Postural control assessment in students with normal hearing and sensorineural hearing loss

Melo, Renato de Souza; Lemos, Andrea; Macky, Carla Fabiana da Silva Toscano; Raposo, Maria Cristina Falcão; Ferraz, Karla Mônica

doi:10.1016/j.bjorl.2014.08.014

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Original Articles • Braz. j. otorhinolaryngol. 81 (4) • Jul-Aug 2015 • https://doi.org/10.1016/j.bjorl.2014.08.014 copy

Postural control assessment in students with normal hearing and sensorineural hearing loss^☆ ☆ Please cite this article as: Melo RS, Lemos A, Macky CF, Raposo MC, Ferraz KM. Postural control assessment in students with normal hearing and sensorineural hearing loss. Braz J Otorhinolaryngol. 2015;81:431-8. ^☆☆ ☆☆ Institution: Department of Physiotherapy, Universidade Federal de Pernambuco, Recife, Pernambuco, PE, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION:

Children with sensorineural hearing loss can present with instabilities in postural control, possibly as a consequence of hypoactivity of their vestibular system due to internal ear injury.

OBJECTIVE:

To assess postural control stability in students with normal hearing (i.e., listeners) and with sensorineural hearing loss, and to compare data between groups, considering gender and age.

METHODS:

This cross-sectional study evaluated the postural control of 96 students, 48 listeners and 48 with sensorineural hearing loss, aged between 7 and 18 years, of both genders, through the Balance Error Scoring Systems scale. This tool assesses postural control in two sensory conditions: stable surface and unstable surface. For statistical data analysis between groups, the Wilcoxon test for paired samples was used.

RESULTS:

Students with hearing loss showed more instability in postural control than those with normal hearing, with significant differences between groups (stable surface, unstable surface) (p < 0.001).

CONCLUSIONS:

Students with sensorineural hearing loss showed greater instability in the postural control compared to normal hearing students of the same gender and age.

Motor skills; Vestibular diseases; Psychomotor performance; Posture; Deafness

Groups	Listeners		Hearing loss		p
	n	(%)	n	(%)
Volunteers	48	(100)	48	(100)	–

Gender
Female	24	(50)	24	(50)	–
Male	24	(50)	24	(50)	–
Age, years (mean)	12.5 ± 3.5	(100)	12.5 ± 3.5	(100)	–

Handedness
Right-handed	45	(93.7)	41	(85.4)	0.181^a
Left-handed	03	(6.3)	07	(14.6)

Degrees of hearing loss:
Mild to moderate	–	–	04	(8.3)	–
Severe to profound	–	–	44	(91.7)

	Listeners (n = 48)	Hearing loss (n = 48)	p
	Mean (CI)	Mean (CI)
Double support (ground)	0.00 (0.00; 0.00)	0.77 (0.28; 1.26)	0.001^a
Single leg support (ground)	2.79 (2.41; 3.17)	5.16 (4.47; 5.86)	<0.001^a
Foot ahead of the other (ground)	0.31 (0.06; 0.56)	3.70 (2.96; 4.45)	<0.001^a
Mean (ground)	1.03 (0.88; 1.88)	3.21 (2.68; 3.74)	<0.001^a

Double support (foam)	0.02 (-0.02; 0.06)	2.73 (1.61; 3.84)	<0.001^a
Single leg support (foam)	4.31 (4.31; 4.60)	7.40 (6.80; 8.00)	<0.001^a
Foot ahead of the other (foam)	1.50 (1.05; 1.95)	6.20 (5.30; 7.10)	<0.001^a
Mean (foam)	1.94 (1.74; 2.14)	5.45 (4.65; 6.23)	<0.001^a

	Female			Male
	Listeners (n = 24)	Hearing loss (n = 24)	p	Listeners (n = 24)	Hearing loss (n = 24)	p
	Mean (CI)	Mean (CI)		Mean (CI)	Mean (CI)
Double support (ground)	0.00 (0.00; 0.00)	0.62 (-0.2; 1.27)	0.042^a	0.00 (0.00; 0.00)	0.91 (0.14; 1.70)	0.011^a
Single leg support (ground)	2.95 (2.38; 3.55)	5.25 (4.30; 6.20)	<0.001^a	2.62 (2.10; 3.15)	5.08 (4.00; 6.18)	0.002^a
Foot ahead of the other (ground)	0.50 (0.70; 0.93)	3.41 (2.26; 4.57)	<0.001^a	0.12 (-0.13; 0.38)	4.00 (3.00; 5.01)	<0.001^a
Mean (ground)	1.15 (0.91; 1.40)	3.10 (2.31; 3.90)	<0.001^a	0.92 (0.71; 1.11)	3.33 (2.55; 4.11)	<0.001^a

