Concurrent Speech Segregation Problems in Hearing Impaired Children

Objective: This study was a basic investigation of the ability of concurrent speech segregation in hearing impaired children. Concurrent segregation is one of the fundamental components of auditory scene analysis and plays an important role in speech perception. In the present study, we compared auditory late responses or ALRs between hearing impaired and normal children. Materials & Methods: Auditory late potentials in response to 12 double vowels were recorded in 10 children with moderate to severe sensory neural hearing loss and 10 normal children. Double vowels (pairs of synthetic vowels) were presented concurrently and binaurally. Fundamental frequency (F0) of these vowels and the size of the difference in F0 between vowels was 100 Hz and 0.5 semitones respectively. Results: Comparing N1-P2 amplitude showed statistically significant difference in some stimuli between hearing impaired and normal children (P<0.05). This complex indexing the vowel change detection and reflecting central auditory speech representation without active client participation was decreased in hearing impaired children. Conclusion: This study showed problems in concurrent speech segregation in hearing impaired children evidenced by ALRs. This information indicated deficiencies in bottom-up processing of speech characteristics based on F0 and its differences in these children

Comparison of External Load Effect on Lumbar Lordosis Among between Low Back Pain Patients and Healthy Individuals

Objective: Lumbar curvature is an important factor in posture and body movement that help us to understand low back pain problems. The aim of this study was evaluation of external load and trunk posture effect on lumbar curvature under static condition.  Materials & Methods: This study is an interventional, quasi-experimental and case-control study. Ten women with non specific chronic low back pain and ten matched without low back pain women were participated in this study. We used simple and non random method for sampling. Two clinometers sensors were used to evaluate lumbar curvature. Six static tasks while holding three levels of load (0, 6, 12 Kg) and two levels of trunk position (neutral and 30 degree of flexion) were simulated for subjects. Data were analyzed by using Kolmogroff-Smirnoff, ANOVA (Repeated Measurement) and independent T-test. Results: Findings revealed lumbar lordosis in patients with low back pain does not change to kyphosis while increasing external load from 0kg to 6kg and 12kg in neutral trunk position (P<0.05). Conclusion: Dysfunction in passive system due to soft tissue disorder, afraid of pain, changes trunk muscles recruitment and reduction of moment arm are likely reasons for increased lumbar lordosis in patients with low back pain during loading

Relation between Working Memory Capacity and Auditory Stream Segregation in Children with Auditory Processing Disorder

Background: This study assessed the relationship between working memory capacity and auditory stream segregation by using the concurrent minimum audible angle in children with a diagnosed auditory processing disorder (APD). Methods: The participants in this cross-sectional, comparative study were 20 typically developing children and 15 children with a diagnosed APD (age, 9–11 years) according to the subtests of multiple-processing auditory assessment. Auditory stream segregation was investigated using the concurrent minimum audible angle. Working memory capacity was evaluated using the non-word repetition and forward and backward digit span tasks. Nonparametric statistics were utilized to compare the between-group differences. The Pearson correlation was employed to measure the degree of association between working memory capacity and the localization tests between the 2 groups. Results: The group with APD had significantly lower scores than did the typically developing subjects in auditory stream segregation and working memory capacity. There were significant negative correlations between working memory capacity and the concurrent minimum audible angle in the most frontal reference location (0° azimuth) and lower negative correlations in the most lateral reference location (60° azimuth) in the children with APD. Conclusion: The study revealed a relationship between working memory capacity and auditory stream segregation in children with APD. The research suggests that lower working memory capacity in children with APD may be the possible cause of the inability to segregate and group incoming information

Preparation and Evaluation of SKI-HI: A Parent-Infant Auditory Training Program for under 3- Year -Old Hearing Impaird Children

Background and Aim: Lack of early detection of and intervention for infants hearing loss results in a significant delay in speech and language development. So auditory rehabilitation plays an important role in improving the diminished communication ability. One of the most successful auditory training approaches is the SKI-HI parent-infant program. The purpose of this study was preparation and evaluation of Farsi-language SKI-HI program for under 3-year-old hearing impaired children. Materials and Methods: After translation and modification of the text of the program, fifteen under 3-year-old children with bilateral severe sensory hearing loss who were fitted with appropriate behind the ear hearing aids received intervention for 6 months. The levels of the auditory skills were measured pre and post intervention. Intervention Efficiency Index (IEI), Pretest Developmental Rate (PDR) and Proportional Change Index (PCI) were computed. Results: The data indicated that there was a significant difference between means of IEI and PDR which were 0.87 and 0.31, respectively. PCI was 3.38 indicated that the children's auditory skills developed at about 2.38 times higher rate after SKI-HI intervention than they did before. PCI confidence interval showed that development in the population is 1.46 to 3.30 times higher after SKI-HI intervention (with 95% probability) the rate of auditory skills. Conclusion: The auditory training with Farsi-language SKI-HI parent-infant program may efficiently affect development of auditory skills of hearing impaired children

