Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing

Publication date: Available online 19 March 2018
Source:Hearing Research
Author(s): Erin Nelson, Ruth M. Reeder, Laura K. Holden, Jill B. Firszt
Binaural hearing allows listeners to take advantage of auditory cues that are necessary for sound localization. Patients with asymmetric or unilateral hearing loss receive degraded or absent binaural cues and often demonstrate decreased sound localization in the horizontal plane. Given the importance of sound localization for everyday function, there is a need for clinically feasible methods to evaluate localization, particularly as validation of intervention for patients with unilateral hearing loss. The present study compared sound localization results obtained for front-facing and rear-facing soundfield systems and for a rear-facing head related transfer function (HRTF) system in two hearing groups, listeners with normal hearing and those with unilateral hearing loss. Results between the three systems were highly correlated and repeatable. Neither age nor a pure-tone average of 0.5, 1, 2 and 4 kHz correlated with localization performance among normal hearing participants. Among the UHL group, age and onset of severe to profound hearing loss were positively correlated with localization results; length of deafness was negatively correlated. Behavioral chance performance was established for localization with rear-facing HRTF and rear-facing soundfield test systems; group mean results for unilateral hearing loss participants were significantly better than chance. Continued work is needed in developing clinically feasible evaluation methods for patients with asymmetric or unilateral hearing loss, particularly as the effects of treatment options are assessed.



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Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing

Publication date: Available online 19 March 2018
Source:Hearing Research
Author(s): Erin Nelson, Ruth M. Reeder, Laura K. Holden, Jill B. Firszt
Binaural hearing allows listeners to take advantage of auditory cues that are necessary for sound localization. Patients with asymmetric or unilateral hearing loss receive degraded or absent binaural cues and often demonstrate decreased sound localization in the horizontal plane. Given the importance of sound localization for everyday function, there is a need for clinically feasible methods to evaluate localization, particularly as validation of intervention for patients with unilateral hearing loss. The present study compared sound localization results obtained for front-facing and rear-facing soundfield systems and for a rear-facing head related transfer function (HRTF) system in two hearing groups, listeners with normal hearing and those with unilateral hearing loss. Results between the three systems were highly correlated and repeatable. Neither age nor a pure-tone average of 0.5, 1, 2 and 4 kHz correlated with localization performance among normal hearing participants. Among the UHL group, age and onset of severe to profound hearing loss were positively correlated with localization results; length of deafness was negatively correlated. Behavioral chance performance was established for localization with rear-facing HRTF and rear-facing soundfield test systems; group mean results for unilateral hearing loss participants were significantly better than chance. Continued work is needed in developing clinically feasible evaluation methods for patients with asymmetric or unilateral hearing loss, particularly as the effects of treatment options are assessed.



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Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing

Publication date: Available online 19 March 2018
Source:Hearing Research
Author(s): Erin Nelson, Ruth M. Reeder, Laura K. Holden, Jill B. Firszt
Binaural hearing allows listeners to take advantage of auditory cues that are necessary for sound localization. Patients with asymmetric or unilateral hearing loss receive degraded or absent binaural cues and often demonstrate decreased sound localization in the horizontal plane. Given the importance of sound localization for everyday function, there is a need for clinically feasible methods to evaluate localization, particularly as validation of intervention for patients with unilateral hearing loss. The present study compared sound localization results obtained for front-facing and rear-facing soundfield systems and for a rear-facing head related transfer function (HRTF) system in two hearing groups, listeners with normal hearing and those with unilateral hearing loss. Results between the three systems were highly correlated and repeatable. Neither age nor a pure-tone average of 0.5, 1, 2 and 4 kHz correlated with localization performance among normal hearing participants. Among the UHL group, age and onset of severe to profound hearing loss were positively correlated with localization results; length of deafness was negatively correlated. Behavioral chance performance was established for localization with rear-facing HRTF and rear-facing soundfield test systems; group mean results for unilateral hearing loss participants were significantly better than chance. Continued work is needed in developing clinically feasible evaluation methods for patients with asymmetric or unilateral hearing loss, particularly as the effects of treatment options are assessed.



