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报告平衡功能良好的聋人存在显著的前庭功能障碍。

Deaf Individuals Who Report Having Good Balance Function Present with Significant Vestibular Deficits.

机构信息

Department of Hearing, Speech and Language Sciences, Gallaudet University, Washington, District of Columbia.

出版信息

J Am Acad Audiol. 2021 Sep;32(8):510-520. doi: 10.1055/s-0041-1731732. Epub 2021 Dec 29.

Abstract

BACKGROUND

Vestibular and/or balance deficits are well documented in deaf individuals. In the adult population, poor vestibular and/or balance function can lead to activity limitations and increased risk of falling. An effective case history by health care providers to probe for potential balance concerns is necessary for appropriate referral; however, patients may not consistently report vestibular and balance symptoms. Currently, there is little information available as to how deaf individuals report these symptoms and how their reported balance ability relates to measures of balance and vestibular functions.

PURPOSE

The aim of the current study was to evaluate self-perceived balance ability in participants who self-identify as either deaf or hearing, and compare these results to measures of balance and vestibular functions.

RESEARCH DESIGN

This is a prospective, between-group design.

STUDY SAMPLE

Data from 57 adults between the ages of 18 to 29 years who self-reported as deaf (39) or hearing (18) were evaluated. Participants completed the activities-specific balance confidence (ABC) scale, a brief case history, self-report rating of balance (SRRB), the Modified Clinical Test of Sensory Integration of Balance (mCTSIB), along with both ocular vestibular-evoked myogenic potentials (oVEMPs) and cervical vestibular-evoked myogenic potentials (cVEMPs). Only participants with SRRBs of good or excellent were included in the inferential analyses.

RESULTS

Proportions of participants rating their balance ability as either good or excellent were similar between both groups, as were the results on the ABC scale. Statistical analyses revealed significant associations between the groups on both oVEMPs and cVEMPs. No significant differences were observed on sway velocities in any of the mCTSIB conditions; however, more than one-third of deaf participants had mCTSIB Condition 4-on foam, eyes closed-scores above 2 standard deviations of the hearing group.

CONCLUSION

Deaf participants self-report similar ratings of balance ability as hearing participants despite significant differences in vestibular function. A relatively large subset of deaf participants had increased sway velocity on balance function testing that required increased reliance on vestibular cues. A thorough discussion of balance and vestibular symptoms should be completed when a patient who self-identifies as deaf is seen by a health care provider so that appropriate screenings or referrals can be completed as necessary.

摘要

背景

失聪人群的前庭和/或平衡功能障碍已得到充分证实。在成年人群中,前庭和/或平衡功能不佳可能导致活动受限和跌倒风险增加。医疗保健提供者通过有效的病史调查来探查潜在的平衡问题是必要的,以进行适当的转介;然而,患者可能不会始终报告前庭和平衡症状。目前,关于失聪个体如何报告这些症状以及他们报告的平衡能力与平衡和前庭功能测量结果的关系,信息甚少。

目的

本研究旨在评估自我报告的平衡能力在自我认同为聋人或听力正常的参与者中的表现,并将这些结果与平衡和前庭功能的测量结果进行比较。

研究设计

这是一项前瞻性的分组设计。

研究样本

评估了年龄在 18 至 29 岁之间的 57 名自我报告为聋人(39 名)或听力正常(18 名)的成年人的数据。参与者完成了活动特异性平衡信心(ABC)量表、简要病史、平衡自我报告评分(SRRB)、改良临床感觉综合平衡测试(mCTSIB)、眼源性前庭诱发肌源性电位(oVEMPs)和颈源性前庭诱发肌源性电位(cVEMPs)。只有 SRRB 评分为良好或优秀的参与者才被纳入推论分析。

结果

两组参与者自我评定平衡能力为良好或优秀的比例相似,ABC 量表的结果也相似。统计分析显示,两组在 oVEMPs 和 cVEMPs 上均存在显著关联。在任何 mCTSIB 条件下,摆动速度均无显著差异;然而,超过三分之一的聋人参与者在 mCTSIB 条件 4-泡沫,闭眼条件下的得分高于听力组的 2 个标准差。

结论

尽管前庭功能存在显著差异,但聋人参与者自我报告的平衡能力评分与听力参与者相似。相当一部分聋人参与者在需要更多依赖前庭线索的平衡功能测试中,摆动速度增加。当医疗保健提供者看到自我认同为聋人的患者时,应充分讨论平衡和前庭症状,以便根据需要完成适当的筛查或转介。

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