Biophysiological and audiological variables in adults

Leisure-time physical activity and incidence of objectively assessed hearing loss: The Niigata Wellness Study

Previous cohort study reported that high physical activity was associated with a low risk of self-reported hearing loss in women. However, no studies have examined the association between physical activity and the development of hearing loss as measured using an objective assessment of hearing loss in men and women. Here, we used cohort data to examine the association between leisure-time physical activity and incidence of objectively assessed hearing loss in men and women. Participants included 27 537 Japanese adults aged 20-80 years without hearing loss, who completed a self-administered physical activity questionnaire between April 2001 and March 2002. The participants were followed up for the development of hearing loss as measured by audiometry between April 2002 and March 2008. During follow-up, 3691 participants developed hearing loss. Compared with the none physical activity group, multivariable adjusted hazard ratios (HRs) for developing hearing loss were 0.93 (95% confidence interval (CI), 0.86-1.01) and 0.87 (0.81-0.95) for the medium (<525 MET-min/week) and high (≥525 MET-min/week) physical activity groups, respectively (p for trend = 0.001). The magnitude of risk reduction was slightly greater in vigorous-intensity activity than in moderate-intensity activity (p for interaction = 0.01). Analysis by sound frequency showed that the amount of physical activity was inversely associated with high frequency hearing loss development (p for trend <0.001), but not with low frequency hearing loss development (p for trend = 0.19). Higher level of leisure-time physical activity was associated with lower incidence of hearing loss, particularly for vigorous-intensity activities and high sound frequencies.

A Prospective Cohort Study of Muscular and Performance Fitness and Risk of Hearing Loss: The Niigata Wellness Study

BACKGROUND

Several cross-sectional studies have linked higher physical fitness with better hearing sensitivity but have not established a causal relation; none have used a prospective design that is less susceptible to bias. We used a prospective cohort study to investigate the association between muscular and performance fitness and the incidence of hearing loss.

METHODS

A total of 21,907 participants without hearing loss received physical fitness assessments between April 2001 and March 2002. Muscular and performance fitness index, an age- and sex-specific summed z-score based on grip strength, vertical jump height, single-leg balance, forward bending, and whole-body reaction time was calculated. Participants were classified into quartiles according to the muscular and performance fitness index and each physical fitness test. They were followed up for the development of hearing loss, assessed by pure-tone audiometry at annual health examinations between April 2002 and March 2008. Hazard ratios and 95% confidence intervals for hearing loss incidence were estimated using Cox proportional hazards regression models.

RESULTS

During follow-up, 2765 participants developed hearing loss. The hazard ratios (95% confidence intervals) for developing hearing loss across the muscular and performance fitness index quartiles (lowest to highest) were 1.00 (reference), 0.88 (0.79-0.97), 0.83 (0.75-0.93), and 0.79 (0.71-0.88) (P_trend <.001). Among the various physical fitness components, a clear dose-response association with hearing loss incidence was observed for vertical jump height and single-leg balance (P_trend <.001 for both).

CONCLUSION

Higher muscular and performance fitness is associated with a lower incidence of hearing loss.

An unusual case of sudden sensorineural hearing loss after cycling class

In this case report, our patient developed sudden sensorineural hearing loss (SSNHL) after loud noise exposure during a popular cardiovascular group exercise cycling class. To increase awareness among all healthcare professionals of the effects of these modern-day group fitness classes on hearing loss, we describe this case and review the current literature on SSNHL and its management. A 35-year old man developed SSNHL in the setting of loud noise exposure during a high intensity aerobic exercise class. After a short course of oral steroids with no improvement, intratympanic steroids were administered weekly for three weeks. The patient showed minimal improvement; thus, hyperbaric oxygen therapy was conducted. Serial audiograms continued to show severe to profound mixed hearing loss in the right ear. In conclusion, individuals who participate in loud, high-intensity aerobic group-exercise classes should be careful of the potential for noise-induced hearing loss. Aerobic exercise may make these individuals more susceptible to noise-induced hearing loss. Early intervention is critical for any chance of recovery.