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Detection of Pathological Voice Using Cepstrum Vectors: A Deep Learning Approach

Publication date: Available online 19 March 2018
Source:Journal of Voice
Author(s): Shih-Hau Fang, Yu Tsao, Min-Jing Hsiao, Ji-Ying Chen, Ying-Hui Lai, Feng-Chuan Lin, Chi-Te Wang
ObjectivesComputerized detection of voice disorders has attracted considerable academic and clinical interest in the hope of providing an effective screening method for voice diseases before endoscopic confirmation. This study proposes a deep-learning-based approach to detect pathological voice and examines its performance and utility compared with other automatic classification algorithms.MethodsThis study retrospectively collected 60 normal voice samples and 402 pathological voice samples of 8 common clinical voice disorders in a voice clinic of a tertiary teaching hospital. We extracted Mel frequency cepstral coefficients from 3-second samples of a sustained vowel. The performances of three machine learning algorithms, namely, deep neural network (DNN), support vector machine, and Gaussian mixture model, were evaluated based on a fivefold cross-validation. Collective cases from the voice disorder database of MEEI (Massachusetts Eye and Ear Infirmary) were used to verify the performance of the classification mechanisms.ResultsThe experimental results demonstrated that DNN outperforms Gaussian mixture model and support vector machine. Its accuracy in detecting voice pathologies reached 94.26% and 90.52% in male and female subjects, based on three representative Mel frequency cepstral coefficient features. When applied to the MEEI database for validation, the DNN also achieved a higher accuracy (99.32%) than the other two classification algorithms.ConclusionsBy stacking several layers of neurons with optimized weights, the proposed DNN algorithm can fully utilize the acoustic features and efficiently differentiate between normal and pathological voice samples. Based on this pilot study, future research may proceed to explore more application of DNN from laboratory and clinical perspectives.



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The 2016 G. Paul Moore Lecture: Lessons in Voice Rehabilitation: Journal of Voice and Clinical Practice

Publication date: Available online 19 March 2018
Source:Journal of Voice
Author(s): Mara Behlau
This Paul Moore Lecture honors the contributions made by authors to the Journal of Voice during a period of 30 years, from 1987. Fifty articles were selected and included under the following five topics: (1) normalcy of the larynx and voice; (2) the clinical speech-language pathologist's evaluation; (3) the patient’s perspective; (4) the core of vocal rehabilitation; and (5) behavioral versus organic dysphonias. The analysis reflects a vivid landscape of the specific area and significant advances in knowledge. It also shows the valuable interdependence between science and clinical practice. The topics highlight the following information: (1) The physical appearance of a healthy larynx varies across individuals with normal voices. (2) The voice is not a binary descriptor (normal versus abnormal) but a variable measure, with many cultural influences on the perceptual auditory analysis of a voice. (3) The clinical speech-language pathologist assessment is multidimensional and multiparametric, with both subjective and objective analyses. The patients' opinion about the impact of a voice problem on his or her quality of life is significant when proposing a treatment. Therefore, it is also included in the initial assessment. (4) Vocal rehabilitation is a nonlinear process that combines direct and indirect approaches. Evidence of the positive effect of voice therapy is now well established. (5) Behavioral dysphonias may be linked to self-regulation of the use of voice and this needs to be taken into consideration. Although organic dysphonias are not necessarily the result of harmful vocal behaviors, they too can benefit from vocal rehabilitation.



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Effects of Therapy With Semi-occluded Vocal Tract and Choir Training on Voice in Adult Individuals With Congenital, Isolated, Untreated Growth Hormone Deficiency

Publication date: Available online 19 March 2018
Source:Journal of Voice
Author(s): Bruna M.R. de Andrade, Eugenia H.O. Valença, Roberto Salvatori, Anita H.O. Souza, Luiz A. Oliveira-Neto, Alaíde H.A. Oliveira, Mario C.P. Oliveira, Enaldo V. Melo, Michelle S. Andrade, Carolina A. Freitas, Michela P. Santos, Fillipe A. Custodio, Gisane C. Monteiro, Susana de Carvalho, Manuel H. Aguiar-Oliveira
ObjectivesVoice is produced by the vibration of the vocal folds expressed by its fundamental frequency (Hz), whereas the formants (F) are fundamental frequency multiples, indicating amplification zones of the vowels in the vocal tract. We have shown that lifetime isolated growth hormone deficiency (IGHD) causes high pitch voice, with higher values of most formant frequencies, maintaining a prepuberal acoustic prediction. The objectives of this work were to verify the effects of the therapy with a semi-occluded vocal tract (SOVTT) and choir training on voice in these subjects with IGHD. We speculated that acoustic vocal parameters can be improved by SOVTT or choir training.Study DesignThis is a prospective longitudinal study without control group.MethodsAcoustic analysis of isolated vowels was performed in 17 adults with IGHD before and after SOVTT (pre-SOVTT and post-SOVTT) and after choir training (post training), in a 30-day period.ResultsThe first formant was higher in post training compared with the pre-SOVTT (P = 0.009). The second formant was higher in post-SOVTT than in pre-SOVTT (P = 0.045). There was a trend of reduction in shimmer in post-choir training in comparison with pre-SOVTT (P = 0.051), and a reduction in post-choir training in comparison with post-SOVTT (P = 0.047).ConclusionsSOVTT was relevant to the second formant, whereas choir training improved first formant and shimmer. Therefore, this speech therapy approach was able to improve acoustic parameters of the voice of individuals with congenital, untreated IGHD. This seems particularly important in a scenario in which few patients are submitted to growth hormone replacement therapy.



