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Peng C, Li D, Guo T, Li S, Chen Y, Zhao L, Mi J. Efficacy of Different Exercises on Mild to Moderate Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil 2024; 103:494-501. [PMID: 38113028 DOI: 10.1097/phm.0000000000002389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE The aims of this study are to evaluate the effectiveness of different exercise interventions on patients with adolescent idiopathic scoliosis and to provide evidence-based exercise prescriptions for this population. METHODS The PubMed, Embase, Cochrane Library, Web of Science, CNKI, Chinese Biomedical Literature Database (CBM), VIP, and Wanfang Data Knowledge Service Platform were searched until January 2023. The data were pooled and a meta-analysis was conducted. RESULTS A total of 19 studies were conducted with 778 participants. The Schroth exercises group (mean difference = -3.48, 95% confidence interval = -4.73 to -2.23, P < 0.00001) and strength training group (mean difference = -3.43, 95% confidence interval = -4.06 to -2.80, P < 0.00001) had better recovery of the Cobb angle than the other groups. The Cobb angle rehabilitation effect was good in the time of less than 60-min group. In addition, there was no significant difference found between the different intervention periods groups ( P > 0.05). CONCLUSIONS Schroth exercise and strength training significantly improved Cobb angle of adolescent idiopathic scoliosis patients; exercising for less than 60 mins is effective for Cobb angle rehabilitation, but prolonging exercise time cannot improve training effectiveness; 12 wks of exercise significantly improved Cobb angle, but prolonged training periods did not have a significant impact.
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Affiliation(s)
- Cheng Peng
- From the China Athletics College, Beijing Sport University, Beijing, China (CP); Physical Education College, Beijing Normal University, Beijing, China (DL); School of Competitive Sports, Beijing Sport University, Beijing, China (TG, SL, YC, JM); and Sport Science School, Beijing Sport University, Beijing, China (LZ)
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Reynard P, Ortega-Solís J, Tronche S, Darrouzet V, Thai-Van H. Guidelines of the French Society of Otorhinolaryngology and Head and Neck Surgery (SFORL) for vestibular rehabilitation in children with vestibular dysfunction. A systematic review. Arch Pediatr 2024; 31:217-223. [PMID: 38697883 DOI: 10.1016/j.arcped.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/20/2024] [Accepted: 02/25/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION The consequence of complete or partial uncompensated vestibular dysfunction in children is usually balance disorders, with the risk of falls and increased fatigue, particularly during tasks requiring postural control. The aim of these recommendations is to establish guidelines for vestibular rehabilitation (VR) in children with vestibular impairment. MATERIAL AND METHODS The guidelines were developed based on a systematic review of the international literature, validated by a multidisciplinary group of French-speaking otorhinolaryngologists, scientists, and physiotherapists. They are classified as grade A, B, C, or expert opinion according to a decreasing level of scientific evidence. RESULTS A PubMed search of studies published between January 1990 and December 2021 was carried out using the keywords "vestibular," "rehabilitation," and "children". After filtering and reviewing the articles, a total of 10 publications were included to establish the recommendations. CONCLUSION It is recommended that a vestibular assessment be carried out before VR, including a study of vestibulo-ocular reflex, otolithic function, and postural control. In cases of vestibular dysfunction, physiotherapy treatment is recommended from an early age to train different aspects of postural control, including anticipatory and reactive postural adjustments. VR adapted to the pediatric population is recommended for children whose vestibular dysfunction leads to functional disorders or symptoms of vertigo for those who have suffered head trauma. It is recommended that children with bilateral vestibular impairment be treated using gaze stabilization exercises for adaptation and substitution. Optokinetic stimulation and virtual reality are not recommended for children and young adolescents.
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Affiliation(s)
- Pierre Reynard
- Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; Center for Research and Innovation in Human Audiology (CERIAH), Institut de l'Audition, Institut Pasteur, Inserm, Paris, France; French Society of Vestibular Physiotherapy (SFKV), 31000 Toulouse, France.
| | - José Ortega-Solís
- Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; French Society of Vestibular Physiotherapy (SFKV), 31000 Toulouse, France
| | - Sophie Tronche
- French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL), 75116 Paris, France
| | - Vincent Darrouzet
- Department of Otolaryngology Head and Neck Surgery, and Skull Base Surgery, University Hospital of Bordeaux, 33000 Bordeaux, France
| | - Hung Thai-Van
- Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; Center for Research and Innovation in Human Audiology (CERIAH), Institut de l'Audition, Institut Pasteur, Inserm, Paris, France; Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
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Mohamed ST, Hazzaa N, Abdel Rahman T, Ezz Eldin DM, Elhusseiny AM. Efficacy of vestibular rehabilitation program in children with balance disorders and sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2024; 179:111931. [PMID: 38555811 DOI: 10.1016/j.ijporl.2024.111931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/25/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Asses the efficacy of a Vestibular-balance rehabilitation program to minimize or reverse balance disability in children with sensorineural hearing loss. METHOD Forty-five hearing-impaired children with balance deficits (i.e., variable degrees of sensorineural hearing loss or auditory neuropathy). Thirty-five were rehabilitated with cochlear implants, and ten with hearing aids. Their age ranged from 4 to 10 years old. A Pre-rehab evaluation was done using questionnaires, neuromuscular evaluation, vestibular and balance office testing, and vestibular lab testing (using cVEMP and caloric test). Customized balances, as well as vestibular rehabilitation exercises, have been applied for three months. That was followed by post-rehab assessment, including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test. RESULTS There was a statistically significant difference in all measured parameters (including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test) after rehabilitation. CONCLUSIONS Vestibular-balance rehabilitation intervention positively impacts vestibular and balance functions in hearing-impaired children.
