Hearing Loss Film “Hearing Hope” Captures Personal Strength, Scientific Vision

National nonprofit organization Hearing Health Foundation (HHF) has created a new short film, “Hearing Hope,” to expand awareness of hearing health through the voices of those who benefit from and those who carry out the foundation’s life-changing work.

The third most prevalent chronic physical condition in the U.S., hearing loss can affect anyone—from first-grader Emmy to retired U.S. Army Colonel John—but its reach is often underestimated. “It’s one of the most common sensory deficits in humans,” explains cochlear implant surgeon Dr. Anil Lalwani. “I think we have to go from it being hidden to being visible.”

Both a hearing aid user and cochlear implant recipient, seventh-grader Alex is doing his part to make hearing loss less hidden. Smiling, he says he wants people to know that hearing with his devices makes him happy. John wishes to be an advocate for veterans and all who live with hearing loss and tinnitus.

The film also highlights resilience in response to the challenges associated with hearing conditions. Video participant Renee saw her dream of becoming an astronaut halted at 17 when her hearing loss was detected. Now she helps send people to space as an engineer at NASA.

Sophia describes the “low, low rock bottom” she hit when she was diagnosed with Usher Syndrome, the leading cause of deafblindness. Yet she feels special knowing her disability shapes her and sets her apart.

Jason recounts having no resources for hearing loss in children when his son, Ethan, failed his newborn hearing screening. Today he’s grateful for Ethan’s aptitude for language, made possible through his early hearing loss intervention.

With the support of HHF, more progress is made each year. “I’m glad that the doctors are trying to figure out how fish and birds can restore their hearing,” says Emmy.

For the past 60 years, HHF has funded promising hearing science and in 2011 established the Hearing Restoration Project (HRP), an international consortium dedicated to finding biological cures for hearing loss using fish, bird, and mouse models to replicate the phenomenon of hearing loss reversal in humans.

“If [the HRP] can achieve that goal of hearing restoration...that would be a marvelous thing for hearing loss,” reiterates Dr. Robert Dobie.

Through “Hearing Hope,” HHF would like to share its mission and message of hope to as many individuals as possible and reassure those with hearing loss and their loved ones they are not alone. As an organization that channels all efforts into research and education, HHF would greatly appreciate any assistance or suggestions to increase the visibility of the film.

Published: 7/25/2018 3:06:00 PM

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Hearing Loss Film “Hearing Hope” Captures Personal Strength, Scientific Vision

National nonprofit organization Hearing Health Foundation (HHF) has created a new short film, “Hearing Hope,” to expand awareness of hearing health through the voices of those who benefit from and those who carry out the foundation’s life-changing work.

The third most prevalent chronic physical condition in the U.S., hearing loss can affect anyone—from first-grader Emmy to retired U.S. Army Colonel John—but its reach is often underestimated. “It’s one of the most common sensory deficits in humans,” explains cochlear implant surgeon Dr. Anil Lalwani. “I think we have to go from it being hidden to being visible.”

Both a hearing aid user and cochlear implant recipient, seventh-grader Alex is doing his part to make hearing loss less hidden. Smiling, he says he wants people to know that hearing with his devices makes him happy. John wishes to be an advocate for veterans and all who live with hearing loss and tinnitus.

The film also highlights resilience in response to the challenges associated with hearing conditions. Video participant Renee saw her dream of becoming an astronaut halted at 17 when her hearing loss was detected. Now she helps send people to space as an engineer at NASA.

Sophia describes the “low, low rock bottom” she hit when she was diagnosed with Usher Syndrome, the leading cause of deafblindness. Yet she feels special knowing her disability shapes her and sets her apart.

Jason recounts having no resources for hearing loss in children when his son, Ethan, failed his newborn hearing screening. Today he’s grateful for Ethan’s aptitude for language, made possible through his early hearing loss intervention.

With the support of HHF, more progress is made each year. “I’m glad that the doctors are trying to figure out how fish and birds can restore their hearing,” says Emmy.

For the past 60 years, HHF has funded promising hearing science and in 2011 established the Hearing Restoration Project (HRP), an international consortium dedicated to finding biological cures for hearing loss using fish, bird, and mouse models to replicate the phenomenon of hearing loss reversal in humans.