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Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing

Publication date: Available online 19 March 2018
Source:Hearing Research
Author(s): Erin Nelson, Ruth M. Reeder, Laura K. Holden, Jill B. Firszt
Binaural hearing allows listeners to take advantage of auditory cues that are necessary for sound localization. Patients with asymmetric or unilateral hearing loss receive degraded or absent binaural cues and often demonstrate decreased sound localization in the horizontal plane. Given the importance of sound localization for everyday function, there is a need for clinically feasible methods to evaluate localization, particularly as validation of intervention for patients with unilateral hearing loss. The present study compared sound localization results obtained for front-facing and rear-facing soundfield systems and for a rear-facing head related transfer function (HRTF) system in two hearing groups, listeners with normal hearing and those with unilateral hearing loss. Results between the three systems were highly correlated and repeatable. Neither age nor a pure-tone average of 0.5, 1, 2 and 4 kHz correlated with localization performance among normal hearing participants. Among the UHL group, age and onset of severe to profound hearing loss were positively correlated with localization results; length of deafness was negatively correlated. Behavioral chance performance was established for localization with rear-facing HRTF and rear-facing soundfield test systems; group mean results for unilateral hearing loss participants were significantly better than chance. Continued work is needed in developing clinically feasible evaluation methods for patients with asymmetric or unilateral hearing loss, particularly as the effects of treatment options are assessed.



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Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing

Publication date: Available online 19 March 2018
Source:Hearing Research
Author(s): Erin Nelson, Ruth M. Reeder, Laura K. Holden, Jill B. Firszt
Binaural hearing allows listeners to take advantage of auditory cues that are necessary for sound localization. Patients with asymmetric or unilateral hearing loss receive degraded or absent binaural cues and often demonstrate decreased sound localization in the horizontal plane. Given the importance of sound localization for everyday function, there is a need for clinically feasible methods to evaluate localization, particularly as validation of intervention for patients with unilateral hearing loss. The present study compared sound localization results obtained for front-facing and rear-facing soundfield systems and for a rear-facing head related transfer function (HRTF) system in two hearing groups, listeners with normal hearing and those with unilateral hearing loss. Results between the three systems were highly correlated and repeatable. Neither age nor a pure-tone average of 0.5, 1, 2 and 4 kHz correlated with localization performance among normal hearing participants. Among the UHL group, age and onset of severe to profound hearing loss were positively correlated with localization results; length of deafness was negatively correlated. Behavioral chance performance was established for localization with rear-facing HRTF and rear-facing soundfield test systems; group mean results for unilateral hearing loss participants were significantly better than chance. Continued work is needed in developing clinically feasible evaluation methods for patients with asymmetric or unilateral hearing loss, particularly as the effects of treatment options are assessed.



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The Potential Effect of Forbrain as an Altered Auditory Feedback Device

Purpose

The purpose of this study was to run a proof of concept on a new commercially available device, Forbrain® (Sound For Life Ltd/Soundev, Luxemburg, model UN38.3), to test whether it can modulate the speech of its users.

Method

Participants were instructed to read aloud a text of their choice during 3 experimental phases: baseline, test, and posttest, while wearing a Forbrain® headset. Critically, for half of the participants (Forbrain group), the device was turned on during the test phase, whereas for the other half (control group), the device was kept off. Voice recordings were analyzed to derive 6 quantitative measures of voice quality over each of the phases of the experiment.

Results

A significant Group × Phase interaction was obtained for the smoothed cepstral peak prominence, a measure of voice harmony, and for the trendline of the long-term average spectrum, a measure of voice robustness, this latter surviving Bonferroni correction for multiple comparisons.

