Article

Maturational effects of the vestibular system: a study of rotary chair, computerized dynamic posturography, and vestibular evoked myogenic potentials with children.

Program in Audiology and Communication Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA.
Journal of the American Academy of Audiology (Impact Factor: 1.59). 07/2007; 18(6):461-81.
Source: PubMed

ABSTRACT Maturational effects were investigated in two age groups (N = 30 per group) of children with normal hearing sensitivity, using rotary chair (RC), computerized dynamic posturography (CDP), and vestibular evoked myogenic potential (VEMP) measures. Children recruited within the younger group were three through six years of age, and children within the older group were nine through eleven years of age. Data obtained for each pediatric group were compared with clinic and/or published adult normative data for each measure. Significant age effects were seen on many CDP subtests (sensory organization test and motor control test); VEMP latencies; and RC gain, phase, and step velocity measures. The results of this study demonstrate significant maturational effects from preschool age through adulthood and suggest that adult normative data may not be appropriate when interpreting pediatric test results. Since adult techniques should oftentimes not be utilized, a proposed test battery is described that may be efficiently utilized with pediatric patients.

1 Follower
 · 
49 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine reliability, diagnostic values, and minimal detectable change scores, 90% confidence (MDC90) of pediatric clinical tests of vestibular function. Twenty children with severe to profound bilateral sensorineural hearing loss and 23 children with typical development, aged 6 to 12 years, participated. The Head Thrust Test, Emory Clinical Vestibular Chair Test, Bucket Test, Dynamic Visual Acuity, Modified Clinical Test of Sensory Interaction on Balance, and Sensory Organization Test were completed twice for reliability. Reference standard diagnostic tests were rotary chair and vestibular evoked myogenic potential. Reliability, sensitivity, specificity, predictive values, likelihood ratios, and MDC90 scores were calculated. Reliability ranged from an intraclass correlation coefficient of 0.73 to 0.95. Sensitivity, specificity, and predictive values, using cutoff scores for each test representing the largest area under the curve, ranged from 63% to 100%. The MDC90 for Dynamic Visual Acuity and Modified Clinical Test of Sensory Interaction on Balance were 8 optotypes and 16.75 seconds, respectively. Clinical tests can be used accurately to identify children with vestibular hypofunction.
    Pediatric physical therapy: the official publication of the Section on Pediatrics of the American Physical Therapy Association 06/2014; 26(2):180-9. DOI:10.1097/PEP.0000000000000039 · 1.29 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To demonstrate the feasibility and clinical significance of cervical vestibular-evoked myogenic potential (cVEMP) test in pediatric patients.Retrospective review study was conducted in a pediatric tertiary care facility. A total of 278 patients were identified with adequate data, including medical notes, results of cVEMP, and imaging studies.Among the total of 278 pediatric patients, only 3 children were not able to finish the cVEMP test successfully. In about 90% of the cases, the cVEMP test was requested to investigate a patient's hearing loss and/or vestibular complaints. Over 90% of the cVEMP tests were ordered by specialists such as pediatric otolaryngologists or otologists. Obtained cVEMP results provided useful information in clinical diagnosis and management in all cases.It is feasible to conduct cVEMP testing in children, including infants, and cVEMP testing can provide valuable information in the diagnosis and management of hearing loss and vestibular impairment. This simple and noninvasive test should be embraced by pediatric professionals.
    Medicine 06/2014; 93(4):e37. DOI:10.1097/MD.0000000000000037 · 4.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: As deaf children are now implanted at a very early age, the influence of a cochlear implant (CI) on the early motor development of children with a hearing loss becomes relevant. Forty-eight children with a hearing loss were included in this controlled prospective follow-up study and were subdivided into a CI group (n = 23) receiving a CI during the follow-up period and a control group (n = 25) receiving no CI during the follow-up period. All children were assessed around the ages of 6 (T1), 12 (T2), 18 (T3), and 24 (T4) months with a motor test battery consisting of the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS) (only at T1 and T2), and Ghent Developmental Balance Test (GDBT) (only at T3 and T4). In addition, collic vestibular-evoked myogenic potential testing was performed in all children. Group differences in PDMS-2 Gross Motor Quotient (GMQ), Fine Motor Quotient, AIMS z score, and GDBT z score were analyzed using Linear Mixed Model (LMM) analysis for repeated measures. For PDMS-2 GMQ, the LMM revealed significant effects for group (p = 0.04), test moment (p < 0.001), and for the interaction between these two factors (p = 0.035). Contrasts indicated that the CI group showed a greater deterioration in PDMS-2 GMQ between T2 and T3 compared with that showed by the control group (p = 0.002). The LMM for PDMS-2 Fine Motor Quotient and AIMS z score showed no significant effects. For GDBT z score, the LMM pointed out significant effects for group (p = 0.013) and test moment (p < 0.001), but no significant interaction between these two factors. Contrasts indicated that the CI group performed significantly weaker than the control group at both test moments (T3 and T4; all p < 0.012) and that both groups showed a significant recovery in GDBTz scores between T3 and T4 (all p < 0.012). This study shows that the trajectory of gross motor development can be changed in children with a hearing loss after a cochlear implantation. Implanted children show a drop in their gross motor performance within the age range of 6 to 18 months, at which period the majority of the implantations took place, with a tendency of recovery toward the age of 2 years. However, longer follow-up will be necessary to trace whether the implanted children catch up their motor delay in comparison with nonimplanted children with a hearing loss at later age.
    Ear and Hearing 12/2014; DOI:10.1097/AUD.0000000000000133 · 2.83 Impact Factor