“If [the HRP] can achieve that goal of hearing restoration...that would be a marvelous thing for hearing loss,” reiterates Dr. Robert Dobie.

Through “Hearing Hope,” HHF would like to share its mission and message of hope to as many individuals as possible and reassure those with hearing loss and their loved ones they are not alone. As an organization that channels all efforts into research and education, HHF would greatly appreciate any assistance or suggestions to increase the visibility of the film.

Published: 7/25/2018 3:06:00 PM

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O 027 - There are common patterns of muscle synergy in cerebral palsy crouch gait

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): M. Shojaeefard, A. Khandan, M. Arab Baniasad, F. Farahmand, S. Baghdadi, A. Vafaei, R. Narimani

Abstract

Background

Muscle synergy is the leading hypothesis on how the central nervous system coordinates limb functions. Cerebral palsy (CP) patients utilize fewer synergies, and are believed to have a simpler neuromuscular control. This study was undertaken to determine whether consistent muscle synergies are recruited during ambulation in cerebral palsy crouch gait and how the muscles contribute to such synergies.

Methods

Ten ambulatory CP patients were recruited. All walked with crouch gait. sEMG data were collected from 14 lower limb muscles during gait analysis. Non-negative matrix factorization method was utilized to extract muscle synergies.

Results and significance

A total of five synergy patterns were extracted. One synergy was shared among all patients, and was more active during swing. Another pattern was observed in seven patients, and was active during stance. These data suggest that CP patients with crouch gait utilize the simplest neuromuscular pattern to ambulate. One synergy is responsible for the swing phase, and one for the stance. This will substantially limit the adaptability of gait to various walking circumstances. The results of this study may help guide gait training programs and maximize the efficiency of ambulation in CP crouch gait.

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O 027 - There are common patterns of muscle synergy in cerebral palsy crouch gait

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): M. Shojaeefard, A. Khandan, M. Arab Baniasad, F. Farahmand, S. Baghdadi, A. Vafaei, R. Narimani

Abstract

Background

Muscle synergy is the leading hypothesis on how the central nervous system coordinates limb functions. Cerebral palsy (CP) patients utilize fewer synergies, and are believed to have a simpler neuromuscular control. This study was undertaken to determine whether consistent muscle synergies are recruited during ambulation in cerebral palsy crouch gait and how the muscles contribute to such synergies.

Methods

Ten ambulatory CP patients were recruited. All walked with crouch gait. sEMG data were collected from 14 lower limb muscles during gait analysis. Non-negative matrix factorization method was utilized to extract muscle synergies.

Results and significance

A total of five synergy patterns were extracted. One synergy was shared among all patients, and was more active during swing. Another pattern was observed in seven patients, and was active during stance. These data suggest that CP patients with crouch gait utilize the simplest neuromuscular pattern to ambulate. One synergy is responsible for the swing phase, and one for the stance. This will substantially limit the adaptability of gait to various walking circumstances. The results of this study may help guide gait training programs and maximize the efficiency of ambulation in CP crouch gait.

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O 091 - A new method for computing gait deviation scores in hemiparesis

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): O. Galarraga, A. Le Saux, F. Hareb

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Age-related changes in arm motion during typical gait

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): Patricia Van de Walle, Pieter Meyns, Kaat Desloovere, Jente De Rijck, Julie Kenis, Evi Verbecque, Tamaya Van Criekinge, Ann Hallemans

Abstract

Background

When toddlers learn to walk, they do so with a typical high guard position of the arms. As gait matures, children develop a reciprocal arm swing. So far, there have been no attempts to describe age-related changes of arm movements during walking after this first rapid development.

Research question

The purpose of this study was to investigate age-related changes in arm movement during typical gait.

Methods

All participants (n = 102) received gait analysis using a full-body marker set (Plug-in Gait). Participants were divided into five age-groups: young children (G1: n = 20; 3.0-5.9y), children (G2: n = 24; 6.0-9.9y), pubertal children (G3: n = 26; 10.0-13.9y), adolescents (G4: n = 16; 14.0-18.9y) and adults (G5: n = 16; 19.0-35.2y). Age-related changes in arm movements were investigated by comparing continuous joint angular waveforms (spm1d) between all groups, as well as by comparing the mean joint angle and range of motion of the different joints between age-groups.