Conclusions

The results of this study indicate the effectiveness of Forbrain® in modifying the speech of its users. It is suggested that Forbrain® works as an altered auditory feedback device. It may hence be used as a clinical device in speech therapy clinics, yet further studies are warranted to test its usefulness in clinical groups.

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The Influence of Misarticulations on Children's Word Identification and Processing

Purpose

The purpose of the present studies was to determine how children's identification and processing of misarticulated words was influenced by substitution commonness.

Method

Sixty-one typically developing preschoolers across 3 experiments heard accurate productions of words (e.g., “leaf”), words containing common substitutions (e.g., “weaf”), and words containing uncommon substitutions (e.g., “yeaf”). On each trial, preschoolers chose between a real object picture (e.g., a leaf) and a nonobject (e.g., an anomalous line drawing). Accuracy and processing were measured using MouseTracker and eye tracking.

Results

Overall, children chose real objects significantly more when presented with accurate productions (e.g., “leaf”) than misarticulated productions (e.g., “weaf” or “yeaf”). Within misarticulation conditions, children chose real objects significantly more when hearing common misarticulations (e.g., “weaf”) than uncommon misarticulations (e.g., “yeaf”). Preschoolers identified words significantly faster and with greater certainty in accurate conditions than misarticulated conditions.

Conclusions

The results of the present studies indicate that the commonness of substitutions influences children's identification of misarticulated words. Children hear common substitutions more frequently and therefore were supported in their identification of these words as real objects. The presence of substitutions, however, slowed reaction time when compared with accurate productions.

Supplemental Material

https://doi.org/10.23641/asha.5965510

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Comparison of Percentage of Syllables Stuttered With Parent-Reported Severity Ratings as a Primary Outcome Measure in Clinical Trials of Early Stuttering Treatment

Purpose

This report investigates whether parent-reported stuttering severity ratings (SRs) provide similar estimates of effect size as percentage of syllables stuttered (%SS) for randomized trials of early stuttering treatment with preschool children.

Method

Data sets from 3 randomized controlled trials of an early stuttering intervention were selected for analyses. Analyses included median changes and 95% confidence intervals per treatment group, Bland–Altman plots, analysis of covariance, and Spearman rho correlations.

Results

Both SRs and %SS showed large effect sizes from pretreatment to follow-up, although correlations between the 2 measures were moderate at best. Absolute agreement between the 2 measures improved as percentage reduction of stuttering frequency and severity increased, probably due to innate measurement limitations for participants with low baseline severity. Analysis of covariance for the 3 trials showed consistent results.

Conclusion

There is no statistical reason to favor %SS over parent-reported stuttering SRs as primary outcomes for clinical trials of early stuttering treatment. However, there are logistical reasons to favor parent-reported stuttering SRs. We conclude that parent-reported rating of the child's typical stuttering severity for the week or month prior to each assessment is a justifiable alternative to %SS as a primary outcome measure in clinical trials of early stuttering treatment.

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The Potential Effect of Forbrain as an Altered Auditory Feedback Device

Purpose

The purpose of this study was to run a proof of concept on a new commercially available device, Forbrain® (Sound For Life Ltd/Soundev, Luxemburg, model UN38.3), to test whether it can modulate the speech of its users.

Method

Participants were instructed to read aloud a text of their choice during 3 experimental phases: baseline, test, and posttest, while wearing a Forbrain® headset. Critically, for half of the participants (Forbrain group), the device was turned on during the test phase, whereas for the other half (control group), the device was kept off. Voice recordings were analyzed to derive 6 quantitative measures of voice quality over each of the phases of the experiment.

Results

A significant Group × Phase interaction was obtained for the smoothed cepstral peak prominence, a measure of voice harmony, and for the trendline of the long-term average spectrum, a measure of voice robustness, this latter surviving Bonferroni correction for multiple comparisons.

Conclusions

The results of this study indicate the effectiveness of Forbrain® in modifying the speech of its users. It is suggested that Forbrain® works as an altered auditory feedback device. It may hence be used as a clinical device in speech therapy clinics, yet further studies are warranted to test its usefulness in clinical groups.

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The Influence of Misarticulations on Children's Word Identification and Processing

Purpose

The purpose of the present studies was to determine how children's identification and processing of misarticulated words was influenced by substitution commonness.