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Affiliation(s)
- Somaia Tawfik Mohamed
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
| | - Nagwa Hazzaa
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
| | - Tayseer Abdel Rahman
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt.
| | - Dalia Mohamed Ezz Eldin
- Physical medicine, rheumatology and rehabilitation, Rheumatology and Rehabilitation Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
| | - Aya Magdy Elhusseiny
- Audiovestibular medicine, Audiology unit, ORL Dept., Faculty of Medicine, Ain Shams University, Abassia Street, Cairo, Egypt
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Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. The impacts of exercise training programs on balance in children with hearing loss: A systematic review and meta-analysis. J Bodyw Mov Ther 2024; 37:296-307. [PMID: 38432821 DOI: 10.1016/j.jbmt.2023.11.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/13/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
INTRODUCTION AND PURPOSE According to the prevalence of balance disorders among children with hearing loss (HL), researchers used exercise programs to improve balance in children with HL. So, the present systematic review and meta-analysis briefly summarize findings regarding the impacts of exercise training programs on balance in children with HL. METHODS Science Direct, MEDLINE/PubMed, SCOPUS, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar were searched from inception until November 11th, 2023. Two independent researchers analyzed and extracted the data from potential papers whose eligibility was confirmed. Then, the PEDro scale was used to obtain quality assessment scores. The total PEDro score is 11 and incorporates the presentation of statistical analysis and evaluation criteria of internal validity. Studies that scored 7-11 were considered methodologically "high", 5 to 6 were "fair", and ≤4 were considered "poor". RESULTS 10 studies involving a total of 304 participations were included in the systematic review. Our results demonstrate that exercise training programs positively impact static balance (p = 0.001) with level 1a evidence, the postural sway (p = 0.001) with level 1a evidence, and dynamic balance (p = 0.001) with level 1a evidence in children with HL. CONCLUSION The findings of this systematic review and meta-analysis related to studies with excellent methodological quality revealed that the intended training programs significantly impact postural sway along with static and dynamic balance in children with HL. It is recommended that future exercise training programs be paired with rehabilitation programs for children with HL.
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Affiliation(s)
- Hamed Zarei
- Physical Education & Sport Sciences, (corrective Exercise and Sport Injuries), Corrective Exercises and Sports Injury Department, Faculty of Physical Education & Sport Sciences, University of Guilan, 4199613776, Rasht, Iran.
| | - Ali Asghar Norasteh
- Physiotherapy Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Lauren J Lieberman
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, NY, 14420, USA
| | - Michael W Ertel
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
| | - Ali Brian
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
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Ortega Solís J, Reynard P, Spruyt K, Bécaud C, Ionescu E, Thai-Van H. Developing a serious game for gaze stability rehabilitation in children with vestibular hypofunction. J Neuroeng Rehabil 2023; 20:128. [PMID: 37752531 PMCID: PMC10521575 DOI: 10.1186/s12984-023-01249-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Children with vestibular hypofunction (VH) may have gaze instability, balance disorders, and delayed postural-motor development. Gaze stabilization exercises (GSE) are designed to improve dynamic visual acuity (DVA). We aimed to assess the acceptability of a serious game prototype called Kid Gaze Rehab (KGR) designed to implement GSE training in children with VH, combined with traditional vestibular rehabilitation. Effects on DVA and motor performance were also analyzed. METHODS Twelve children (6 to 9 years old) were included. Sessions were held at the hospital twice a week, for 5 weeks. An adapted French version of The Child Simulator Sickness Questionnaire (SSQ) and the Face Scale Pain-Revised (FPS-R) were used to assess pain in the cervical region and undesirable side effects after each session. Vestibular and motor function parameters (active and passive DVA and Movement Assessment Battery for Children-Second Edition, MABC-2) were assessed before and after the training. RESULTS All children included completed the 10 sessions. The FPS-R visual analog scale and SSQ showed good cervical tolerance and no oculomotor or vegetative adverse effects nor spatial disorientation. After training, active DVA scores were significantly improved for the right, left, and up directions (p < 0.05). Passive DVA scores were significantly improved for the left and down directions (p < 0.01 and p < 0.05, respectively). MABC-2 scores were improved in the balance and ball skill sections (p < 0.05). CONCLUSION An innovative pediatric training method, the use of a dedicated serious game for gaze stabilization was well-tolerated as a complement to conventional vestibular rehabilitation in children with VH. Moreover, both DVA and motor performance were found to improve in the study sample. Although replication studies are still needed, serious game-based training in children with VH could represent a promising rehabilitation approach for years to come. TRIAL REGISTRATION The study was conducted in accordance with the Declaration of Helsinki and approved by an Institutional Review Board (local ethics committee, CPP Sud-Est IV, ID 2013-799). The study protocol was registered on ClinicalTrials.gov (NCT04353115).
