The Contribution of Hearing and Hearing Loss to Balance Control

Abstract

This study investigated the hypothesis that a hearing ‘map' of our surroundings is used to maintain balance control. We investigated the effects of sound on postural sway using centre of pressure analysis in 50 subjects with normal hearing, 28 with hearing loss and 19 with vestibular dysfunction. The acoustic environments utilized sound cues that were either present or absent. It was found that auditory cues are utilized by subjects with normal hearing to improve postural sway. The ability to utilize sound for postural control is diminished when there is a hearing loss, but this appears to be overcome by the use of a hearing aid. Patients with additional vestibular deficits exploit auditory cues to a greater degree, suggesting that sensory weighting to enhance the use of auditory cues may be applied when there is diminished sensory redundancy.

Improvements in Gait With Hearing Aids and Cochlear Implants

“…This extends results of previous reports suggesting that spatial auditory cues can improve static balance (1,16), and that hearing instruments may function as balance aids (3,4). Participant M demonstrated consistent, clinically significant improvement while aided, increasing gait velocity by 20.5cm/sec and mini-BESTest by 5 points.…”

“…Our results suggest that optimizing auditory inputs may be an effective tool to improve gait, as previously shown in static conditions (3,4), but may be of clinical utility only in some people. Optimization of benefit could include wearing assistive devices such as hearing aids or cochlear implants, or the thoughtful design of interior spaces to maximize the effectiveness of the acoustic environment.…”

“…Spatial audition is an additional input that can affect stability during quiet standing (1-4). The ability of external auditory inputs to stabilize gait has not been examined and is particularly important as falls are particularly likely to occur during ambulation (5).…”

Scoping Review of Systems to Train Psychomotor Skills in Hearing Impaired Children

“…Balance develops during childhood, becoming a paramount parameter for the achievement of gross motor skills, such as running or jumping/standing on one leg [21]. Auditory inputs provide additional cues to control balance, creating a hearing “map” of surroundings that NH individuals use to maintain balance control and reduce postural sway [16,22]. HI children may experience balance difficulties, especially those with vestibular deficits [23,24] or within the first year of cochlear implants, when children exhibit higher rates of vestibular loss [25,26,27,28].…”

“…HI children tend to use visual feedback in a higher amount than NH children, especially when balance is compromised by sensory disturbance (e.g., irregular surface) and the risk of falling increases [29,30]. Hearing aids, vestibular rehabilitation and physical exercise have proven effective to enhance vestibular adaptation and improve balance in HI children or after cochlear implant surgery [22,25,31]. HI individuals with additional vestibular deficits seem to exploit auditory cues in a higher degree, due to the reduced sensory redundancy [22].…”