Results

The overall shape of movement patterns was comparable across all age groups. Nevertheless, with advancing age, consistency increased. At the shoulder, G1&2 showed a larger mean extension angle compared to older children and adults. The range of shoulder axial rotation was significantly larger in adults compared to all other age groups. In the youngest groups (G1-G2), an increased mean elbow flexion and mean wrist extension angle was found.

Significance

Determining an exact age of maturation of arm swing remains difficult as parameter specific adult-like values were not reached at the same age but should not be set before the age of ten to fourteen years for any parameter.

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O 091 - A new method for computing gait deviation scores in hemiparesis

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): O. Galarraga, A. Le Saux, F. Hareb

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Age-related changes in arm motion during typical gait

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): Patricia Van de Walle, Pieter Meyns, Kaat Desloovere, Jente De Rijck, Julie Kenis, Evi Verbecque, Tamaya Van Criekinge, Ann Hallemans

Abstract

Background

When toddlers learn to walk, they do so with a typical high guard position of the arms. As gait matures, children develop a reciprocal arm swing. So far, there have been no attempts to describe age-related changes of arm movements during walking after this first rapid development.

Research question

The purpose of this study was to investigate age-related changes in arm movement during typical gait.

Methods

All participants (n = 102) received gait analysis using a full-body marker set (Plug-in Gait). Participants were divided into five age-groups: young children (G1: n = 20; 3.0-5.9y), children (G2: n = 24; 6.0-9.9y), pubertal children (G3: n = 26; 10.0-13.9y), adolescents (G4: n = 16; 14.0-18.9y) and adults (G5: n = 16; 19.0-35.2y). Age-related changes in arm movements were investigated by comparing continuous joint angular waveforms (spm1d) between all groups, as well as by comparing the mean joint angle and range of motion of the different joints between age-groups.

Results

The overall shape of movement patterns was comparable across all age groups. Nevertheless, with advancing age, consistency increased. At the shoulder, G1&2 showed a larger mean extension angle compared to older children and adults. The range of shoulder axial rotation was significantly larger in adults compared to all other age groups. In the youngest groups (G1-G2), an increased mean elbow flexion and mean wrist extension angle was found.

Significance

Determining an exact age of maturation of arm swing remains difficult as parameter specific adult-like values were not reached at the same age but should not be set before the age of ten to fourteen years for any parameter.

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Parents' Perception of Health-Related Quality of Life in Children With Cochlear Implants: The Impact of Language Skills and Hearing

Purpose

The study compared how parents of children with cochlear implants (CIs) and parents of children with normal hearing perceive their children's health-related quality of life (HR-QOL).

Method

The sample consisted of 186 Norwegian-speaking children in the age span of 5;0–12;11 (years;months): 106 children with CIs (53% boys, 47% girls) and 80 children with normal hearing (44% boys, 56% girls). No children had known additional disabilities affecting language, cognitive development, or HR-QOL. Parents completed the generic questionnaire Pediatric Quality of Life Inventory (Varni, Seid, & Kurtin, 2001), whereas children completed a test battery measuring different aspects of language and hearing.

Results

Parents of children with CIs reported statistically significantly poorer HR-QOL in their children, on Pediatric Quality of Life Inventory total score and the subdomains social functioning and school functioning. Roughly 50% of parents of children with CIs reported HR-QOL levels (total score) within normal limits. No significant differences between groups emerged on the physical health and emotional functioning subscales. For the children in the group with CIs, better speech perception in everyday situations was associated with higher proxy-ratings of HR-QOL. Better spoken language skills were weakly to moderately associated with higher HR-QOL.

Conclusions

The findings suggest that the social and school situation is not yet resolved satisfactorily for children with CIs. Habilitation focusing on spoken language skills and better sound environment may improve social interactions with peers and overall school functioning.

