Vestibular function in adults with intellectual disabilities: feasibility and outcome of a vestibular screening protocol in Special Olympics athletes

Leyssens, Laura; Hecke, Ruth Van; Moons, Karlien; Luypaert, Sofie; Willems, Melina; Danneels, Maya; Martens, Sarie; Dhondt, Cleo; Maes, Leen

doi:10.1080/14992027.2020.1834633

Cited by 4 publications

(7 citation statements)

References 69 publications

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“…Participants were instructed to fixate a small visual target at 1.50 m distance, while the examiner performed unpredictable and abrupt head impulses (10° to 20° amplitude) in the horizontal, LARP (stimulation of left anterior and right posterior SCC), and RALP (stimulation of right anterior and left anterior SCC) planes. Afterward, the data were thoroughly cleaned respecting the following criteria: (1) head velocity between 120 (LARP and RALP) or 150 (horizontal) and 250 °/s and (2) head bounce below 25% of the peak head velocity (MacDougall et al 2016; Leyssens et al 2021a). Recordings with very noisy eye traces or eye blinks were deleted, based on the video recording and obtained traces of the measurement.…”

Section: Methodsmentioning

confidence: 99%

Assessing the Clinical Value of Objective and Patient-Reported Audiovestibular Outcome Measures in the Risk Estimation of Systemic Cobalt Toxicity for Patients With a Metal-on-Metal Hip Implant

Leyssens¹,

Vinck²,

Straeten

et al. 2022

Ear &Amp; Hearing

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Objectives: Based on limited evidence from case reports and small cohort studies of metal-on-metal (MoM) hip implant patients with presumed systemic cobalt (Co) toxicity, and a few animal studies on Co-induced damage to the otovestibular system, it was hypothesised that Co exhibits an ototoxic potential alongside other systemic manifestations. Preliminary investigations from our research group in MoM patients confirmed this assumption for the auditory system, whereas no signs of Co-induced vestibular impairment were detected, and a clear dose-response relationship between the auditory function and the blood Co levels was lacking. Therefore, the current study aimed to extend and validate these findings in a larger sample of MoM patients and control subjects, to explore the potential clinical value of audiovestibular outcome measures in the risk estimation of systemic Co toxicity in this patient population.Design: Fifty patients (32 to 68 years) with a primary unilateral/bilateral MoM hip implant were matched for age, gender, and noise exposure to 50 nonimplanted control subjects. Both groups underwent the same protocol, consisting of an objective auditory [i.e., conventional and highfrequency audiometry, transient-evoked and distortion (TEOAEs and DPOAEs), auditory brainstem responses] and vestibular (i.e., cervical and ocular vestibular evoked myogenic potentials, horizontal and vertical video head impulse tests) test battery, a questionnaire inquiring auditory, balance, and general neurological symptoms, and a blood sample collection to determine the plasma Co concentration. Results:The auditory test battery presented consistently higher audiometric thresholds in the MoM patient group, with group differences ranging from 2.1 to 5.7 dB in the lower frequencies (0.25 to 6.0 kHz) and from 4.6 to 9.3 dB in the high frequencies (8.0 to 14.0 kHz). Group differences at high frequencies were statistically significant (p ≤ 0.001). Additionally, significantly lower TEOAE (p = 0.009) and DPOAE (p < 0.001) amplitudes were observed in the MoM patients when the better ear was included in the analysis, and more absent TEOAE and DPOAE responses were found between 1.0 and 4.0 kHz (0.008 ≤ p ≤ 0.039). Within the vestibular test battery, the MoM patients showed longer N1 and P1 ocular vestibular evoked myogenic potentials latencies for the left ear, and lower video head impulse test gains for the left anterior and right posterior semicircular canals (0.005 ≤ p ≤0.035). The patient-reported (questionnaire) outcome delivered no significant group differences (p > 0.01). Six patients had elevated Co levels according to our local institutional threshold (>4 or 5 µg/l for unilateral or bilateral MoM hip implants, resp.), but their audiovestibular outcome measures did not differ significantly from those of the other patients.Conclusions: Corresponding to our preliminary investigations, the results indicate possibly Co-induced (predominantly high-frequency) auditory impairment, probably triggered by toxic damage to the cochlear structures...