Method

Sixty-one typically developing preschoolers across 3 experiments heard accurate productions of words (e.g., “leaf”), words containing common substitutions (e.g., “weaf”), and words containing uncommon substitutions (e.g., “yeaf”). On each trial, preschoolers chose between a real object picture (e.g., a leaf) and a nonobject (e.g., an anomalous line drawing). Accuracy and processing were measured using MouseTracker and eye tracking.

Results

Overall, children chose real objects significantly more when presented with accurate productions (e.g., “leaf”) than misarticulated productions (e.g., “weaf” or “yeaf”). Within misarticulation conditions, children chose real objects significantly more when hearing common misarticulations (e.g., “weaf”) than uncommon misarticulations (e.g., “yeaf”). Preschoolers identified words significantly faster and with greater certainty in accurate conditions than misarticulated conditions.

Conclusions

The results of the present studies indicate that the commonness of substitutions influences children's identification of misarticulated words. Children hear common substitutions more frequently and therefore were supported in their identification of these words as real objects. The presence of substitutions, however, slowed reaction time when compared with accurate productions.

Supplemental Material

https://doi.org/10.23641/asha.5965510

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Comparison of Percentage of Syllables Stuttered With Parent-Reported Severity Ratings as a Primary Outcome Measure in Clinical Trials of Early Stuttering Treatment

Purpose

This report investigates whether parent-reported stuttering severity ratings (SRs) provide similar estimates of effect size as percentage of syllables stuttered (%SS) for randomized trials of early stuttering treatment with preschool children.

Method

Data sets from 3 randomized controlled trials of an early stuttering intervention were selected for analyses. Analyses included median changes and 95% confidence intervals per treatment group, Bland–Altman plots, analysis of covariance, and Spearman rho correlations.

Results

Both SRs and %SS showed large effect sizes from pretreatment to follow-up, although correlations between the 2 measures were moderate at best. Absolute agreement between the 2 measures improved as percentage reduction of stuttering frequency and severity increased, probably due to innate measurement limitations for participants with low baseline severity. Analysis of covariance for the 3 trials showed consistent results.

Conclusion

There is no statistical reason to favor %SS over parent-reported stuttering SRs as primary outcomes for clinical trials of early stuttering treatment. However, there are logistical reasons to favor parent-reported stuttering SRs. We conclude that parent-reported rating of the child's typical stuttering severity for the week or month prior to each assessment is a justifiable alternative to %SS as a primary outcome measure in clinical trials of early stuttering treatment.

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The Potential Effect of Forbrain as an Altered Auditory Feedback Device

Purpose

The purpose of this study was to run a proof of concept on a new commercially available device, Forbrain® (Sound For Life Ltd/Soundev, Luxemburg, model UN38.3), to test whether it can modulate the speech of its users.

Method

Participants were instructed to read aloud a text of their choice during 3 experimental phases: baseline, test, and posttest, while wearing a Forbrain® headset. Critically, for half of the participants (Forbrain group), the device was turned on during the test phase, whereas for the other half (control group), the device was kept off. Voice recordings were analyzed to derive 6 quantitative measures of voice quality over each of the phases of the experiment.

Results

A significant Group × Phase interaction was obtained for the smoothed cepstral peak prominence, a measure of voice harmony, and for the trendline of the long-term average spectrum, a measure of voice robustness, this latter surviving Bonferroni correction for multiple comparisons.

Conclusions

The results of this study indicate the effectiveness of Forbrain® in modifying the speech of its users. It is suggested that Forbrain® works as an altered auditory feedback device. It may hence be used as a clinical device in speech therapy clinics, yet further studies are warranted to test its usefulness in clinical groups.

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The Influence of Misarticulations on Children's Word Identification and Processing

Purpose

The purpose of the present studies was to determine how children's identification and processing of misarticulated words was influenced by substitution commonness.

Method

Sixty-one typically developing preschoolers across 3 experiments heard accurate productions of words (e.g., “leaf”), words containing common substitutions (e.g., “weaf”), and words containing uncommon substitutions (e.g., “yeaf”). On each trial, preschoolers chose between a real object picture (e.g., a leaf) and a nonobject (e.g., an anomalous line drawing). Accuracy and processing were measured using MouseTracker and eye tracking.