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Affiliation(s)
- José Ortega Solís
- Service d'Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 5 Place d'Arsonval, Lyon, 69003, France
- Société française de kinésithérapie vestibulaire, Toulouse, France
| | - Pierre Reynard
- Service d'Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 5 Place d'Arsonval, Lyon, 69003, France
- Société française de kinésithérapie vestibulaire, Toulouse, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre de Recherche et d'Innovation en Audiologie Humaine, Institut Pasteur, Institut de l'Audition, rue du Docteur Roux, Paris, 75015, France
| | - Karen Spruyt
- Université Paris Cité, NeuroDiderot - INSERM, Hôpital Robert Debré AP-HP, 48 Bd Sérurier, Bingen, Paris, 75019, France
| | - Cécile Bécaud
- Service d'Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 5 Place d'Arsonval, Lyon, 69003, France
- Société française de kinésithérapie vestibulaire, Toulouse, France
| | - Eugen Ionescu
- Service d'Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 5 Place d'Arsonval, Lyon, 69003, France
- Centre de Recherche et d'Innovation en Audiologie Humaine, Institut Pasteur, Institut de l'Audition, rue du Docteur Roux, Paris, 75015, France
| | - Hung Thai-Van
- Service d'Audiologie & Explorations Oto-Neurologiques, Hospices Civils de Lyon, 5 Place d'Arsonval, Lyon, 69003, France.
- Université Claude Bernard Lyon 1, Lyon, France.
- Centre de Recherche et d'Innovation en Audiologie Humaine, Institut Pasteur, Institut de l'Audition, rue du Docteur Roux, Paris, 75015, France.
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. Balance Control in Individuals with Hearing Impairment: A Systematic Review and Meta-Analysis. Audiol Neurootol 2023; 29:30-48. [PMID: 37557094 DOI: 10.1159/000531428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 05/30/2023] [Indexed: 08/11/2023] Open
Abstract
Comprehensive insights into balance control of individuals with hearing impairment are compared with individuals with hearing. Primary sources were obtained from 7 databases including PubMed, LILACS, SCOPUS, CINAHL, PEDro, CENTRAL, and Web of Science. The search period extended from inception until January 5, 2022. The systematic review included 24 studies and 27 trials, with a total of 2,148 participants. The meta-analysis showed a significant difference in the average balance control between individuals with hearing impairment and individuals with hearing, with individuals with hearing having a favorable advantage (p = 0.001). Additionally, average balance control was found to be in favor of individuals with hearing (p = 0.001) when comparing individuals with hearing impairment who participated in sports. Finally, individuals with hearing impairment who participated in sports demonstrated a significantly higher average difference in balance control (p = 0.001) when compared to sedentary people with hearing impairment. Our meta-analysis results indicate a balance defect in individuals with hearing impairment compared to individuals with hearing. In addition, with increasing age, the balance in individuals with hearing impairment improved. Additionally, the dependence of individuals with hearing impairment on the visual and proprioception systems to maintain balance increased. Finally, there was more dependence on the proprioception than the visual system, while individuals with hearing had stronger average balance control than individuals with hearing impairment who participated in sports, when compared to sedentary people with hearing impairment.
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Affiliation(s)
- Hamed Zarei
- Corrective Exercises and Sports Injury Department, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran
| | - Ali Asghar Norasteh
- Physiotherapy Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Lauren J Lieberman
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, New York, USA
| | - Michael W Ertel
- Department of Physical Education, University of South Carolina, Columbia, South Carolina, USA
| | - Ali Brian
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, New York, USA
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Melo RS, Lemos A, Delgado A, Raposo MCF, Ferraz KM, Belian RB. Use of Virtual Reality-Based Games to Improve Balance and Gait of Children and Adolescents with Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:6601. [PMID: 37514897 PMCID: PMC10385194 DOI: 10.3390/s23146601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Children and adolescents with sensorineural hearing loss (SNHL) often experience motor skill disturbances, particularly in balance and gait, due to potential vestibular dysfunctions resulting from inner ear damage. Consequently, several studies have proposed the use of virtual reality-based games as a technological resource for therapeutic purposes, aiming to improve the balance and gait of this population. OBJECTIVE The objective of this systematic review is to evaluate the quality of evidence derived from randomized or quasi-randomized controlled trials that employed virtual reality-based games to enhance the balance and/or gait of children and adolescents with SNHL. METHODS A comprehensive search was conducted across nine databases, encompassing articles published in any language until 1 July 2023. The following inclusion criteria were applied: randomized or quasi-randomized controlled trials involving volunteers from both groups with a clinical diagnosis of bilateral SNHL, aged 6-19 years, devoid of physical, cognitive, or neurological deficits other than vestibular dysfunction, and utilizing virtual reality-based games as an intervention to improve balance and/or gait outcomes. RESULTS Initially, a total of 5984 articles were identified through the searches. Following the removal of duplicates and screening of titles and abstracts, eight studies remained for full reading, out of which three trials met the eligibility criteria for this systematic review. The included trials exhibited a very low quality of evidence concerning the balance outcome, and none of the trials evaluated gait. The meta-analysis did not reveal significant differences in balance improvement between the use of traditional balance exercises and virtual reality-based games for adolescents with SNHL (effect size: -0.48; [CI: -1.54 to 0.57]; p = 0.37; I2 = 0%). CONCLUSION Virtual reality-based games show promise as a potential technology to be included among the therapeutic options for rehabilitating the balance of children and adolescents with SNHL. However, given the methodological limitations of the trials and the overall low quality of evidence currently available on this topic, caution should be exercised when interpreting the results of the trials analyzed in this systematic review.
