Kowalewski Victoria, Patterson Rita, Hartos Jessica, Bugnariu Nicoleta
University of North Texas Health Science Center, USA.
J Prev Med (Wilmington). 2018;3(2). doi: 10.21767/2572-5483.100033. Epub 2018 Apr 9.
The number of steps required to regain balance is an easily obtainable clinical outcome measure. This study assessed whether number of steps during loss of balance could identify older adults with hearing loss who have balance deficits. We aimed to answer two questions: 1) Does hearing loss negatively affect the ability to regain balance, as reflected by an increased number of steps needed to respond to a perturbation while simultaneously attending to speech-in-noise; and 2) Do hearing aids improve balance control, reflected by a decrease in number of steps needed to regain balance?
20 young adults and 20 older adults with normal hearing, and 19 older adults with hearing loss performed an auditory-balance dual-task. Participants were asked to listen and repeat back sentences from a standardized audiology test, while simultaneously responding to backward surface translations. Outcome measures were performed on the auditory test and number of steps needed to regain balance. Repeated measures ANCOVA models were run in using group, time, hearing levels, and perturbation levels as predictors.
Auditory scores confirmed difficulty hearing speech-in-noise in older adults with hearing loss and no hearing aids, and in young and older adults with normal hearing and simulated hearing loss. Results showed that group, auditory and balance conditions are significantly related to both outcomes measures and time is not significant for steps. Older adults with hearing loss had a significant increase in number of steps needed to regain balance compared to young adults and older adults with normal hearing.
Number of steps may be an appropriate clinical assessment tool for identifying fall risk in older adults with hearing loss. Further research needs to be performed to identify proper assessments and treatment interventions for older adults with hearing loss who have balance deficits.
恢复平衡所需的步数是一种易于获得的临床结果指标。本研究评估了平衡丧失期间的步数是否能够识别出存在平衡缺陷的听力损失老年人。我们旨在回答两个问题:1)听力损失是否会对恢复平衡的能力产生负面影响,这表现为在同时注意噪声中的言语时,对干扰做出反应所需的步数增加;2)助听器是否能改善平衡控制,这表现为恢复平衡所需的步数减少?
20名听力正常的年轻成年人、20名听力正常的老年人以及19名听力损失老年人进行了听觉 - 平衡双重任务。参与者被要求听并重复标准化听力测试中的句子,同时对向后的表面平移做出反应。对听觉测试和恢复平衡所需的步数进行结果测量。使用组、时间、听力水平和干扰水平作为预测变量运行重复测量协方差分析模型。
听觉分数证实,在未佩戴助听器的听力损失老年人以及听力正常和模拟听力损失的年轻和老年人中,在噪声中听言语存在困难。结果表明,组、听觉和平衡条件与两种结果测量均显著相关,而时间对步数不显著。与听力正常的年轻成年人和老年人相比,听力损失的老年人恢复平衡所需的步数显著增加。
步数可能是识别听力损失老年人跌倒风险的一种合适的临床评估工具。需要进一步开展研究,以确定针对存在平衡缺陷的听力损失老年人的适当评估和治疗干预措施。