Relationships among measures of physical activity and hearing in African Americans: The Jackson Heart Study

OBJECTIVES/HYPOTHESIS

To evaluate the relationships among measures of physical activity and hearing in the Jackson Heart Study.

STUDY DESIGN

Prospective cohort study.

METHODS

We assessed hearing on 1,221 Jackson Heart Study participants who also had validated physical activity questionnaire data on file. Hearing thresholds were measured across frequency octaves from 250 to 8,000 Hz, and various frequency pure-tone averages (PTAs) were constructed, including PTA4 (average of 500, 1,000, 2,000, and 4,000 Hz), PTA-high (average of 4,000 and 8,000 Hz), PTA-mid (average of 1,000 and 2,000 Hz), and PTA-low (average of 250 and 500 Hz). Hearing loss was defined for pure tones and pure-tone averages as >25 dB HL in either ear and averaged between the ears. Associations between physical activity and hearing were estimated using linear regression, reporting changes in decibel hearing level, and logistic regression, reporting odds ratios (OR) of hearing loss.

RESULTS

Physical activity exhibited a statistically significant but small inverse relationship with PTA4, -0.20 dB HL per doubling of activity (95% confidence interval [CI]: -0.35, -0.04; P = .016), as well as with PTA-low and pure tones at 250, 2,000, and 4,000 Hz in adjusted models. Multivariable logistic regression modeling supported a decrease in the odds of high-frequency hearing loss among participants who reported at least some moderate weekly physical activity (PTA-high, OR: 0.69 [95% CI: 0.52, 0.92]; P = .011 and 4000 Hz, OR: 0.75 [95% CI: 0.57, 0.99]; P = .044).

CONCLUSIONS

Our study provides further evidence that physical activity is related to better hearing; however, the clinical significance of this relationship cannot be estimated given the nature of the cross-sectional study design.

LEVEL OF EVIDENCE

2b Laryngoscope, 126:2376-2381, 2016.

Association between accelerometer-assessed physical activity and objectively measured hearing sensitivity among U.S. adults with diabetes

PURPOSE

The purpose of this study was to examine the association between objectively measured physical activity and hearing sensitivity among a nationally representative sample of U.S. adults with diabetes.

METHOD

Data from the 2003-2006 National Health and Nutrition Examination Survey were used. One hundred eighty-four U.S. adults with diabetes wore an ActiGraph 7164 accelerometer and had their hearing function objectively assessed. A negative binomial logistic regression was used to examine the association between moderate-to-vigorous physical activity (MVPA) and hearing sensitivity. RESULTS were adjusted for age, gender, race/ethnicity, education, body mass index, comorbidity index, marital status, cotinine, homocysteine, high-density lipoprotein cholesterol, glycohemoglobin (HbA1c), C-reactive protein, microalbuminuria, noise exposure, and vision impairment.

RESULTS

Compared to those with hearing within normal limits, results showed that participants with mild hearing loss and moderate or greater hearing loss, respectively, engaged in 93% fewer minutes of MVPA (incident rate ratio = 0.07; 95% CI [0.01, 0.60]) and 94% fewer minutes of MVPA (incident rate ratio = 0.06; 95% CI [0.01, 0.54]).

CONCLUSION

Adults with diabetes who have greater hearing impairment are less physically active. Future research is needed to determine the direction of causality.

Association Between Cardiorespiratory Fitness and Hearing Sensitivity

Purpose

As a follow-up to previous smaller scale studies, the purpose of the present study was to examine the link between cardiorespiratory fitness and hearing sensitivity using a nationally representative U.S. sample of adults.

Method

Data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES; U.S. Centers for Disease Control and Prevention [CDC], 2011) were used in the analyses. After exclusions, the final sample included 1,082 NHANES participants ages 20–49 years. Maximum oxygen uptake (VO 2max ) was obtained from an established nonexercise prediction equation and through heart-rate extrapolation during a treadmill-based submaximal test. Audiometry data were objectively measured to obtain estimates of low (LPTA) and high (HPTA) pure-tone frequency average.

