Assessing Gait Stability before and after Cochlear Implantation

Kaczmarczyk, Katarzyna; Błażkiewicz, Michalina; Wiszomirska, Ida; Pietrasik, Katarzyna; Zdrodowska, Agnieszka; Wit, Andrzej; Barton, Gábor; Skarżyńśki, Henryk

doi:10.1155/2019/2474273

Cited by 4 publications

(3 citation statements)

References 37 publications

(58 reference statements)

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“…Confirming that high GSR values are associated with poor postural control [ 45 , 57 ], a large, negative and significant association was found. This result suggested the GSR is a predictor of falls in the older adult population, as was found in previous studies [ 58 , 59 ].…”

Section: Discussionsupporting

confidence: 86%

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults

Nascimento

Gouveia

Marques

et al. 2023

JCM

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This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical declines (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.

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Section: Discussionsupporting

confidence: 86%

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults

Nascimento

Gouveia

Marques

et al. 2023

JCM

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“…Authors reported that unilateral CI could alter a previously uncompensated vestibular injury; thus, inducing compensation, greater self-confidence, and improvement in spatial orientation [ 33 , 34 ]. In a recent publication, gait stability was evaluated in 21 patients after CI, finding better parameters than those observed before surgery; the authors report that videonystagmography, vHIT, and VEMP were performed to demonstrate these data, but results are not described in the study; furthermore, these patients did not present vestibular symptoms before implantation [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Control of Disabling Vertigo in Ménière’s Disease Following Cochlear Implantation without Labyrinthectomy

et al. 2022

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Background: The placement of a cochlear implant (CI) can restore auditory function in the case of profound cochlear deafness, which may be due to Ménière’s disease (MD) or be associated with symptoms related to endolymphatic hydrops. The usual treatment of disabling vertigo in MD is based on vestibular deafferentation by labyrinth ablation. The aim of the present study was to retrospectively evaluate the efficacy of the CI in the control of disabling vestibular manifestations in the case of MD unresponsive to medical treatments. Methods: A case series of five MD patients with disabling vestibular manifestations associated with profound hearing loss was included. A complete audio-vestibular evaluation was performed after CI positioning. Results: All patients reported clinical benefits after implant positioning: no vestibular crisis was reported after the surgery. The vHIT and the caloric test showed a normal function or a mild vestibular hypofunction. The auditory performances were comparable to those in the general implanted population. All patients reported subjective tinnitus reduction. Conclusions: To date, very few studies have reported vestibular outcomes in hydropic pathology on the implanted side; our results are encouraging. We can therefore confirm the efficacy and safety of the CI as a unique treatment for hearing loss, dizziness, and tinnitus in case of disabling cochlear hydrops, especially in those patients where the history of the disease requires preservation of the vestibular function.

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“…Since no patient in our study had a conspicuous result in the Romberg test, it can be concluded that neither preoperatively nor postoperatively was a central lesion present. Kaczmarczyk et al (45) who used the Romberg test to assess gait stability before and after cochlear implantation, also found no increased stance or gait instability postoperatively.…”

Section: Romberg Testmentioning

confidence: 98%

Vertigo Associated With Cochlear Implant Surgery: Correlation With Vertigo Diagnostic Result, Electrode Carrier, and Insertion Angle

et al. 2021

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Objective: Vertigo is a common side effect of cochlear implant (CI) treatment. This prospective study examines the incidence of postoperative vertigo over time and aims to analyze influencing factors such as electrode design and insertion angle (IA).Study Design and Setting: This is a prospective study which has been conducted at a tertiary referral center (academic hospital).Patients: A total of 29 adults were enrolled and received a unilateral CI using one of six different electrode carriers, which were categorized into “structure-preserving” (I), “potentially structure-preserving” (II), and “not structure-preserving” (III).Intervention: Subjective vertigo was assessed by questionnaires at five different time-points before up to 6 months after surgery. The participants were divided into four groups depending on the time of the presence of vertigo before and after surgery. Preoperatively and at 6 months postoperatively, a comprehensive vertigo diagnosis consisting of Romberg test, Unterberger test, subjective visual vertical, optokinetic test, video head impulse test, and caloric irrigation test was performed. In addition, the IA was determined, and the patients were divided in two groups (<430°; ≥430°).Main Outcome Measures: The incidence of vertigo after CI surgery (group 1) was reported, as well as the correlation of subjective vertigo with electrode array categories (I–III) and IA.Results: Among the participants, 45.8% experienced new vertigo after implantation. Based on the questionnaire data, a vestibular origin was suspected in 72.7%. The results did not show a significant correlation with subjective vertigo for any of the performed tests. In group 1 with postoperative vertigo, 18% of patients showed conspicuous results in a quantitative analysis of caloric irrigation test despite the fact that the category I or II electrodes were implanted, which are suitable for structure preservation. Average IA was 404° for the overall group and 409° for group 1. There was no statistically significant correlation between IA and perceived vertigo.Conclusions: Though vertigo after CI surgery seems to be a common complication, the test battery used here could not objectify the symptoms. Further studies should clarify whether this is due to the multifactorial cause of vertigo or to the lack of sensitivity of the tests currently in use. The proof of reduced probability for vertigo when using atraumatic electrode carrier was not successful, nor was the proof of a negative influence of the insertion depth.

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Assessing Gait Stability before and after Cochlear Implantation

Cited by 4 publications

References 37 publications

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults

Control of Disabling Vertigo in Ménière’s Disease Following Cochlear Implantation without Labyrinthectomy

Vertigo Associated With Cochlear Implant Surgery: Correlation With Vertigo Diagnostic Result, Electrode Carrier, and Insertion Angle

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