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Evaluation of an Explicit Intervention to Teach Novel Grammatical Forms to Children With Developmental Language Disorder

Purpose

Unlike traditional implicit approaches used to improve grammatical forms used by children with developmental language disorder, explicit instruction aims to make the learner consciously aware of the underlying language pattern. In this study, we compared the efficacy of an explicit approach to an implicit approach when teaching 3 novel grammatical forms varying in linguistic complexity.

Method

The study included twenty-five 5- to 8-year-old children with developmental language disorder, 13 of whom were randomized to receive an implicit-only (I-O) intervention whereas the remaining 12 participants were randomized to receive a combined explicit–implicit (E-I) intervention to learn 3 novel grammatical forms. On average, participants completed 4.5 teaching sessions for each form across 9 days. Acquisition was assessed during each teaching session. Approximately 9 days posttreatment for each form, participants completed probes to assess maintenance and generalization.

Results

Analyses revealed a meaningful and statistically significant learning advantage for the E-I group on acquisition, maintenance, and generalization measures when performance was collapsed across the 3 novel targets (p < .02, Φs > 0.60). Significant differences between the groups, with the E-I group outperforming the I-O group, only emerged for 1 of the 3 target forms. However, all effect sizes ranged from medium to large (Φs = 0.25–0.76), and relative risk calculations all exceeded 0, indicating a greater likelihood of learning the target form with E-I instruction than I-O instruction.

Conclusions

Study findings indicate that, as compared to implicit instruction, children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with explicit instruction. Further research is needed to evaluate the use of explicit instruction when teaching true grammatical forms to children with language impairment.

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Parents' Perception of Health-Related Quality of Life in Children With Cochlear Implants: The Impact of Language Skills and Hearing

Purpose

The study compared how parents of children with cochlear implants (CIs) and parents of children with normal hearing perceive their children's health-related quality of life (HR-QOL).

Method

The sample consisted of 186 Norwegian-speaking children in the age span of 5;0–12;11 (years;months): 106 children with CIs (53% boys, 47% girls) and 80 children with normal hearing (44% boys, 56% girls). No children had known additional disabilities affecting language, cognitive development, or HR-QOL. Parents completed the generic questionnaire Pediatric Quality of Life Inventory (Varni, Seid, & Kurtin, 2001), whereas children completed a test battery measuring different aspects of language and hearing.

Results

Parents of children with CIs reported statistically significantly poorer HR-QOL in their children, on Pediatric Quality of Life Inventory total score and the subdomains social functioning and school functioning. Roughly 50% of parents of children with CIs reported HR-QOL levels (total score) within normal limits. No significant differences between groups emerged on the physical health and emotional functioning subscales. For the children in the group with CIs, better speech perception in everyday situations was associated with higher proxy-ratings of HR-QOL. Better spoken language skills were weakly to moderately associated with higher HR-QOL.

Conclusions

The findings suggest that the social and school situation is not yet resolved satisfactorily for children with CIs. Habilitation focusing on spoken language skills and better sound environment may improve social interactions with peers and overall school functioning.

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Evaluation of an Explicit Intervention to Teach Novel Grammatical Forms to Children With Developmental Language Disorder

Purpose

Unlike traditional implicit approaches used to improve grammatical forms used by children with developmental language disorder, explicit instruction aims to make the learner consciously aware of the underlying language pattern. In this study, we compared the efficacy of an explicit approach to an implicit approach when teaching 3 novel grammatical forms varying in linguistic complexity.

Method

The study included twenty-five 5- to 8-year-old children with developmental language disorder, 13 of whom were randomized to receive an implicit-only (I-O) intervention whereas the remaining 12 participants were randomized to receive a combined explicit–implicit (E-I) intervention to learn 3 novel grammatical forms. On average, participants completed 4.5 teaching sessions for each form across 9 days. Acquisition was assessed during each teaching session. Approximately 9 days posttreatment for each form, participants completed probes to assess maintenance and generalization.