Results

VO 2max was not associated with hearing sensitivity when using the heart-rate extrapolation method but was significantly associated with hearing sensitivity (for women) when applying the nonexercise prediction equation for both LPTA and HPTA ( p < .01). Women with higher predicted cardiorespiratory fitness were 6% more likely than women with lower predicted cardio-respiratory fitness to have good hearing compared to worse hearing.

Conclusion

Cardiorespiratory fitness was associated with hearing sensitivity when using the nonexercise prediction equation to measure VO 2max . Further studies are needed to confirm these findings. Findings suggest a potentially auditory-protective effect of cardiorespiratory fitness.

The influence of cardiovascular health on peripheral and central auditory function in adults: a research review

PURPOSE

This article provides a comparative review of research that has been conducted over the past 60+ years on the influence of cardiovascular health on the function of the peripheral and central auditory systems, and findings on the influence of improvements in cardiovascular health on those same systems.

METHOD

Research spanning the past 6 decades reviewed for this article has both hypothesized and confirmed the cardiovascular system's effects on the peripheral and central auditory systems. A review of the influence of the cardiovascular system is presented in this article, and a potential new avenue for auditory rehabilitation is postulated. The review presented in this article does not represent all studies conducted in the topic area but does provide an in-depth look into this fascinating area of research.

CONCLUSIONS

The negative influence of impaired cardiovascular health on both the peripheral and central auditory system and the potential positive influence of improved cardiovascular health on these same systems have been found through a sizable body of research that has been conducted over more than 6 decades. The most significant positive relationship between improved cardiovascular health and improvements in those auditory systems has been found among older adults. If that relationship continues to be confirmed, then a potential new avenue for auditory rehabilitation on behalf of adults who possess impaired auditory function may be discovered.

Association between cardiovascular health and hearing function: pure-tone and distortion product otoacoustic emission measures

PURPOSE

A reduction in hearing sensitivity is often considered to be a normal age-related change. Recent studies have revisited prior ways of thinking about sensory changes over time, uncovering health variables other than age that play a significant role in sensory changes.

METHOD

In this cross-sectional study, cardiovascular (CV) health, pure-tone thresholds at 1000 to 4000 Hz, and distortion product otoacoustic emissions (DPOAEs), with and without contralateral noise, were measured in 101 participants age 10-78 years.

RESULTS

Persons in the "old" age category (49-78 years) had worse pure-tone hearing sensitivity and DPOAEs than persons in the younger age categories (p < .05), affirming an age effect. Although hearing decline occurred in all persons in all CV fitness categories of every age group, those with low CV fitness in the old age group had significantly worse pure-tone hearing at 2000 and 4000 Hz (p <.05). Otoacoustic emission measurements were better for the old high-fit group but not significantly influenced by CV fitness level across age groups.

CONCLUSIONS

Results of the current study elucidate the potentially positive impact of CV health on hearing sensitivity over time. This finding was particularly robust among older adults.

Effects of exercise training on hearing ability

This study was designed to determine whether improvements in both cardiovascular fitness and hearing sensitivity occurred following 2 months of aerobic exercise training. Seventeen moderately-low fit (VO2 peak <32 ml/kg/min) young adults were evaluated for cardiovascular fitness and pure-tone and temporary threshold shifts (TTS) at 2, 3, and 4 kHz before and following 10 min of noise. Subjects exercised for 8 weeks by cycling on a bicycle ergometer at 70% of their peak oxygen consumption (VO2 peak). Average VO2 peak increased 34% (p < 0.05) above pre-exercise training levels. Both pure-tone hearing (2 and 3 kHz) and TTS improved following 2 months of exercise training at the evaluated frequencies (2, 3, and 4 kHz) (p < 0.05). Cardiovascular health as indicated by VO2 peak was associated with hearing sensitivity. Although the mechanisms have not been identified, these results support the existence of a cardiovascular health-hearing synergism.

