Weaver Tyler S, Shayman Corey S, Hullar Timothy E
Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon.
Otol Neurotol. 2017 Oct;38(9):1327-1332. doi: 10.1097/MAO.0000000000001551.
Auditory input in people with hearing impairment will improve balance while walking.
Auditory input is increasingly recognized as an additional input for balance. Several studies have found auditory cues to improve static balance measured on a sway platform. The effect of audition on gait, a dynamic task also linked to fall risk, has not been fully examined. If a positive effect were shown between audition and balance, it would further indicate that improving hearing could also improve balance.
Inertial sensors quantified gait parameters of 13 bilateral hearing aid users and 12 bilateral cochlear implant (CI) users with their hearing devices on and off. Outcome measures included gait velocity, stride length variability, swing time variability, and double support phase.
Group analysis of each of the gait outcomes showed no significant differences between the aided and unaided conditions in both the hearing aid and CI groups. Gait velocity, an outcome most strongly linked to fall risk had 95% confidence interval differences of -2.16 to 1.52 and -1.45 to 4.17 cm/s in hearing aid and CI users, respectively (aided versus unaided condition). There was considerable variation among participants with some individuals improving in all four parameters.
The overall findings were not statistically significant, however, a small subset of our population improved clinically across several outcomes. This demonstrates that audition may have a clinically beneficial effect on balance in some patients.
听力受损者的听觉输入会在行走时改善平衡。
听觉输入越来越被视为平衡的一种额外输入。多项研究发现听觉线索可改善在摇摆平台上测量的静态平衡。听觉对步态（一项也与跌倒风险相关的动态任务）的影响尚未得到充分研究。如果在听觉与平衡之间显示出积极效果，这将进一步表明改善听力也可以改善平衡。
惯性传感器对13名双侧使用助听器的用户和12名双侧使用人工耳蜗（CI）的用户在佩戴和不佩戴听力设备时的步态参数进行了量化。结果指标包括步态速度、步长变异性、摆动时间变异性和双支撑期。
对每个步态结果的组分析显示，助听器组和人工耳蜗组在佩戴和未佩戴设备的情况下均无显著差异。步态速度是与跌倒风险最密切相关的结果，在助听器用户和人工耳蜗用户中，佩戴与未佩戴设备情况下的95%置信区间差异分别为-2.16至1.52和-1.45至4.17厘米/秒。参与者之间存在相当大的差异，一些个体在所有四个参数上都有所改善。
总体研究结果在统计学上不显著，然而，我们研究人群中的一小部分在多个结果上有临床改善。这表明听觉在某些患者中可能对平衡有临床有益作用。