Results

Analyses revealed a meaningful and statistically significant learning advantage for the E-I group on acquisition, maintenance, and generalization measures when performance was collapsed across the 3 novel targets (p < .02, Φs > 0.60). Significant differences between the groups, with the E-I group outperforming the I-O group, only emerged for 1 of the 3 target forms. However, all effect sizes ranged from medium to large (Φs = 0.25–0.76), and relative risk calculations all exceeded 0, indicating a greater likelihood of learning the target form with E-I instruction than I-O instruction.

Conclusions

Study findings indicate that, as compared to implicit instruction, children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with explicit instruction. Further research is needed to evaluate the use of explicit instruction when teaching true grammatical forms to children with language impairment.

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Cochlear Implants and Children with Vestibular Impairments.

Related Articles

Cochlear Implants and Children with Vestibular Impairments.

Semin Hear. 2018 Aug;39(3):305-320

Authors: Cushing SL, Papsin BC

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

PMID: 30038457 [PubMed]

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Development of a Pediatric Balance Center: A Multidisciplinary Approach.

Related Articles

Development of a Pediatric Balance Center: A Multidisciplinary Approach.

Semin Hear. 2018 Aug;39(3):243-256

Authors: Bachmann K, Lavender V, Castiglione M

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

PMID: 30038453 [PubMed]

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Epidemiology of Vestibular Impairments in a Pediatric Population.

Related Articles

Epidemiology of Vestibular Impairments in a Pediatric Population.

Semin Hear. 2018 Aug;39(3):229-242

Authors: Wiener-Vacher SR, Quarez J, Priol AL

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

PMID: 30038452 [PubMed]

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Hearing-impaired young people - a physician's guide .

Related Articles

Hearing-impaired young people - a physician's guide .

Clin Med (Lond). 2017 Dec;17(6):521-524

Authors: Easson A, Walter S

Abstract
Physicians reading this will have a broad range of in-depth knowledge about their own subspecialty. However, in daily medical practice there are topics of which all physicians should have some knowledge. Those who deal with young people should have some knowledge of the needs of the hearing-impaired population within this group of patients. This article is intended to provide an overview of young people with hearing impairment (HIYP), the challenges they face and what we can do to help them. In this paper, we assume that data published regarding hearing-impaired children apply to HIYP from 13 years (the age at which the transition process begins) to 25 years of age (the age at which 'youth' according to the World health Organization and the Education Health Care Plan ends).

PMID: 29196352 [PubMed - indexed for MEDLINE]

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Cochlear Implants and Children with Vestibular Impairments.

Related Articles

Cochlear Implants and Children with Vestibular Impairments.

Semin Hear. 2018 Aug;39(3):305-320

Authors: Cushing SL, Papsin BC

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

PMID: 30038457 [PubMed]

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Development of a Pediatric Balance Center: A Multidisciplinary Approach.

Related Articles

Development of a Pediatric Balance Center: A Multidisciplinary Approach.

Semin Hear. 2018 Aug;39(3):243-256

Authors: Bachmann K, Lavender V, Castiglione M

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

PMID: 30038453 [PubMed]

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Epidemiology of Vestibular Impairments in a Pediatric Population.

Related Articles

Epidemiology of Vestibular Impairments in a Pediatric Population.

Semin Hear. 2018 Aug;39(3):229-242

Authors: Wiener-Vacher SR, Quarez J, Priol AL

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

PMID: 30038452 [PubMed]

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Hearing-impaired young people - a physician's guide .

Related Articles

Hearing-impaired young people - a physician's guide .

Clin Med (Lond). 2017 Dec;17(6):521-524

Authors: Easson A, Walter S

Abstract
Physicians reading this will have a broad range of in-depth knowledge about their own subspecialty. However, in daily medical practice there are topics of which all physicians should have some knowledge. Those who deal with young people should have some knowledge of the needs of the hearing-impaired population within this group of patients. This article is intended to provide an overview of young people with hearing impairment (HIYP), the challenges they face and what we can do to help them. In this paper, we assume that data published regarding hearing-impaired children apply to HIYP from 13 years (the age at which the transition process begins) to 25 years of age (the age at which 'youth' according to the World health Organization and the Education Health Care Plan ends).