Results

Overall, children chose real objects significantly more when presented with accurate productions (e.g., “leaf”) than misarticulated productions (e.g., “weaf” or “yeaf”). Within misarticulation conditions, children chose real objects significantly more when hearing common misarticulations (e.g., “weaf”) than uncommon misarticulations (e.g., “yeaf”). Preschoolers identified words significantly faster and with greater certainty in accurate conditions than misarticulated conditions.

Conclusions

The results of the present studies indicate that the commonness of substitutions influences children's identification of misarticulated words. Children hear common substitutions more frequently and therefore were supported in their identification of these words as real objects. The presence of substitutions, however, slowed reaction time when compared with accurate productions.

Supplemental Material

https://doi.org/10.23641/asha.5965510

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Comparison of Percentage of Syllables Stuttered With Parent-Reported Severity Ratings as a Primary Outcome Measure in Clinical Trials of Early Stuttering Treatment

Purpose

This report investigates whether parent-reported stuttering severity ratings (SRs) provide similar estimates of effect size as percentage of syllables stuttered (%SS) for randomized trials of early stuttering treatment with preschool children.

Method

Data sets from 3 randomized controlled trials of an early stuttering intervention were selected for analyses. Analyses included median changes and 95% confidence intervals per treatment group, Bland–Altman plots, analysis of covariance, and Spearman rho correlations.

Results

Both SRs and %SS showed large effect sizes from pretreatment to follow-up, although correlations between the 2 measures were moderate at best. Absolute agreement between the 2 measures improved as percentage reduction of stuttering frequency and severity increased, probably due to innate measurement limitations for participants with low baseline severity. Analysis of covariance for the 3 trials showed consistent results.

Conclusion

There is no statistical reason to favor %SS over parent-reported stuttering SRs as primary outcomes for clinical trials of early stuttering treatment. However, there are logistical reasons to favor parent-reported stuttering SRs. We conclude that parent-reported rating of the child's typical stuttering severity for the week or month prior to each assessment is a justifiable alternative to %SS as a primary outcome measure in clinical trials of early stuttering treatment.

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Effect of static foot posture on the dynamic stiffness of foot joints during walking

Publication date: Available online 17 March 2018
Source:Gait & Posture
Author(s): E. Sanchis-Sales, J.L. Sancho-Bru, A. Roda-Sales, J. Pascual Huerta
BackgroundThe static foot posture has been related to the development of lower limb injuries.Research questionThis study aimed to investigate the dynamic stiffness of foot joints during gait in the sagittal plane to understand the role of the static foot posture in the development of injuries.MethodsSeventy healthy adult male subjects with different static postures, assessed by the Foot Posture Index (FPI) (30 normal, 20 highly pronated and 20 highly supinated), were recruited. Kinematic and kinetic data were recorded using an optical motion capture system and a pressure platform, and dynamic stiffness at the different stages of the stance was calculated from the slopes of the linear regression on the flexion moment-angle curves. The effect of foot type on dynamic stiffness and on ranges of motion and moments was analysed using ANOVAs and post-hoc tests, and linear correlation between dynamic stiffness and FPI was also tested.ResultsHighly pronated feet showed a significantly smaller range of motion at the ankle and metatarsophalangeal joints and also a larger range of moments at the metatarsophalangeal joint than highly supinated feet. Dynamic stiffness during propulsion was significantly greater at all foot joints for highly pronated feet, with positive significant correlations with the squared FPI. Highly supinated feet showed greater dynamic stiffness than normal feet, although to a lesser extent. Highly pronated feet during normal gait experienced the greatest decrease in the dorsiflexor moments during propulsion, normal feet being the most balanced regarding work generated and absorbed.SignificanceExtreme static foot postures show greater dynamic stiffness during propulsion and greater absorbed work, which increases the risk of developing injuries. The data presented may be used when designing orthotics or prostheses, and also when planning surgery that modifies joint stiffness.



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Gait and footwear in children and adolescents with Charcot-Marie-Tooth disease: a cross-sectional, case-controlled study