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Affiliation(s)
- Renato S Melo
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife 50670-901, PE, Brazil
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Andrea Lemos
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Alexandre Delgado
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife 50070-550, PE, Brazil
| | | | - Karla Mônica Ferraz
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Rosalie Barreto Belian
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife 50670-901, PE, Brazil
- Department of Medicine, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
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Martens S, Maes L, Dhondt C, Vanaudenaerde S, Sucaet M, De Leenheer E, Van Hoecke H, Van Hecke R, Rombaut L, Dhooge I. Vestibular Infant Screening-Flanders: What is the Most Appropriate Vestibular Screening Tool in Hearing-Impaired Children? Ear Hear 2023; 44:385-398. [PMID: 36534644 DOI: 10.1097/aud.0000000000001290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES As children with sensorineural hearing loss have an increased risk for vestibular impairment, the Vestibular Infant Screening-Flanders project implemented a vestibular screening by means of cervical vestibular evoked myogenic potentials (cVEMP) at the age of 6 months for each child with hearing loss in Flanders (Belgium). Given that vestibular deficits can affect the child's development, this vestibular screening should allow early detection and intervention. However, less is currently known about which screening tool would be the most ideal and how vestibular impairment can evolve. Therefore, this study aimed to determine the most appropriate tool to screen for vestibular deficits, to assess the necessity of vestibular follow-up, and to set clinical guidelines for vestibular screening in children with hearing loss. DESIGN In total, 71 children with congenital or early-onset sensorineural hearing loss were enrolled (mean age at first appointment = 6.7 months). Follow-up was provided at 6 months, 1, 2, and 3 years of age. Below three years of age, the video Head Impulse Test (vHIT) of the horizontal semicircular canals (SCC), the cVEMP, and the rotatory test at 0.16, 0.04, and 0.01 Hz were applied. At 3 years of age, the vHIT of the vertical SCC and ocular vestibular evoked myogenic potentials (oVEMP) were added. To evaluate early motor development, the Alberta Infant Motor Scale (AIMS) results at 6 months and 1-year old were included. RESULTS At 6 months of age, the highest success rate was obtained with the cVEMP (90.0%) compared to the vHIT (70.0%) and the rotatory test (34.3-72.9%). Overall, vestibular deficits were found in 20.0% of the children, consisting of 13.9% with both SCC and otolith deficits (bilateral: 9.3%, unilateral: 4.6%), and 6.1% with unilateral isolated SCC (4.6%) or otolith (1.5%) deficits. Thus, vestibular deficits would not have been detected in 4.6% of the children by only using the cVEMP, whereas 1.5% would have been missed when only using the vHIT. Although vestibular deficits were more frequently found in severe to profound hearing loss (28.6%), characteristics of vestibular function were highly dependent on the underlying etiology. The AIMS results showed significantly weaker early motor development in children with bilateral vestibular deficits ( p = 0.001), but could not differentiate children with bilateral normal vestibular function from those with unilateral vestibular deficits ( p > 0.05). Progressive or delayed-onset vestibular dysfunction was only found in a few cases (age range: 12-36 months), in which the hearing loss was mainly caused by congenital cytomegalovirus (cCMV). CONCLUSIONS The cVEMP is the most feasible screening tool to assess vestibular function in 6-months-old children with hearing loss. Although the majority of children with vestibular deficits are detected with the cVEMP, the vHIT seems even more sensitive as isolated SCC deficits are associated with specific etiologies of hearing loss. As a result, the cVEMP is an appropriate vestibular screening tool, which is advised at least in severe to profound hearing loss, but certain etiologies require the addition of the vHIT (i.e., cCMV, meningitis, cochleovestibular anomalies with or without syndromic hearing loss).
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Affiliation(s)
- Sarie Martens
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- These authors contributed equally to this work
| | - Leen Maes
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
- These authors contributed equally to this work
| | - Cleo Dhondt
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Marieke Sucaet
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Els De Leenheer
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Helen Van Hoecke
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ruth Van Hecke
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Lotte Rombaut
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Ingeborg Dhooge
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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10
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Neuromuscular mechanisms of motor adaptation to repeated gait-slip perturbations in older adults. Sci Rep 2022; 12:19851. [PMID: 36400866 PMCID: PMC9674587 DOI: 10.1038/s41598-022-23051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
Individuals can rapidly develop adaptive skills for fall prevention after their exposure to the repeated-slip paradigm. However, the changes in neuromuscular control contributing to such motor adaptation remain unclear. This study investigated changes in neuromuscular control across different stages of slip-adaptation by examining muscle synergies during slip training. Electromyography signals during 24 repeated slip trials in gait were collected for 30 healthy older adults. Muscle synergies in no-adaptation (novel slip), early-adaptation (slip 6 to 8), and late-adaptation trials (slip 22 to 24) were extracted. The similarity between the recruited muscle synergies in these different phases was subsequently analyzed. Results showed that participants made significant improvements in their balance outcomes from novel slips to adapted slips. Correspondingly, there was a significant increase in the muscle synergy numbers from no-adaptation slips to the adapted slips. The participants retained the majority of muscle synergies (5 out of 7) used in novel slips post adaptation. A few new patterns (n = 8) of muscle synergies presented in the early-adaptation stage to compensate for motor errors due to external perturbation. In the late-adaptation stage, only 2 out of these 8 new synergies were retained. Our findings indicated that the central nervous system could generate new muscle synergies through fractionating or modifying the pre-existing synergies in the early-adaptation phase, and these synergies produce motor strategies that could effectively assist in recovery from the slip perturbation. During the late-adaptation phase, the redundant synergies generated in the early-adaptation phase get eliminated as the adaptation process progresses with repeated exposure to the slips, which further consolidates the slip adaptation. Our findings improved the understanding of the key muscle synergies involved in preventing backward balance loss and how neuromuscular responses adapt through repeated slip training, which might be helpful to design synergy-based interventions for fall prevention.