PMID: 29196352 [PubMed - indexed for MEDLINE]

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The relationship between acute pain and dynamic postural stability indices in individuals with patellar tendinopathy

Publication date: September 2018

Source: Gait & Posture, Volume 65

Author(s): Adam B. Rosen, Jupil Ko, Cathleen N. Brown

Abstract

Background

Patellar tendinopathy is a common condition resulting in persistent pain, frequently reported during physical activity. The relationship between dynamic postural stability and pain in these individuals is unclear and how it may affect postural stability.

Research Question

Is there a relationship between acute pain and dynamic postural stability indices in individuals with patellar tendinopathy?

Methods

Twenty-two recreationally active individuals with patellar tendinopathy participated. Participants performed a two-legged jump and landed on a single test-limb on a force platform. They completed 100 mm visual analogue scales (VAS) before and after landing trials. Anterior-posterior (APSI), medial-lateral (MLSI), vertical (VSI), and composite (DPSI) stability indices were calculated from ground reaction force data. The relationship between stability indices and VAS for pain as well as pain change scores were assessed via non-parametric Spearman’s rho (ρ) rank correlations (p≤.05).

Results

Baseline pain was not significantly correlated with any stability indices. Post-landing pain was significantly correlated with MLSI (ρ = 0.540, p = 0.004) while, VSI (ρ = 0.353, p = 0.053) and DPSI (ρ = 0.347, p = 0.057) had moderate, yet insignificant correlations. Pain change scores demonstrated a large correlation with MLSI (ρ = 0.598, p = 0.002).

Significance

As pain increased in individuals with patellar tendinopathy, dynamic postural stability indices values increased, indicating more difficulty transitioning from a dynamic to static state. Although balance deficits are not typically associated with patellar tendinopathy, it appears pain and dynamic postural stability may be related in these individuals.

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P 016 – Preliminary results of the dynamic functional leg alignment in healthy young adults during level walking: An explorative study

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): C. Kaufmann, K. Widhalm, S. Durstberger, M. Klinger, P. Putz

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Walking with an induced unilateral knee extension restriction affects lower but not upper body biomechanics in healthy adults

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): Michael Sotelo, Patric Eichelberger, Martina Furrer, Heiner Baur, Stefan Schmid

Abstract

Background

Unilateral knee flexion contractures (KFC) are frequently seen in orthopedic rehabilitation and often interfere with the normal gait pattern, resulting in passive and/or active secondary deviations. In order to prevent KFC-related complications such as patellofemoral pain or the knee spine syndrome, a comprehensive understanding of such deviations is necessary.

Research question

How does an artificially induced unilateral KFC affect whole body biomechanics in young healthy adults during gait?

Methods

Twenty-four healthy young adults (females/males: 13/11; mean age: 27.3 ± 3.8 years) were included in this cross-sectional study. Using an 8-camera optical motion capture system and two embedded force plates, three-dimensional lower extremity, pelvis and trunk kinematics as well as lower extremity joint moments were derived during normal walking and walking with unilateral KFCs by means of a lightweight knee brace locked at 30° and 60° of flexion. Data were analyzed using one-dimensional statistical parametric mapping, allowing explorative group comparisons of continuous data rather than pre-defined discrete parameters.

Results

On the braced side, increased hip flexion (p < 0.001, 1-100 % of gait cycle [%GC]), knee flexion (p < 0.001, 1-72 and 82-100 %GC) and ankle dorsiflexion angles (p < 0.001, 1-100 %GC) as well as external knee flexion moments (p < 0.001, 1-98 % of stance phase [%StPh]) and ankle dorsiflexion moments (p < 0.001, 74-94 %StPh) and decreased hip flexion- and adduction moments (p < 0.001, 1-32 %StPh and p < 0.001, 71-92 %StPh, respectively) were observed. The unbraced side showed similar but less pronounced deviations. Pelvis and upper body kinematics were not altered, suggesting that the lower limbs fully compensate for KFCs of less than 30°.

Significance

Asymmetric limb loading and considerable increases in external knee flexion moments might increase the risk for adverse effects of lower extremity joints in the long-term. It seems therefore important to treat KFCs as early as possible and to implement preventive strategies to avoid possible complications.