Publication date: Available online 19 March 2018
Source:Gait & Posture
Author(s): Rachel A. Kennedy, Jennifer L. McGinley, Kade L. Paterson, Monique M. Ryan, Kate Carroll
ObjectiveChildren with Charcot-Marie-Tooth disease (CMT) report problems with gait and footwear. We evaluated differences in spatio-temporal gait variables and gait variability between children with CMT and typically developing (TD) children, and investigated the effect of footwear upon gait.MethodA cross-sectional study of 30 children with CMT and 30 age- and gender-matched TD children aged 4-18 years. Gait was assessed at self-selected speed on an electronic walkway while barefoot and in two types of the child’s own footwear; optimal (e.g., athletic-type runners) and suboptimal (e.g., flip-flops).ResultsChildren with CMT walked more slowly (mean (SD) −13.81 (3.61) cm/sec), with shorter steps (−6.28 (1.37) cm), wider base of support (+2.47 (0.66) cm; all p < 0.001) and greater base of support variability (0.48 (0.15) cm, p = 0.002) compared to TD children. Gait was faster in optimal footwear than suboptimal (−7.55 (1.31) cm/sec) and barefoot (−7.42 (1.07) cm/sec; both p < 0.001) in the combined group of children. Gait in suboptimal footwear was more variable compared to barefoot and optimal footwear. Greater base of support variability and reduced balance was moderately correlated for both groups (CMT and TD).ConclusionGait is slower with shorter, wider steps and greater base of support variability in children with CMT. Poor balance is associated with greater base of support gait variability. Suboptimal footwear negatively affects gait in all children (CMT and TD), which has clinical implications for children and adolescents with CMT who have weaker feet and ankles, and poor balance.



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Effect of static foot posture on the dynamic stiffness of foot joints during walking

Publication date: Available online 17 March 2018
Source:Gait & Posture
Author(s): E. Sanchis-Sales, J.L. Sancho-Bru, A. Roda-Sales, J. Pascual Huerta
BackgroundThe static foot posture has been related to the development of lower limb injuries.Research questionThis study aimed to investigate the dynamic stiffness of foot joints during gait in the sagittal plane to understand the role of the static foot posture in the development of injuries.MethodsSeventy healthy adult male subjects with different static postures, assessed by the Foot Posture Index (FPI) (30 normal, 20 highly pronated and 20 highly supinated), were recruited. Kinematic and kinetic data were recorded using an optical motion capture system and a pressure platform, and dynamic stiffness at the different stages of the stance was calculated from the slopes of the linear regression on the flexion moment-angle curves. The effect of foot type on dynamic stiffness and on ranges of motion and moments was analysed using ANOVAs and post-hoc tests, and linear correlation between dynamic stiffness and FPI was also tested.ResultsHighly pronated feet showed a significantly smaller range of motion at the ankle and metatarsophalangeal joints and also a larger range of moments at the metatarsophalangeal joint than highly supinated feet. Dynamic stiffness during propulsion was significantly greater at all foot joints for highly pronated feet, with positive significant correlations with the squared FPI. Highly supinated feet showed greater dynamic stiffness than normal feet, although to a lesser extent. Highly pronated feet during normal gait experienced the greatest decrease in the dorsiflexor moments during propulsion, normal feet being the most balanced regarding work generated and absorbed.SignificanceExtreme static foot postures show greater dynamic stiffness during propulsion and greater absorbed work, which increases the risk of developing injuries. The data presented may be used when designing orthotics or prostheses, and also when planning surgery that modifies joint stiffness.



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Gait and footwear in children and adolescents with Charcot-Marie-Tooth disease: a cross-sectional, case-controlled study

Publication date: Available online 19 March 2018
Source:Gait & Posture
Author(s): Rachel A. Kennedy, Jennifer L. McGinley, Kade L. Paterson, Monique M. Ryan, Kate Carroll
ObjectiveChildren with Charcot-Marie-Tooth disease (CMT) report problems with gait and footwear. We evaluated differences in spatio-temporal gait variables and gait variability between children with CMT and typically developing (TD) children, and investigated the effect of footwear upon gait.MethodA cross-sectional study of 30 children with CMT and 30 age- and gender-matched TD children aged 4-18 years. Gait was assessed at self-selected speed on an electronic walkway while barefoot and in two types of the child’s own footwear; optimal (e.g., athletic-type runners) and suboptimal (e.g., flip-flops).ResultsChildren with CMT walked more slowly (mean (SD) −13.81 (3.61) cm/sec), with shorter steps (−6.28 (1.37) cm), wider base of support (+2.47 (0.66) cm; all p < 0.001) and greater base of support variability (0.48 (0.15) cm, p = 0.002) compared to TD children. Gait was faster in optimal footwear than suboptimal (−7.55 (1.31) cm/sec) and barefoot (−7.42 (1.07) cm/sec; both p < 0.001) in the combined group of children. Gait in suboptimal footwear was more variable compared to barefoot and optimal footwear. Greater base of support variability and reduced balance was moderately correlated for both groups (CMT and TD).ConclusionGait is slower with shorter, wider steps and greater base of support variability in children with CMT. Poor balance is associated with greater base of support gait variability. Suboptimal footwear negatively affects gait in all children (CMT and TD), which has clinical implications for children and adolescents with CMT who have weaker feet and ankles, and poor balance.



