Differing postural control patterns in individuals with bilateral and unilateral hearing loss

Brittani Morris; Maura Cosetti; Jennifer Kelly; Junhui Yang; Daphna Harel; Andrew Medlin; Anat V Lubetzky

doi:10.1016/j.amjoto.2023.103866

Differing postural control patterns in individuals with bilateral and unilateral hearing loss

Am J Otolaryngol. 2023 Jul-Aug;44(4):103866. doi: 10.1016/j.amjoto.2023.103866. Epub 2023 Mar 23.

Authors

Brittani Morris¹, Maura Cosetti², Jennifer Kelly³, Junhui Yang⁴, Daphna Harel⁵, Andrew Medlin⁶, Anat V Lubetzky⁶

Affiliations

¹ Department of Physical Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States of America. Electronic address: bam594@nyu.edu.
² Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America.
³ Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America; Vestibular Rehabilitations, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America.
⁴ Department of Mathematics and Statistics, College of Natural Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America.
⁵ Department of Applied Statistics, Social Science and Humanities, Steinhardt School of Culture Education and Human Development, New York University, New York, NY, United States of America.
⁶ Department of Physical Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States of America.

PMID: 36989756
PMCID: PMC10330028 (available on 2024-07-01)
DOI: 10.1016/j.amjoto.2023.103866

Abstract

Objectives: Hearing loss (HL) is associated with imbalance and increased fall risk. The mechanism underlying this relationship and differences across types of hearing loss remains unclear. Head mounted displays (HMD) can shed light on postural control mechanisms via an analysis of head sway.

Purpose: The purpose of this study was to evaluate head sway in response to sensory perturbations in individuals with bilateral (BHL) or unilateral hearing loss (UHL) and compare them to controls.

Materials and methods: We recruited 36 controls, 23 individuals with UHL and 14 with BHL. An HMD (HTC Vive) measured head sway while participants stood on the floor, hips-width apart. Stimuli included two levels of visuals and sound. Root Mean Square Velocity (RMSV) and Power Spectral Density (PSD) were used to quantify head sway.

Results: Adjusting for age, individuals with BHL had significantly higher anterior-posterior and medio-lateral RMSV than controls and individuals with UHL. Individuals with UHL demonstrated significantly lower response to visual perturbations in RMSV AP and in all 3 frequency segments of PSD compared to controls. Individuals with UHL showed significantly lower movements at high frequencies compared to controls. Sounds or severity of HL did not impact head sway.

Conclusions: Individuals with BHL demonstrated increased sway with visual perturbations and should be clinically assessed for balance performance and fall risk. Individuals with UHL exhibited reduced responses to visual stimuli compared with controls, which may reflect conscious movement processing. Additional studies are needed to further understand the mechanistic relationship between hearing loss and imbalance.

Keywords: Head kinematics; Head sway; Head-mounted display; Sensory integration for balance; Virtual reality.

MeSH terms

Deafness*
Hearing Loss, Unilateral*
Humans
Movement
Postural Balance / physiology
Sound

Grants and funding

R21 DC018101/DC/NIDCD NIH HHS/United States