vertigo.

J Am Coll Radiol. 2018 Nov;15(11S):S321-S331

Authors: Expert Panel on Neurologic Imaging:, Sharma A, Kirsch CFE, Aulino JM, Chakraborty S, Choudhri AF, Germano IM, Kendi AT, Kim HJ, Lee RK, Liebeskind DS, Luttrull MD, Moritani T, Murad GJA, Shah LM, Shih RY, Symko SC, Bykowski J

Abstract
This article presents guidelines for imaging utilization in patients presenting with hearing loss or vertigo, symptoms that sometimes occur concurrently due to proximity of receptors and neural pathways responsible for hearing and balance. These guidelines take into account the superiority of CT in providing bony details and better soft-tissue resolution offered by MRI. It should be noted that a dedicated temporal bone CT rather than a head CT best achieves delineation of disease in many of these patients. Similarly, optimal assessment often requires a dedicated high-resolution protocol designed to assess temporal bone and internal auditory canals even though such a study will be requested and billed as a brain MRI. Angiographic techniques are helpful in some patients, especially in the setting of vertigo. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

PMID: 30392601 [PubMed - in process]

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The effect of simultaneously and sequentially delivered cognitive and aerobic training on mobility among older adults with hearing loss.

Related Articles

The effect of simultaneously and sequentially delivered cognitive and aerobic training on mobility among older adults with hearing loss.

Gait Posture. 2018 Oct 23;67:262-268

Authors: Bruce H, Lai L, Bherer L, Lussier M, St-Onge N, Li KZH

Abstract
BACKGROUND: Older adults exhibit declines in auditory and motor functioning, which are compensated for through the recruitment of cognitive resources. Cognitive or physical training alone has been shown to improve cognitive functioning and transfer to motor tasks, but results are mixed when these are combined in studies of healthy older adults, and few studies have included those with age-related hearing loss (ARHL), who are at a higher risk of falls.
RESEARCH QUESTION: To examine format effects in mixed training, we used a repeated measures intervention design to compare the efficacy of Simultaneous and Sequential multimodal training formats.
METHODS: 42 older adults (Mage = 68.05, SDage = 4.65, females = 26) with (ARHL) and without hearing loss (OAH) completed an intervention study consisting of 12 sessions of multimodal training (computerized cognitive dual-task and recumbent aerobic cycling). Participants were randomly assigned to either the Simultaneous (concurrent cognitive and aerobic) or Sequential training group (cognitive followed by aerobic) and completed assessments of single- and dual-task mobility concurrent with an auditory working memory task. Training gains were assessed with repeated measures ANOVAs using magnitude of improvement from pre- to post-training on primary outcome measures as the dependent variable.
RESULTS: Gains in auditory working memory were greater in the Sequential group than Simultaneous particularly among OAH. ARHL participants were unaffected by format. While all participants improved on a measure of chair rises, there was no benefit to standing balance. The results demonstrate an advantage to Sequential training, suggesting a benefit to focusing on each task in isolation.
SIGNIFICANCE: The gains noted in the ARHL indicate the potential benefit of incorporating cognitive remediation into traditional audiological rehabilitation. Moreover, it is important to consider the cost of dividing attention when combining training.

PMID: 30390596 [PubMed - as supplied by publisher]

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Sound Quality Effects of an Adaptive Nonlinear Frequency Compression Processor with Normal-Hearing and Hearing-Impaired Listeners.

Sound Quality Effects of an Adaptive Nonlinear Frequency Compression Processor with Normal-Hearing and Hearing-Impaired Listeners.

J Am Acad Audiol. 2018 Nov 02;:

Authors: Glista D, Hawkins M, Vaisberg JM, Pourmand N, Parsa V, Scollie S

Abstract
BACKGROUND: Frequency lowering (FL) technology offers a means of improving audibility of high-frequency sounds. For some listeners, the benefit of such technology can be accompanied by a perceived degradation in sound quality, depending on the strength of the FL setting.
PURPOSE: The studies presented in this article investigate the effect of a new type of FL signal processing for hearing aids, adaptive nonlinear frequency compression (ANFC), on subjective speech quality.
RESEARCH DESIGN: Listener ratings of sound quality were collected for speech stimuli processed with systematically varied fitting parameters.
STUDY SAMPLE: Study 1 included 40 normal-hearing (NH) adult and child listeners. Study 2 included 11 hearing-impaired (HI) adult and child listeners. HI listeners were fitted with laboratory-worn hearing aids for use during listening tasks.
INTERVENTION: Speech quality ratings were assessed across test conditions consisting of various strengths of static nonlinear frequency compression (NFC) and ANFC speech. Test conditions included those that were fine-tuned on an individual basis per hearing aid fitting and conditions that were modified to intentionally alter the sound quality of the signal.
DATA COLLECTION AND ANALYSIS: Listeners rated speech quality using the MUlti Stimulus test with Hidden Reference and Anchor (MUSHRA) test paradigm. Ratings were analyzed for reliability and to compare results across conditions.
RESULTS: Results show that interrater reliability is high for both studies, indicating that NH and HI listeners from both adult and child age groups can reliably complete the MUSHRA task. Results comparing sound quality ratings across experimental conditions suggest that both the NH and HI listener groups rate the stimuli intended to have poor sound quality (e.g., anchors and the strongest available parameter settings) as having below-average sound quality ratings. A different trend in the results is reported when considering the other experimental conditions across the listener groups in the studies. Speech quality ratings measured with NH listeners improve as the strength of ANFC decreases, with a range of bad to good ratings reported, on average. Speech quality ratings measured with HI listeners are similar and above-average for many of the experimental stimuli, including those with fine-tuned NFC and ANFC parameters.
CONCLUSIONS: Overall, HI listeners provide similar sound quality ratings when comparing static and adaptive forms of frequency compression, especially when considering the individualized parameter settings. These findings suggest that a range in settings may result in above-average sound quality for adults and children with hearing impairment. Furthermore, the fitter should fine-tune FL parameters for each individual listener, regardless of type of FL technology.

PMID: 30395533 [PubMed - as supplied by publisher]

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Risk Assessment of Recreational Noise-Induced Hearing Loss from Exposure through a Personal Audio System-iPod Touch.

Risk Assessment of Recreational Noise-Induced Hearing Loss from Exposure through a Personal Audio System-iPod Touch.

J Am Acad Audiol. 2018 Nov 01;:

Authors: Gopal KV, Mills LE, Phillips BS, Nandy R

Abstract
BACKGROUND: Recreational noise-induced hearing loss (RNIHL) is a major health issue and presents a huge economic burden on society. Exposure to loud music is not considered hazardous in our society because music is thought to be a source of relaxation and entertainment. However, there is evidence that regardless of the sound source, frequent exposure to loud music, including through personal audio systems (PAS), can lead to hearing loss, tinnitus, difficulty processing speech, and increased susceptibility to age-related hearing loss.
PURPOSE: Several studies have documented temporary threshold shifts (TTS) (a risk indicator of future permanent impairment) in subjects that listen to loud music through their PAS. However, there is not enough information regarding volume settings that may be considered to be safe. As a primary step toward quantifying the risk of RNIHL through PAS, we assessed changes in auditory test measures before and after exposure to music through the popular iPod Touch device set at various volume levels.
RESEARCH DESIGN: This project design incorporated aspects of both between- and within-subjects and used repeated measures to analyze individual groups.
STUDY SAMPLE: A total of 40 adults, aged 18-31 years with normal hearing were recruited and randomly distributed to four groups. Each group consisted of five males and five females.
DATA COLLECTION AND ANALYSIS: Subjects underwent two rounds of testing (pre- and postmusic exposure), with a 30-min interval, where they listened to a playlist consisting of popular songs through an iPod at 100%, 75%, 50%, or 0% volume (no music). Based on our analysis on the Knowles Electronic Manikin for Acoustic Research, with a standardized 711 coupler, it was determined that listening to the playlist for 30 min through standard earbuds resulted in an average level of 97.0 dBC at 100% volume, 83.3 dBC at 75% volume, and 65.6 dBC at 50% volume. Pure-tone thresholds from 500-8000 Hz, extended high-frequency pure tones between 9-12.5 kHz, and distortion product otoacoustic emissions (DPOAE) were obtained before and after the 30-min music exposure. Analysis of variance (ANOVA) was performed with two between-subjects factors (volume and gender) and one within-subjects factor (frequency). Change (shift) in auditory test measures was used as the outcome for the ANOVA.
RESULTS: Results indicated significant worsening of pure-tone thresholds following music exposure only in the group that was exposed to 100% volume at the following frequencies: 2, 3, 4, 6 and 8 kHz. DPOAEs showed significant decrease at 2000 and 2822 Hz, also only for the 100% volume condition. No significant changes were found between pre- and postmusic exposure measures in groups exposed to 75%, 50%, or 0% volume conditions. Follow-up evaluations conducted a week later indicated that pure-tone thresholds had returned to the premusic exposure levels.
CONCLUSIONS: These results provide quantifiable information regarding safe volume control settings on the iPod Touch with standard earbuds. Listening to music using the iPod Touch at 100% volume setting for as little as 30 min leads to TTS and worsening of otoacoustic emissions, a risk for permanent auditory damage.