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11
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Zhou Y, Qi J. Effectiveness of Interventions on Improving Balance in Children and Adolescents With Hearing Impairment: A Systematic Review. Front Physiol 2022; 13:876974. [PMID: 35651874 PMCID: PMC9150273 DOI: 10.3389/fphys.2022.876974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022] Open
Abstract
Although children and adolescents with hearing impairment are at risks of falls from balance problems, reliable information on effects of interventions are scare. Therefore, the purpose of this review is to systematically summarize studies on the evidence of interventions to improve balance ability in children and adolescents with hearing impairment. A systematic literature search was conducted on five major electronic databases. Studies were included if: 1) interventions or trials focusing on improving balance in children and adolescents with hearing impairment; 2) research targeting children with hearing impairment (samples with a mean age below 18 years); 3) studies were published in English peer-reviewed journals due to language barriers and resource limitations; and 4) study designs were randomized controlled trial or quasi-experiment. A nine-item tool adapted from the Consolidated Standards of Reporting Trials Statement was used to assess the quality of the studies. Through the search strategy, 373 articles were identified, and 15 studies published between 1981 and 2021 met the inclusion criteria. Most of the studies reviewed were categorized as medium or low quality, and only three were identified as high quality. Exercise interventions were adopted in 80% of the included studies, whereas studies that employed music + vibration, motor, and game as the intervention modalities accounted for the remaining 20.0%. The results of this review showed that the included trials with exercise interventions had a positive influence on the balance among children and adolescents with hearing impairment (the post-intervention scores were significantly higher than the pre-intervention or the control group scores). In addition, the interventions with duration of 8–16 weeks were more effective than those with less than 8 weeks. However, due to most of the reviewed studies were of low methodological quality, the trials results analyzed by this systematic review should be interpreted with caution. Further investigations of high-quality studies are therefore needed to prove the effectiveness of interventions on improving balance performance in children and adolescents with hearing impairment. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], PROSPERO [308803].
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Affiliation(s)
- Yan Zhou
- Xingzhi College, Zhejiang Normal University, Jinhua, China
| | - Jing Qi
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
- *Correspondence: Jing Qi,
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12
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Zheng J, Yu Z, Wang Y, Fu Y, Chen D, Zhou H. Acoustic Core-Shell Resonance Harvester for Application of Artificial Cochlea Based on the Piezo-Triboelectric Effect. ACS NANO 2021; 15:17499-17507. [PMID: 34606234 DOI: 10.1021/acsnano.1c04242] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The demand for flexible, efficient, and self-powered cochlear implants applied to remedy sensorineural hearing loss caused by dysfunctional hair cells remains urgent. Herein, we report an acoustic core-shell resonance harvester for the application of artificial cochleae based on the piezo-triboelectric effect. Integrating dispersed BaTiO3 particles as cores and porous PVDF-TrFE as shells, the acoustic harvest devices with ingenious core-shell structures exhibit outstanding piezo-triboelectric properties (Voc = 15.24 V, DAsc = 9.22 mA/m2). The acoustic harvest principle reveals that BaTiO3 nanocores resonate with sound waves and bounce against porous PVDF-TrFE microshells, thereby generating piezo-triboelectric signals. By experimental measurement and numerical modeling, the vibration process and resonance regulation of acoustic harvest devices were intensively investigated to regulate the influential parameters. Furthermore, the acoustic harvesters exhibit admirable feasibility and sensitivity for sound recording and show potential application for artificial cochlea.