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Effect of static foot posture on the dynamic stiffness of foot joints during walking

Publication date: Available online 17 March 2018
Source:Gait & Posture
Author(s): E. Sanchis-Sales, J.L. Sancho-Bru, A. Roda-Sales, J. Pascual Huerta
BackgroundThe static foot posture has been related to the development of lower limb injuries.Research questionThis study aimed to investigate the dynamic stiffness of foot joints during gait in the sagittal plane to understand the role of the static foot posture in the development of injuries.MethodsSeventy healthy adult male subjects with different static postures, assessed by the Foot Posture Index (FPI) (30 normal, 20 highly pronated and 20 highly supinated), were recruited. Kinematic and kinetic data were recorded using an optical motion capture system and a pressure platform, and dynamic stiffness at the different stages of the stance was calculated from the slopes of the linear regression on the flexion moment-angle curves. The effect of foot type on dynamic stiffness and on ranges of motion and moments was analysed using ANOVAs and post-hoc tests, and linear correlation between dynamic stiffness and FPI was also tested.ResultsHighly pronated feet showed a significantly smaller range of motion at the ankle and metatarsophalangeal joints and also a larger range of moments at the metatarsophalangeal joint than highly supinated feet. Dynamic stiffness during propulsion was significantly greater at all foot joints for highly pronated feet, with positive significant correlations with the squared FPI. Highly supinated feet showed greater dynamic stiffness than normal feet, although to a lesser extent. Highly pronated feet during normal gait experienced the greatest decrease in the dorsiflexor moments during propulsion, normal feet being the most balanced regarding work generated and absorbed.SignificanceExtreme static foot postures show greater dynamic stiffness during propulsion and greater absorbed work, which increases the risk of developing injuries. The data presented may be used when designing orthotics or prostheses, and also when planning surgery that modifies joint stiffness.



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Gait and footwear in children and adolescents with Charcot-Marie-Tooth disease: a cross-sectional, case-controlled study

Publication date: Available online 19 March 2018
Source:Gait & Posture
Author(s): Rachel A. Kennedy, Jennifer L. McGinley, Kade L. Paterson, Monique M. Ryan, Kate Carroll
ObjectiveChildren with Charcot-Marie-Tooth disease (CMT) report problems with gait and footwear. We evaluated differences in spatio-temporal gait variables and gait variability between children with CMT and typically developing (TD) children, and investigated the effect of footwear upon gait.MethodA cross-sectional study of 30 children with CMT and 30 age- and gender-matched TD children aged 4-18 years. Gait was assessed at self-selected speed on an electronic walkway while barefoot and in two types of the child’s own footwear; optimal (e.g., athletic-type runners) and suboptimal (e.g., flip-flops).ResultsChildren with CMT walked more slowly (mean (SD) −13.81 (3.61) cm/sec), with shorter steps (−6.28 (1.37) cm), wider base of support (+2.47 (0.66) cm; all p < 0.001) and greater base of support variability (0.48 (0.15) cm, p = 0.002) compared to TD children. Gait was faster in optimal footwear than suboptimal (−7.55 (1.31) cm/sec) and barefoot (−7.42 (1.07) cm/sec; both p < 0.001) in the combined group of children. Gait in suboptimal footwear was more variable compared to barefoot and optimal footwear. Greater base of support variability and reduced balance was moderately correlated for both groups (CMT and TD).ConclusionGait is slower with shorter, wider steps and greater base of support variability in children with CMT. Poor balance is associated with greater base of support gait variability. Suboptimal footwear negatively affects gait in all children (CMT and TD), which has clinical implications for children and adolescents with CMT who have weaker feet and ankles, and poor balance.



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The Impact of a Smile....

Many of you probably remember the song You’re Never Fully Dressed Without A Smile from the movie Annie, but did you know that how you smile might also be important?

Recent research, which was partially funded by the National Institute of Health, suggests that the type of smile one gets can impact another person’s response to stressful situations. Specifically, these investigators evaluated the stress response of 90 male college students giving a short speech. They found that the type of smile given by “an evaluator” after the speech impacted their stress response.

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