PMID: 30395532 [PubMed - as supplied by publisher]

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Sound Quality Effects of an Adaptive Nonlinear Frequency Compression Processor with Normal-Hearing and Hearing-Impaired Listeners.

Sound Quality Effects of an Adaptive Nonlinear Frequency Compression Processor with Normal-Hearing and Hearing-Impaired Listeners.

J Am Acad Audiol. 2018 Nov 02;:

Authors: Glista D, Hawkins M, Vaisberg JM, Pourmand N, Parsa V, Scollie S

Abstract
BACKGROUND: Frequency lowering (FL) technology offers a means of improving audibility of high-frequency sounds. For some listeners, the benefit of such technology can be accompanied by a perceived degradation in sound quality, depending on the strength of the FL setting.
PURPOSE: The studies presented in this article investigate the effect of a new type of FL signal processing for hearing aids, adaptive nonlinear frequency compression (ANFC), on subjective speech quality.
RESEARCH DESIGN: Listener ratings of sound quality were collected for speech stimuli processed with systematically varied fitting parameters.
STUDY SAMPLE: Study 1 included 40 normal-hearing (NH) adult and child listeners. Study 2 included 11 hearing-impaired (HI) adult and child listeners. HI listeners were fitted with laboratory-worn hearing aids for use during listening tasks.
INTERVENTION: Speech quality ratings were assessed across test conditions consisting of various strengths of static nonlinear frequency compression (NFC) and ANFC speech. Test conditions included those that were fine-tuned on an individual basis per hearing aid fitting and conditions that were modified to intentionally alter the sound quality of the signal.
DATA COLLECTION AND ANALYSIS: Listeners rated speech quality using the MUlti Stimulus test with Hidden Reference and Anchor (MUSHRA) test paradigm. Ratings were analyzed for reliability and to compare results across conditions.
RESULTS: Results show that interrater reliability is high for both studies, indicating that NH and HI listeners from both adult and child age groups can reliably complete the MUSHRA task. Results comparing sound quality ratings across experimental conditions suggest that both the NH and HI listener groups rate the stimuli intended to have poor sound quality (e.g., anchors and the strongest available parameter settings) as having below-average sound quality ratings. A different trend in the results is reported when considering the other experimental conditions across the listener groups in the studies. Speech quality ratings measured with NH listeners improve as the strength of ANFC decreases, with a range of bad to good ratings reported, on average. Speech quality ratings measured with HI listeners are similar and above-average for many of the experimental stimuli, including those with fine-tuned NFC and ANFC parameters.
CONCLUSIONS: Overall, HI listeners provide similar sound quality ratings when comparing static and adaptive forms of frequency compression, especially when considering the individualized parameter settings. These findings suggest that a range in settings may result in above-average sound quality for adults and children with hearing impairment. Furthermore, the fitter should fine-tune FL parameters for each individual listener, regardless of type of FL technology.

PMID: 30395533 [PubMed - as supplied by publisher]

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Risk Assessment of Recreational Noise-Induced Hearing Loss from Exposure through a Personal Audio System-iPod Touch.

Risk Assessment of Recreational Noise-Induced Hearing Loss from Exposure through a Personal Audio System-iPod Touch.

J Am Acad Audiol. 2018 Nov 01;:

Authors: Gopal KV, Mills LE, Phillips BS, Nandy R

Abstract
BACKGROUND: Recreational noise-induced hearing loss (RNIHL) is a major health issue and presents a huge economic burden on society. Exposure to loud music is not considered hazardous in our society because music is thought to be a source of relaxation and entertainment. However, there is evidence that regardless of the sound source, frequent exposure to loud music, including through personal audio systems (PAS), can lead to hearing loss, tinnitus, difficulty processing speech, and increased susceptibility to age-related hearing loss.
PURPOSE: Several studies have documented temporary threshold shifts (TTS) (a risk indicator of future permanent impairment) in subjects that listen to loud music through their PAS. However, there is not enough information regarding volume settings that may be considered to be safe. As a primary step toward quantifying the risk of RNIHL through PAS, we assessed changes in auditory test measures before and after exposure to music through the popular iPod Touch device set at various volume levels.
RESEARCH DESIGN: This project design incorporated aspects of both between- and within-subjects and used repeated measures to analyze individual groups.
STUDY SAMPLE: A total of 40 adults, aged 18-31 years with normal hearing were recruited and randomly distributed to four groups. Each group consisted of five males and five females.
DATA COLLECTION AND ANALYSIS: Subjects underwent two rounds of testing (pre- and postmusic exposure), with a 30-min interval, where they listened to a playlist consisting of popular songs through an iPod at 100%, 75%, 50%, or 0% volume (no music). Based on our analysis on the Knowles Electronic Manikin for Acoustic Research, with a standardized 711 coupler, it was determined that listening to the playlist for 30 min through standard earbuds resulted in an average level of 97.0 dBC at 100% volume, 83.3 dBC at 75% volume, and 65.6 dBC at 50% volume. Pure-tone thresholds from 500-8000 Hz, extended high-frequency pure tones between 9-12.5 kHz, and distortion product otoacoustic emissions (DPOAE) were obtained before and after the 30-min music exposure. Analysis of variance (ANOVA) was performed with two between-subjects factors (volume and gender) and one within-subjects factor (frequency). Change (shift) in auditory test measures was used as the outcome for the ANOVA.
RESULTS: Results indicated significant worsening of pure-tone thresholds following music exposure only in the group that was exposed to 100% volume at the following frequencies: 2, 3, 4, 6 and 8 kHz. DPOAEs showed significant decrease at 2000 and 2822 Hz, also only for the 100% volume condition. No significant changes were found between pre- and postmusic exposure measures in groups exposed to 75%, 50%, or 0% volume conditions. Follow-up evaluations conducted a week later indicated that pure-tone thresholds had returned to the premusic exposure levels.
CONCLUSIONS: These results provide quantifiable information regarding safe volume control settings on the iPod Touch with standard earbuds. Listening to music using the iPod Touch at 100% volume setting for as little as 30 min leads to TTS and worsening of otoacoustic emissions, a risk for permanent auditory damage.

PMID: 30395532 [PubMed - as supplied by publisher]

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Lower Extremity Joint Angle Local Dynamic Stability of Novice and Trained Runners in Traditional and Minimal Footwear

Publication date: Available online 5 November 2018

Source: Gait & Posture

Author(s): Nicholas S. Frank, Jack P. Callaghan, Stephen D. Prentice

Abstract

Background

Understanding if footwear cushioning influences movement stability may be helpful in reducing injuries related to repetitive loading. Research Question: The purpose of this study was to identify the relationship between running experience and midsole cushioning on local dynamic stability of the ankle, knee and hip.

Methods

: Twenty-four trained and novice runners were recruited to run on a treadmill for five minutes in each of four different shoe conditions. Midsole thickness (thick/thin) and stiffness (soft / hard) were manipulated yielding four conditions. Lyapunov exponents were estimated using the Wolf algorithm from sagittal ankle, knee and hip kinematics.

Results

Trained runners had increased movement stability in all shoe conditions compared to their novice counterparts. Midsole thickness and stiffness, overall, did not affect movement stability within each of the running groups. Novice runners displayed decreased movement stability at the hip while running in the thick/soft running shoes. It was found that running experience has a greater influence on movement stability in the lower limbs compared to the midsole characteristics that were manipulated in this experiment. The hip was most stable followed by the knee and the ankle highlighting decreased stability in distal joints.

Conclusions

It appears that midsole design within current design ranges do not have the ability to influence movement stability.

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Lower Extremity Joint Angle Local Dynamic Stability of Novice and Trained Runners in Traditional and Minimal Footwear

Publication date: Available online 5 November 2018

Source: Gait & Posture

Author(s): Nicholas S. Frank, Jack P. Callaghan, Stephen D. Prentice

Abstract

Background

Understanding if footwear cushioning influences movement stability may be helpful in reducing injuries related to repetitive loading. Research Question: The purpose of this study was to identify the relationship between running experience and midsole cushioning on local dynamic stability of the ankle, knee and hip.

Methods

: Twenty-four trained and novice runners were recruited to run on a treadmill for five minutes in each of four different shoe conditions. Midsole thickness (thick/thin) and stiffness (soft / hard) were manipulated yielding four conditions. Lyapunov exponents were estimated using the Wolf algorithm from sagittal ankle, knee and hip kinematics.

Results

Trained runners had increased movement stability in all shoe conditions compared to their novice counterparts. Midsole thickness and stiffness, overall, did not affect movement stability within each of the running groups. Novice runners displayed decreased movement stability at the hip while running in the thick/soft running shoes. It was found that running experience has a greater influence on movement stability in the lower limbs compared to the midsole characteristics that were manipulated in this experiment. The hip was most stable followed by the knee and the ankle highlighting decreased stability in distal joints.

Conclusions

It appears that midsole design within current design ranges do not have the ability to influence movement stability.

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