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Affiliation(s)
- Jiaqi Zheng
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Zhaohan Yu
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yunming Wang
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yue Fu
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Dan Chen
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Huamin Zhou
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
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Melo RS, Lemos A, Raposo MCF, Monteiro MG, Lambertz D, Ferraz KM. Repercussions of the Degrees of Hearing Loss and Vestibular Dysfunction on the Static Balance of Children With Sensorineural Hearing Loss. Phys Ther 2021; 101:6322542. [PMID: 34270771 DOI: 10.1093/ptj/pzab177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/16/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the static balance of children with sensorineural hearing loss (SNHL) according to the degrees of SNHL and the function of the vestibular system. METHODS This cross-sectional study was conducted in public schools located in Caruaru, Pernambuco state, Brazil, with 130 children (65 with normal hearing and 65 with SNHL as documented by air and bone conduction audiometry) of both sexes between 7 and 11 years old. Static balance was assessed by a stabilometric analysis using a force platform consisting of the circular area of center-of-pressure displacement of the children evaluated in 3 positions: bipedal support with feet together and parallel (PF), tandem feet (TF), and 1 foot (OF), carried out under 2 sensory conditions each, with eyes open and eyes closed. After balance assessments, the children with SNHL received examinations of auditory and vestibular functions-through audiometry and computerized vectoelectronystagmography, respectively-to compose the groups according to degrees of SNHL and vestibular function. RESULTS The children with severe and profound SNHL demonstrated more static balance instabilities than the children with normal hearing in 5 positions assessed with eyes open (PF, TF, and OF) and eyes closed (PF and TF). The same phenomenon occurred in children with SNHL and associated vestibular dysfunction in all of the positions assessed with eyes open and eyes closed (PF, TF, and OF). CONCLUSION The larger the degree of SNHL, the greater the balance instability of the children. The children with SNHL and associated vestibular dysfunction showed the highest balance instabilities in this study. IMPACT Children with larger degrees of SNHL and associated vestibular dysfunction might require prolonged periods to rehabilitate their balance.
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Affiliation(s)
- Renato S Melo
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | - Milena Guimarães Monteiro
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Daniel Lambertz
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Karla Mônica Ferraz
- Department of Physical Therapy, Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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A Systematic Review on the Association Between Vestibular Dysfunction and Balance Performance in Children With Hearing Loss. Ear Hear 2021; 43:712-721. [PMID: 34611117 PMCID: PMC8958172 DOI: 10.1097/aud.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to understand the functional impact of vestibular dysfunction on balance control in children with hearing loss. The vestibular system is an important contributor to maintaining balance. In adults, vestibular dysfunction is known to lead to unsteadiness and falls. Considerably less is known about the effects of vestibular dysfunction in children with hearing loss. DESIGN We conducted a systematic review in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included articles on children with hearing loss who underwent vestibular and balance testing. The Downs and Black checklist was used to assess the risk of bias. RESULTS A total of 20 articles were included in this systematic review, of which, 17 reported an association between vestibular dysfunction and balance abnormalities in children with hearing loss. Bias (as measured by the Downs and Black Checklist) was a concern, as most studies were nonblinded cohort studies or case series selected through convenience sampling. CONCLUSIONS Research to date has predominantly found that children with concomitant hearing loss and vestibular impairment tend to perform more poorly on balance measures than either children with hearing loss and normal vestibular function or children with both normal-hearing and normal vestibular function. A standardized approach to assessing both vestibular function and balance would better characterize the impact of vestibular dysfunction in children with hearing loss at the population level.
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15
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Vestibular disorders in children: A retrospective analysis of vestibular function test findings. Int J Pediatr Otorhinolaryngol 2021; 146:110751. [PMID: 33964674 DOI: 10.1016/j.ijporl.2021.110751] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/07/2021] [Accepted: 04/26/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This study was designed to describe the most common vestibular disorders in children and their associated findings on vestibular function testing. METHOD Data from 203 children with a mean age of 11.16 ± 3.87 (range, 1-17) years were collected from among 3400 patients who underwent vestibular assessment at a vertigo center in a tertiary hospital over a 3-year period. A retrospective data analysis was performed for 203 children. RESULTS Vestibular disorders were diagnosed in 78.3% (n = 159) of 203 children among 3400 patients, which revealed a 3-year incidence of 4.67% in our study. Benign paroxysmal positional vertigo (BPPV) was the most common diagnosis in our group of children (49%; n = 100), which involved both primary BPPV, and secondary BPPV that was associated with other vestibular pathologies. Vestibular migraine (VM) was the second most common diagnosis (41%; n = 83) followed by benign paroxysmal vertigo of childhood (BPVC; 4.5%, n = 9), vestibular neuritis (VN; 4.5%, n = 9), and psychogenic vertigo (4.5%, n = 9). Our study showed that Meniere's Disease (MD; 1.5%, n = 3) and central vertigo (1.5%, n = 3) were less commonly diagnosed in children. Perilymphatic fistula (PLF) was diagnosed and surgically confirmed in only one child. CONCLUSION BPPV and VM were the most common pediatric vestibular disorders in our study. Clinicians should be aware of the prevalence, signs, and symptoms of the most common vestibular disorders in children to enable diagnosis, treatment, and rehabilitation. Vestibular function testing with age-appropriate adaptations results in improved differential diagnosis, which guides medical treatment and rehabilitation.