Influence of fitness on susceptibility to noise-induced temporary threshold shift

PURPOSE

Two earlier reports indicated that cardiovascular fitness attenuates susceptibility to noise-induced temporary threshold shift (TTS) in hearing sensitivity; however, other parameters of fitness also may be related to this phenomenon. This study investigated the association of three different physical fitness indicators on TTS.

METHODS

Maximal aerobic power (VO2max), body composition. and recent activity history were determined in 33 normal-hearing females of various fitness levels. Audiometric thresholds were obtained at 2000, 3000, 4000, and 6000 Hz before and immediately after 10 min of exposure to 108-dB SPL narrow-band noise centered at 2000 Hz.

RESULTS

All postnoise measurements were significantly less than prenoise measurements (P < 0.0001) with the greatest TTS occurring at 3000 Hz. Similarly, the strongest Pearson-product correlations for VO2max, % fat, and recent activity history with TTS occurred at 3000 Hz (r = -0.68, 0.60, -0.59, respectively; P < 0.05). Canonical correlation analysis indicated a moderate correlation between physical fitness and TTS (Rc = 0.71: P < 0.01). Individually, VO2max, % fat, and recent activity history had correlations of -0.70, 0.62, and -0.63, respectively, to the TTS canonical variable.

CONCLUSIONS

From these results, we concluded that there is a moderate association of physical fitness and diminished temporary hearing loss experienced after noise exposure.

Temporary threshold shift induced by physical exercise

Several studies have demonstrated how physical exercise can increase noise-induced temporary threshold shifts (TTS), but until now no evidence of TTS exclusively attributable to physical activity has yet been reported. In this study the hearing pure-tone thresholds of 10 subjects were evaluated at rest and at three designated times following the end of a work load corresponding to 50% and 80% of the maximum oxygen uptake (VO2 max). The results obtained demonstrate a definite effect of physical exercise on the hearing threshold at 6000 and 8000 Hz and that the higher the frequency, the greater the chance of detecting a TTS. Evaluation of the variations in some physiologic parameters (VO2 max, blood lactate and blood pressure) could not statistically correlate the same with TTS. The physiopathologic mechanisms responsible for TTS are still unknown and require further studies which should make allowances for the deferred effects of metabolic variations on the cochlear function.

Cardiovascular adjustments to high- and low-intensity exercise do not regulate temporary threshold shifts

Sixteen adults cycled for 10 min at low and high intensities--with and without noise. The noise consisted of a 1/3 octave band-filtered noise with a 2,000 Hz center frequency at 104 dB SPL. Regardless of whether or not noise was present, systolic blood pressure increased 14% and 40% above rest during low- and high-intensity exercise, respectively. Heart rate also increased above rest (36% and 90%) during low- and high-intensity exercise, respectively. Temporary threshold shifts (TTS) at 3,000, 4,000 and 6,000 Hz could not be differentiated following low- and high-intensity exercise when noise was not present. We report significant TTS at the three frequencies following 10 min of noise exposure with or without low- or high-intensity exercise. TTS was not influenced by either the 14-40% increase in blood pressure or the 36-90% increase in heart rate induced by exercise. The inability of noise alone to influence either blood pressure or heart rate appears to implicate systems other than the cardiovascular in the regulation of hearing sensitivity.

The influence of physical exercise on susceptibility to noise-induced temporary threshold shift

In order to investigate whether physical exercise would influence susceptibility to temporary threshold shift (TTS), 9 subjects were exposed to a narrow-band noise at 105 dB SPL for 10 min three times in each of four test conditions. In three of the test conditions, noise exposure was combined with physical exercise at a level of 40% of the individual subject's maximum work capacity. Under these conditions, subjects were exposed to the noise before, during, or after exercise. In the fourth condition, subjects were exposed to the noise only. The results indicated that noise with simultaneous exercise increased the TTS susceptibility when compared with the other test conditions (p less than or equal to 0.05).

Is there a relationship between hypercholesterolaemia and noise-induced hearing loss?