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The relationship between acute pain and dynamic postural stability indices in individuals with patellar tendinopathy

Publication date: September 2018

Source: Gait & Posture, Volume 65

Author(s): Adam B. Rosen, Jupil Ko, Cathleen N. Brown

Abstract

Background

Patellar tendinopathy is a common condition resulting in persistent pain, frequently reported during physical activity. The relationship between dynamic postural stability and pain in these individuals is unclear and how it may affect postural stability.

Research Question

Is there a relationship between acute pain and dynamic postural stability indices in individuals with patellar tendinopathy?

Methods

Twenty-two recreationally active individuals with patellar tendinopathy participated. Participants performed a two-legged jump and landed on a single test-limb on a force platform. They completed 100 mm visual analogue scales (VAS) before and after landing trials. Anterior-posterior (APSI), medial-lateral (MLSI), vertical (VSI), and composite (DPSI) stability indices were calculated from ground reaction force data. The relationship between stability indices and VAS for pain as well as pain change scores were assessed via non-parametric Spearman’s rho (ρ) rank correlations (p≤.05).

Results

Baseline pain was not significantly correlated with any stability indices. Post-landing pain was significantly correlated with MLSI (ρ = 0.540, p = 0.004) while, VSI (ρ = 0.353, p = 0.053) and DPSI (ρ = 0.347, p = 0.057) had moderate, yet insignificant correlations. Pain change scores demonstrated a large correlation with MLSI (ρ = 0.598, p = 0.002).

Significance

As pain increased in individuals with patellar tendinopathy, dynamic postural stability indices values increased, indicating more difficulty transitioning from a dynamic to static state. Although balance deficits are not typically associated with patellar tendinopathy, it appears pain and dynamic postural stability may be related in these individuals.

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P 016 – Preliminary results of the dynamic functional leg alignment in healthy young adults during level walking: An explorative study

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): C. Kaufmann, K. Widhalm, S. Durstberger, M. Klinger, P. Putz

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Walking with an induced unilateral knee extension restriction affects lower but not upper body biomechanics in healthy adults

Publication date: Available online 25 July 2018

Source: Gait & Posture

Author(s): Michael Sotelo, Patric Eichelberger, Martina Furrer, Heiner Baur, Stefan Schmid

Abstract

Background

Unilateral knee flexion contractures (KFC) are frequently seen in orthopedic rehabilitation and often interfere with the normal gait pattern, resulting in passive and/or active secondary deviations. In order to prevent KFC-related complications such as patellofemoral pain or the knee spine syndrome, a comprehensive understanding of such deviations is necessary.

Research question

How does an artificially induced unilateral KFC affect whole body biomechanics in young healthy adults during gait?

Methods

Twenty-four healthy young adults (females/males: 13/11; mean age: 27.3 ± 3.8 years) were included in this cross-sectional study. Using an 8-camera optical motion capture system and two embedded force plates, three-dimensional lower extremity, pelvis and trunk kinematics as well as lower extremity joint moments were derived during normal walking and walking with unilateral KFCs by means of a lightweight knee brace locked at 30° and 60° of flexion. Data were analyzed using one-dimensional statistical parametric mapping, allowing explorative group comparisons of continuous data rather than pre-defined discrete parameters.

Results

On the braced side, increased hip flexion (p < 0.001, 1-100 % of gait cycle [%GC]), knee flexion (p < 0.001, 1-72 and 82-100 %GC) and ankle dorsiflexion angles (p < 0.001, 1-100 %GC) as well as external knee flexion moments (p < 0.001, 1-98 % of stance phase [%StPh]) and ankle dorsiflexion moments (p < 0.001, 74-94 %StPh) and decreased hip flexion- and adduction moments (p < 0.001, 1-32 %StPh and p < 0.001, 71-92 %StPh, respectively) were observed. The unbraced side showed similar but less pronounced deviations. Pelvis and upper body kinematics were not altered, suggesting that the lower limbs fully compensate for KFCs of less than 30°.

Significance

Asymmetric limb loading and considerable increases in external knee flexion moments might increase the risk for adverse effects of lower extremity joints in the long-term. It seems therefore important to treat KFCs as early as possible and to implement preventive strategies to avoid possible complications.

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