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16
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Van Hecke R, Deconinck FJA, Wiersema JR, Clauws C, Danneels M, Dhooge I, Leyssens L, Van Waelvelde H, Maes L. Balanced Growth project: a protocol of a single-centre observational study on the involvement of the vestibular system in a child's motor and cognitive development. BMJ Open 2021; 11:e049165. [PMID: 34117049 PMCID: PMC8202106 DOI: 10.1136/bmjopen-2021-049165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/07/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The involvement of the vestibular system in the motor and higher (cognitive) performances of typically developing or vestibular-impaired children is currently unknown or has only scarcely been explored. Interestingly, arguments for an interaction between vestibular, motor and cognitive functions in children can also be supported by research on children known for their difficulties in motor and/or cognitive processing (eg, children with neurodevelopmental disorders (NDD)), as they often present with vestibular-like characteristics. Therefore, in order to elucidate this interaction, and to increase the understanding of the pathophysiology and symptomatology of vestibular disorders and NDD in children, the Balanced Growth project was developed. It includes the following objectives: (1) to understand the association between motor skills, cognitive performances and the vestibular function in typically developing school-aged children, with special focus on the added value of the vestibular system in higher cognitive skills and motor competence; (2) to investigate whether a vestibular dysfunction (with/without an additional auditory disease) has an impact on motor skills, cognitive performances and motor-cognitive interactions in children and (3) to assess if an underlying vestibular dysfunction can be identified in school-aged children with NDD, with documentation of the occurrence and characteristics of vestibular dysfunctions in this group of children using an extensive vestibular test battery. METHODS AND ANALYSIS In order to achieve the objectives of the observational cross-sectional Balanced Growth study, a single-task and dual-task test protocol was created, which will be performed in three groups of school-aged children (6-12 years old): (1) a typically developing group (n=140), (2) (audio) vestibular-impaired children (n=30) and (3) children with an NDD diagnosis (n=55) (ie, autism spectrum disorder, attention deficit/hyperactivity disorder and/or developmental coordination disorder). The test protocol consists of several custom-made tests and already existing validated test batteries and includes a vestibular assessment, an extensive motor assessment, eight neurocognitive tests, a cognitive-motor interaction assessment and includes also additional screenings to control for potential confounding factors (eg, hearing status, intelligence, physical activity, etc). ETHICS AND DISSEMINATION The current study was approved by the ethics committee of Ghent University Hospital on 4 June 2019 with registration number B670201940165 and is registered at Clinical Trials (clinicaltrials.gov) with identifier NCT04685746. All research findings will be disseminated in peer-reviewed journals and presented at vestibular as well as multidisciplinary international conferences and meetings. TRIAL REGISTRATION NUMBER NCT04685746.
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Affiliation(s)
- Ruth Van Hecke
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Frederik J A Deconinck
- Department of Movement and Sports Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Jan R Wiersema
- Department of Experimental Clinical and Health Psychology, Ghent University Faculty of Psychology and Educational Sciences, Ghent, Belgium
| | - Chloe Clauws
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Maya Danneels
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Ingeborg Dhooge
- Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
- Department of Head and Skin, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Laura Leyssens
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Hilde Van Waelvelde
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
- Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
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Singh A, Raynor EM, Lee JW, Smith SL, Heet H, Garrison D, Wrigley J, Kaylie DM, Riska KM. Vestibular Dysfunction and Gross Motor Milestone Acquisition in Children With Hearing Loss: A Systematic Review. Otolaryngol Head Neck Surg 2021; 165:493-506. [PMID: 33430703 DOI: 10.1177/0194599820983726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe the impact of vestibular dysfunction on gross motor development in children with hearing loss. DATA SOURCES MEDLINE (PubMed), Embase (Elsevier), Web of Science (Clarivate), and the Cumulative Index of Nursing and Allied Health Literature (EBSCO). REVIEW METHODS A systematic review was reported in concordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Articles on children with hearing loss who underwent at least 1 instrumented measure of vestibular function and had gross motor milestones assessed were included. The Downs and Black checklist was used to assess risk of bias and methodological quality. RESULTS Eleven articles were included in the systematic review. Three articles stratified quantitative results of gross motor milestone acquisition by severity of vestibular impairment. Over half of studies were case series published within the last 5 years. This systematic review showed that children with hearing loss and severe, bilateral vestibular dysfunction demonstrate delayed gross motor milestones. However, it was difficult to draw conclusions on whether milder forms of vestibular dysfunction significantly affect gross motor milestone acquisition in children with hearing loss. The reason is that most studies were of low to moderate quality, used different assessment methods, and contained results that were descriptive in nature. CONCLUSIONS This emerging area would benefit from future research, such as higher-quality studies to assess vestibular function and gross motor milestones. This would allow for better characterization of the impacts of vestibular impairment, especially milder forms, in children with hearing loss.