Many investigators who have analysed the possible correlation between hearing loss and high serum cholesterol levels have found that hearing appears to be influenced by high blood lipids. Noise, as is well known, also influences hearing, particularly at high frequencies. It increases serum cholesterol levels during short-term experiments. The present investigation addresses the question of a possibly increased ototraumatic influence by the combination of high serum cholesterol levels and occupational noise exposure. Seventy-eight 50-year-old men with high serum cholesterol levels from a WHO study were compared with 75 50-year-old men who were randomly selected from the same WHO material. Group mean audiograms showed that hearing was similar in both groups, with a moderate high frequency hearing loss having a configuration suggestive of a noise-induced hearing loss. Analysis of the individual histories and the pure-tone audiograms showed that noise was the most predominant factor influencing hearing at any specific frequency or combination of frequencies. There was a statistically significant tendency for the high-cholesterol group that had suffered the most noise exposure, to have a high-frequency hearing loss. There was also a tendency for the low-cholesterol group to have a high-frequency loss if they had been excessively exposed to occupational noise. No further correlations were found. The present results indicate a slightly increased risk of acquiring a high-frequency sensorineural hearing loss for people who work in noisy environments and have high serum cholesterol levels.

The effect of a four-month physical fitness program on a young and an old group matched for physical fitness

A young (X = 36.8 years) and an old (X = 52.9 years) group (n = 12) matched for physical fitness performed a graded exercise test at the beginning and after a 4-month physical fitness program consisting of calisthenics, jogging, and recreational activities. The purpose of the study was to determine if there were any differences in response to physical training in the two age groups of similar fitness. Sixteen physiological and four biochemical variables were measured. There was no significant difference in VO2 max between the young and old groups. Also, there were no significant differences between groups for serum total lipids, cholesterol, triglycerides, or glucose levels. The effects of the training program were similar for both the young and old groups.

Influence of physical fitness on second- and third-order personality factors using orthogonal and oblique rotations

The study investigated the relationship between physical fitness and personality variables at second- and third-order factor-analytic structures. Further, the stability of the factor structures at pre- and post-physical fitness program tests was examined by orthogonal and oblique rotations. Physical fitness and personality data were collected on 56 middle-aged males. The fitness and personality variables were factor analyzed and rotated orthogonally and obliquely by the principal axis form of solution. As a result, five second-order factors were extracted, both initially and finally. Factor scores were estimated for each S on each of the second-order factors, and data were factor analyzed to extract the third-order factors. The second-order factors closely resembled Cattell's factors, but subtle differences were found to exist between initial and final factor structures that may have been due to the influence of the fitness program. Two third-order factors were extracted initially and three finally when the factor scores were rotated orthogonally and obliquely, and physical fitness was associated with two of these hierarchical factors both initially and finally. The hierarchical factor structures appeared to be comparable to the scales of Eysenck. On the basis of the present findings it was concluded that the problem of rotation was not of importance and scientifically uninteresting and that the hierarchical factor solutions were highly stable. Further, it appears that the hierarchical levels of personality are manifested in two syndromes confounded by "traits" and "states" of personality. These two syndromes are Introversion vs. Extraversion and Neuroticism vs. Stability. The extraction of additional factors, such as Low Superego Strength vs. High Superego Strength, as in this study, is completely dependent upon the treatment or conditions superimposed.

Cardiovascular risk factors and hearing loss. A study of 1,000 fifty-year-old men

The hypothesis that cardiovascular risk factors might be of importance in the development of sensori-neural hearing loss was tested in a material of 1000 fifty-year-old men. No significant correlations were found. The present study confirmed the well-known observation that the left ear usually is poorer than the right. Hearing loss in the right ear was found to be related to the smoking habits in the groups with no history of noise exposure. The explanation for this is discussed. Hearing loss was more common in social class 3 than in the other social classes. This difference was principally referable to noise exposure but also to conductive hearing loss. A prospective study of this material will further analyze the question concerning a possible relationship between cardiovascular risk factors and hearing loss.