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Section: Methodsmentioning

confidence: 99%

Assessing the Clinical Value of Objective and Patient-Reported Audiovestibular Outcome Measures in the Risk Estimation of Systemic Cobalt Toxicity for Patients With a Metal-on-Metal Hip Implant

Leyssens¹,

Vinck²,

Straeten

et al. 2022

Ear &Amp; Hearing

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“…As described in our previous work (Leyssens et al, 2020), 45 adults with intellectual disabilities (experimental group) participated in the vestibular screening at the National Games of Special Olympics Belgium (SOB) in 2019. From this group, 30 (67%) athletes (21 (70%) males, 9 (30%) females) between the ages of 18 and 61 years old ( M = 36.4, SD = 11.43) also completed an assessment of the static and dynamic postural stability, the visual acuity, and auditory function.…”

Section: Methodsmentioning

confidence: 99%

“…The vestibular assessment consisted of a cervical vestibular evoked myogenic potentials (cVEMP) measurement and a video head impulse test (vHIT) in the horizontal plane, which are complementary in terms of evaluating the otolith (mainly saccule) and (lateral) semicircular canal system, respectively. A detailed description of the procedures and technical properties of these test items can be consulted in our previous work (Leyssens et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, as an extension to our previous work (Leyssens et al, 2020), this study aimed to explore the impact of visual, auditory and vestibular dysfunctions on postural balance in a heterogeneous sample of adults with intellectual disabilities. Additionally, the postural balance performance of this group was compared to that of an age‐ and gender‐weighted control group.…”

Section: Introductionmentioning

confidence: 99%

“…The peripheral vestibular function has only been limitedly studied in people with intellectual disabilities (Abadie et al, 2000; Costa, 2011; Dannenbaum et al, 2016; Willaert et al, 2019; Zur et al, 2013). Therefore, our research group initiated a study to investigate the occurrence and characteristics of vestibular deficits in the heterogeneous adult population with intellectual disabilities, which suggested a higher occurrence of vestibular dysfunctions in this population compared to the general population (Leyssens et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Postural balance problems in people with intellectual disabilities: Do not forget the sensory input systems

Leyssens

Hecke

Moons

et al. 2021

Research Intellect Disabil

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Background This pilot study aimed to explore the impact of visual, auditory and vestibular dysfunctions on the postural balance performance in adults with intellectual disabilities. Additionally, a comparison was made between the subjects with intellectual disabilities and a control group concerning static and dynamic balance tasks. Method Thirty adults with intellectual disabilities and 25 control subjects received a postural balance assessment. Additionally, the experimental group was subjected to a visual, auditory and vestibular screening. Results The experimental group performed significantly worse and/or showed more sway compared to the control group for all balance tasks (p < .01) except the timed up and go test. Within the experimental group, a significant positive correlation (rs(24) = 0.513, p = .007) was observed between the number of failed sensory screening items and the number of failed balance tasks. Conclusions These findings suggest significant involvement of peripheral sensorial deficits in the balance problems that people with intellectual disabilities often experience.

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Audiological and Other Factors Influencing Serious Injury From Falls in Adults With Intellectual and Developmental Disabilities

Doettl

Turner²,

Plyler

et al. 2021

Perspect ASHA SIGs

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Purpose Falls in adults with intellectual and developmental disabilities (IDDs) are a challenge for the organizations responsible for their management and care. This study represents the initiation of a program to identify, manage, and rehabilitate individuals at risk for falls in this population. Method A retrospective analysis of an active database was provided by the East Tennessee Regional Office of the Department of Intellectual and Developmental Disabilities. The data from 1,652 reportable falls from state-contracted support agencies over the calendar years of 2016–2018 were analyzed using chi-square and decision tree analyses for a dependent variable of serious injury and independent variables consisting of hearing deficits, impaired mobility including balance and vestibular deficits, enrollment in current physical therapy services for impaired mobility, staff instructions present for individuals at risk for falls, staff instructions followed, falls training for the supporting staff, current fall prevention plan in place, aggressive or compulsive behaviors, history of falls, medical conditions, visual deficits, familiar environments, adaptive equipment, intrinsic and extrinsic factors, medication change/side effects, obesity, and repeat falls. Results Significant factors included age, aggressive/compulsive behaviors, physical therapist (PT) services, balance deficits, and intrinsic factors. Post hoc analysis also indicated individuals receiving PT with a history of falls increased their risk of serious injury in unfamiliar environments. Individuals not receiving PT and exhibiting aggressive behaviors increased their risk of serious injury with visual deficits. For individuals not receiving PT services and not exhibiting aggressive behaviors, intrinsic factors increased the risk of serious injury. Conclusions These results describe the characteristics that can predict an increased risk for serious injury from a fall in an adult community-dwelling population with IDDs. These data can be used to implement changes to reduced injury from falls, including improved identification of undiagnosed vestibular deficits and assessment for the need for vestibular rehabilitation.

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Vestibular function in adults with intellectual disabilities: feasibility and outcome of a vestibular screening protocol in Special Olympics athletes

Cited by 4 publications

References 69 publications

Assessing the Clinical Value of Objective and Patient-Reported Audiovestibular Outcome Measures in the Risk Estimation of Systemic Cobalt Toxicity for Patients With a Metal-on-Metal Hip Implant

Assessing the Clinical Value of Objective and Patient-Reported Audiovestibular Outcome Measures in the Risk Estimation of Systemic Cobalt Toxicity for Patients With a Metal-on-Metal Hip Implant

Postural balance problems in people with intellectual disabilities: Do not forget the sensory input systems

Audiological and Other Factors Influencing Serious Injury From Falls in Adults With Intellectual and Developmental Disabilities

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