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Affiliation(s)
- Anisha Singh
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Eileen M Raynor
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Janet W Lee
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Sherri L Smith
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA.,Center for the Study of Aging and Human Development, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Hannah Heet
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Doug Garrison
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Jordan Wrigley
- Medical Center Library and Archives, Duke University, Durham, North Carolina, USA
| | - David M Kaylie
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Kristal M Riska
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA.,Center for the Study of Aging and Human Development, School of Medicine, Duke University, Durham, North Carolina, USA
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Mitsutake T, Imura T, Tanaka R. The Effects of Vestibular Rehabilitation on Gait Performance in Patients with Stroke: A Systematic Review of Randomized Controlled Trials. J Stroke Cerebrovasc Dis 2020; 29:105214. [PMID: 33066892 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patients with post-stroke hemiparesis have poor postural stability; nevertheless, it is unclear whether vestibular rehabilitation affects gait performance after a stroke or not. We performed a systematic review of randomized controlled trials to investigate the effects of vestibular rehabilitation on gait performance in patients with post stroke. METHODS The Medline, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, and Cumulative Index to Nursing and Allied Health Literature databases were comprehensively searched. All literature published from each source's earliest date to June 2019 was included. Study selection and data extraction were performed independently by paired reviewers. Outcomes of gait performance were the 10-Meter Walking Test, Timed Up and Go Test, and Dynamic Gait Index. We applied the Physiotherapy Evidence Database scale to evaluate the risk of bias and the Grading of Recommendations Assessment, Development and Evaluation system to evaluate the quality of a body of evidence. RESULTS Three studies were included, and two out of three trials showed beneficial effects of vestibular rehabilitation in post-stroke patients. Quality assessment using the Grading of Recommendations Assessment, Development and Evaluation criteria found very low-quality evidence of all included studies due to inadequate allocation concealment, low participant numbers, and lack of blinding. CONCLUSION This review found beneficial effects of vestibular rehabilitation on gait performance in patients with stroke. However, due to the very low-quality evidence of previous randomized controlled trials as assessed by the Grading of Recommendations Assessment, Development and Evaluation criteria, definitive conclusions on the effectiveness of vestibular rehabilitation cannot be made. Hence, more high-quality and large-scale randomized controlled trials of vestibular rehabilitation after stroke are needed.
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Affiliation(s)
- Tsubasa Mitsutake
- Department of Physical Therapy, Fukuoka International University of Health and Welfare, Fukuoka 814-0001, Japan.
| | - Takeshi Imura
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Ryo Tanaka
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan
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Ertugrul G, Sennaroglu G, Karakaya J, Sennaroglu L. Postural instability in children with severe inner ear malformations: Characteristics of vestibular and balance function. Int J Audiol 2020; 60:115-122. [PMID: 32885696 DOI: 10.1080/14992027.2020.1808250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the postural instability and vestibular functions in children with severe inner ear malformations (IEMs). DESIGN A prospective case-control study. STUDY SAMPLE The study group consisted of 10 children using unilateral auditory brainstem implant (ABI) with labyrinthine aplasia or rudimentary otocyst. The age-matched control groups consisted of 10 unilateral cochlear implant (CI) users with normal inner ear structures and 10 healthy peers. All tests were performed to implant users when the implants were off. RESULTS All median VOR gains in the ABI group (median anterior, lateral, and posterior canal 0.15, 0.05, and 0.05, respectively, for the non-implanted sides) were significantly lower than those of the control groups (median VOR gains ≥ 0.90 in both control groups). There were no oVEMP and cVEMP responses in the study group. The mean BOT-2 balance scores of the ABI (3.70 ± 1.34) group was dramatically lower than those of the CI (9.40 ± 2.88) and healthy control (16.20 ± 4.16, p < 0.001). CONCLUSIONS The postural instability in children with severe IEMs was higher than those in CI users with normal inner ear structures and healthy peers. The level of deficiency in the labyrinthine was more important for postural stability in children.
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Affiliation(s)
- Gorkem Ertugrul
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Sennaroglu
- Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Dunlap PM, Khoja SS, Whitney SL, Freburger JK. Predictors of Physical Therapy Referral Among Persons With Peripheral Vestibular Disorders in the United States. Arch Phys Med Rehabil 2020; 101:1747-1753. [PMID: 32445851 DOI: 10.1016/j.apmr.2020.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the rate of physical therapy (PT) referral and patient and physician characteristics associated with PT referral for benign paroxysmal positional vertigo (BPPV) and other peripheral vestibular disorders (PVD) in ambulatory care clinics in the United States. DESIGN Cross-sectional analysis of the National Ambulatory Medical Care Survey 2004-2015 SETTING: Ambulatory care clinics in the United States. PARTICIPANTS We identified 5.6 million weighted adult visits for BPPV (International Classification of Diseases-9th Revision-Clinical Modifications (ICD-9-CM): 386.11) and 6.6 million weighted visits for other PVDs (ICD-9-CM: 386.1-386.9, excluding 386.11 and 386.2) made by patients 18 years and older from 2004 through 2015. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patient, clinical, and physician characteristics were extracted, and descriptive statistics were stratified by referral to PT. Two multivariable logistic regression models were estimated for each diagnostic group (BPPV and other PVDs) to identify predictors of PT referral. RESULTS PT referrals for BPPV increased from 6.2% in the period from 2004 to 2006 to 12.9% in the period from 2013 to 2015, whereas PT referrals for other PVDs decreased from 3.8% in the period from 2004 to 2006 to 0.5% in the period from 2013 to 2015. Other insurance coverage (versus private) and neurologists and other specialists (versus otolaryngologists) were associated with a greater odds of PT referral for BPPV. Visits made in the Midwest and West (versus the Northeast) and in rural versus metropolitan areas had greater odds of PT referral for BPPV. Relative to otolaryngologists, primary care physicians were less likely to refer to PT for other PVDs. Visits made in metropolitan versus rural areas and visits with 1 or more comorbidities (versus none) had greater odds of PT referral for other PVDs. CONCLUSIONS PT referrals remain low for ambulatory care visits for BPPV and other PVDs in the United States. Referral to PT for BPPV and other PVDs varied by insurance type, physician specialty, and office location.
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Affiliation(s)
- Pamela M Dunlap
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
| | - Samannaaz S Khoja
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA; Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA
| | - Janet K Freburger
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
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