Double support (foam)	0.00 (0.00; 0.00)	2.25 (0.70; 3.80)	0.007^a	0.42 (-0.04; 0.13)	3.20 (1.51; 4.90)	0.002^a
Single leg support (foam)	4.45 (4.00; 4.90)	6.87 (5.60; 7.75)	<0.001^a	4.16 (3.76; 4.57)	7.91 (7.09; 8.74)	<0.001^a
Foot ahead of the other (foam)	1.75 (1.06; 2.43)	5. 60 (4.12; 7.05)	<0.001^a	1.25 (0.62; 1.88)	6.83 (5.68; 8.00)	<0.001^a
Mean (foam)	2.07 (1.75; 2.38)	4.90 (3.75; 6.05)	<0.001^a	1.82; (1.56; 2.07)	6.00 (4.90; 7.10)	<0.001^a

	7–10 years			11–14 years			15–18 years
	Listeners (n = 16)	Hearing loss (n = 16)	p	Listeners (n = 16)	Hearing loss (n = 16)	p	Listeners (n = 16)	Hearing loss (n = 16)	p
	Mean (CI)	Mean (CI)		Mean (CI)	Mean (CI)		Mean (CI)	Mean (CI)
Double support (ground)	0.00 (0.00; 0.00)	1.94 (0.61; 3.26)	0.011^a	0.00 (0.00; 0.00)	0.31 (-0.01; 0.63)	0.059^a	0.00 (0.00; 0.00)	0.06 (-0.07; 0.20)	0.317^a
Single leg support (ground)	3.56 (2.80; 4.31)	5.62 (4.08; 7.16)	0.014^a	2.37 (1.73; 3.01)	5.68 (4.55; 6.81)	0.001^a	2.44 (1.92; 2.95)	4.20 (3.17; 5.20)	0.014^a
Foot ahead of the other (ground)	0.25 (-114; 0.61)	5.37 (4.00; 6.74)	0.001^a	0.37 (-0.17; 0.92)	3.75 (2.87; 4.63)	0.001^a	0.31 (-0.15; 0.78)	2.00 (0.80; 3.20)	0.019^a
Mean (ground)	1.27 (0.97; 1.56)	4.31 (3.10; 5.52)	0.001^a	0.91 (0.63; 1.20)	3.25 (2.70; 3.80)	<0.001^a	0.91 (0.68; 1.15)	2.10 (1.40; 2.76)	0.009^a
Double support (foam)	0.00 (0.00; 0.00)	5.50 (3.21; 7.78)	0.002^a	0.00 (0.00; 0.00)	1.62 (0.10; 3.14)	0.026^a	0.07 (-0.07; 0.20)	1.06 (-0.36; 2.50)	0.144^a
Single leg support (foam)	4.81 (4.25; 5.37)	8.62 (7.61; 9.63)	0.001^a	4.00 (3.44; 4.55)	7.31 (6.38; 8.24)	<0.001^a	4.12 (3.70; 4.55)	6.25 (5.21; 7.30)	0.003^a
Foot ahead of the other (foam)	1.75 (0.90; 2.60)	8.62 (7.56; 9.70)	0.001^a	0.88 (0.17; 1.57)	6.25 (5.26; 7.23)	0.001^a	1.87 (1.00; 2.74)	3.75 (2.00; 5.51)	0.058^a
Mean (foam)	2.18 (1.80; 2.56)	7.58 (6.24; 8.92)	<0.001^a	1.62 (1.30; 1.96)	5.06 (4.14; 6.00)	<0.001^a	2.02 (1.70; 2.35)	3.70 (2.46; 4.91)	0.008^a

	Mild/moderate (n = 04)	Severe/profound (n = 44)	p
	Mean (CI)	Mean (CI)
Double support (ground)	0.25 (-0.54; 1.04)	0.82 (0.29; 1.35)	0.843^a
Single leg support (ground)	2.00 (-0.25; 4.25)	5.45 (4.76; 6.14)	0.002^a
Foot ahead of the other (ground)	1.00 (-2.20; 4.20)	3.95 (3.20; 4.70)	0.031^a
Mean (ground)	1.09 (-0.73; 2.89)	3.41 (2.87; 3.95)	0.005^a

Double support (foam)	1.25 (-1.14; 3.63)	2.86 (1.65; 4.07)	0.787^a
Single leg support (foam)	5.75 (3.03; 8.46)	7.54 (6.92; 8.16)	0.106^a
Foot ahead of the other (foam)	3.00 (-0.89; 6.90)	6.50 (5.56; 7.43)	0.031^a
Mean (foam)	3.33 (0.52; 6.14)	5.63 (4.81; 6.45)	0.125^a

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail: renatomelo10@hotmail.com (R.S. Melo).