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中度听力损失患者的姿势控制能力下降。

Decreased postural control in people with moderate hearing loss.

作者信息

Thomas Ewan, Martines Francesco, Bianco Antonino, Messina Giuseppe, Giustino Valerio, Zangla Daniele, Iovane Angelo, Palma Antonio

机构信息

Sport and Exercise Sciences Research Unit Bio.Ne.C. Department, ENT Section, University of Palermo PosturaLab Center, Palermo, Italy.

出版信息

Medicine (Baltimore). 2018 Apr;97(14):e0244. doi: 10.1097/MD.0000000000010244.

Abstract

Balance is a complex process that involves multiple sensory integrations. The auditory, visual, and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect balance and therefore increase the risk of falling.The aim of this study was to understand whether hearing loss could influence balance, cervical posture, and muscle activation in the cervical region.Thirteen patients (61 ± 13 years; 161.8 ± 11.0 cm; 70.5 ± 15.9 kg) with moderate hearing loss (Right ear -60 ± 21 dB; Left ear -61 ± 24 dB) underwent: an audiometric examination, a postural examination (with open and closed eyes) through a stabilometric platform, a cervical ROM examination through a head accelerometer, and a sternocleidomastoid electromyography (EMG) examination.A linear regression analysis has shown a regression coefficient (R) 0.76 and 0.69 between hearing loss and the posturographic parameters, on the sagittal sway, with open and closed eyes, respectively. The combination of frontal and sagittal sway is able to explain up to 84% of the variance of the audiometric assessment. No differences were found between right and left hemibody between the audiometric, posturographic, cervical ROM parameters, and in EMG amplitude. ROM and EMG parameters have not shown any significant associations with hearing loss, for both right and left head rotation.Hearing loss is associated to increased posturographic measures, especially the sagittal sway, underlining a reduced postural control in people with hearing impairments. No association was found between the heads posture and neck activation with hearing loss. Hearing loss may be associated with an increased risk of falls.

摘要

平衡是一个复杂的过程,涉及多种感觉整合。听觉、视觉和前庭系统是主要的贡献因素。听力损失或听力障碍可能会引发不适当的姿势策略,进而影响平衡,从而增加跌倒风险。本研究的目的是了解听力损失是否会影响平衡、颈椎姿势以及颈部肌肉激活。13名中度听力损失患者(年龄61±13岁;身高161.8±11.0厘米;体重70.5±15.9千克)(右耳-60±21分贝;左耳-61±24分贝)接受了以下检查:听力测试、通过稳定测力平台进行的姿势检查(睁眼和闭眼)、通过头部加速度计进行的颈椎活动度检查以及胸锁乳突肌肌电图(EMG)检查。线性回归分析显示,听力损失与姿势描记参数之间的回归系数(R)在睁眼和闭眼时矢状面摆动分别为0.76和0.69。额面和矢状面摆动的组合能够解释高达84%的听力测试评估方差。在听力测试、姿势描记、颈椎活动度参数以及肌电图振幅方面,左右半侧身体之间未发现差异。对于左右头部旋转,活动度和肌电图参数与听力损失均未显示出任何显著关联。听力损失与姿势描记测量值增加有关,尤其是矢状面摆动,这表明听力受损者的姿势控制能力下降。未发现头部姿势和颈部激活与听力损失之间存在关联。听力损失可能与跌倒风险增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdc4/5902301/c4550f59deb9/medi-97-e0244-g002.jpg

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