Determinant Factors in Graft Rejection Using Cox Regression, among the Recipients of Second Renal Transplant in Imam Khomeini Hospital in Urmia, 1988-2000

Background: The objective of this study was to evaluate graft survival among the recipients of second renal transplant in Imam Khomeini centre hospital in Urmia. Methods: The study population consisted of 50 patients receiving renal grafts for the second time between 1988 and 2008 in Imam Khomeini centre hospital in Urmia. Two survival outcomes, first and second graft survival, were analyzed. Graft survival was defined from date of transplant until its rejection. For the purpose of graft survival analysis, graft failure was defined as return to dialysis, and death due to the functioning graft. Data were collected through individual patient questionnaires. Demographic and clinical factors, transfusion history, type of immunosuppressive drugs, levels of serum creatinine, triglyceride, cholesterol, and LDL at 3 and 6 months after transplantation were collected. Cox-proportional hazard model and Kaplan-Meier were used to data analysis. Results: First graft survival at 1, 2, 3, and 5 years was 74%, 66%, 53%, and 41%, respectively. Second graft survival at 1, 2, 3, and 5 years was 81%, 74%, 70%, and 61%, respectively. Causes of graft loss in first renal transplantation were 6% sever acute graft rejection, 12% acute graft rejection and 82% chronic graft rejection. In the multivariate analysis, only serum creatinine, blood pressure, and immunosuppressive drugs predicted first graft loss and serum creatinine, immunosuppressive drugs, and related donor family predicted second graft rejection. Conclusion: The serum creatinine and immunosuppressive drugs including cyclosporine, cellcept, and prednisolone are the most influential factors on graft survival

The Short Effects of Two Spinal Stabilization Exercise on Balance Tests and Limit of Stability in Men with Non–Specific Chronic Low Back Pain: Randomized Clinical Trial Study

Objective: This study investigated the short-term effects of two stability exercises, including Abdominal Hollowing and Abdominal bracing on stabilization parameters of Biodex Stability System in male subjects with non-specific recurrent low back pain. Materials & Methods: This Randomized Clinical Trial and case–control study was performed on 30 male subjects with non-specific recurrent low back pain by sample of convenience and randomly allocated into 3 control group( 10 subject) and 2 experimental group (10 subject). Dynamic balance stability indices (Overall, Anterior–Posterior and Medial–Lateral) and Limit of Stability were measured by using Biodex Stability System before and immediately after exercise. Results: Our finding showed that all indices except with Medial–Lateral were increased significantly in experimental group in comparison with control. In Abdominal Bracing group, both level of stability of 8 and 3, showed a significant reduction (P<0.05). The limit of Stability in both experimental groups with abdominal Hallowing (P=0.001) and Abdominal Bracing (P=0.01) increased significantly. Conclusion: The findings revealed that one session training enhances balance status, due to muscle activity improvement

Effect of Cognitive and Central Auditory Impairments on Satisfaction of Amplification in Hearing Impaired Older Adults

Objectives: Older adults show many difficulties of speech perception in noisy situations due to peripheral and central auditory impairments, and cognitive dysfunctions. One of the most common rehabilitative procedures for older adults with hearing loss is amplification. However, there is some evidence of dissatisfaction of amplification in older adults. Methods & Materials: We assessed cognitive station, central auditory function, and satisfaction of 19 participants with hearing aids using mini-mental state examination (MMSE), dichotic digits test (DDT), and the satisfaction with amplification in daily life scale respectively. Our cases had moderate sensory hearing loss in both ears. Results: Kruskal-Wallis statistics showed significant correlation between cognitive impairments (MMSE scores) and satisfaction of amplification (P0.05). Conclusion: We showed central auditory processing impairments in hearing impaired older adults with cognitive dysfunctions. It is indicated that older adults with hearing loss might have cognitive impairments inducing dissatisfaction of amplification

Berg Balance Scale Reliability for Evaluation in Children with Spastic Diplegia

Objective: Assessment of balance in children with neurological disorders is quite necessary in any rehabilitation therapy. There are various versions of balance tests for balance assessment of adults however, little has been done with regard to introducing a reliable test for evaluation of the balance in children with spastic cerebral palsy. The purpose of this study was to investigate the inter and intrarater reliability of Berg balance scale in children with spastic diplegia. Materials & Methods: In this descriptive and methodological study twenty spastic diplegia children with non probability selection participated. Children were in the range of 6-12 Yrs (Mean, SD, 7/35 &1/84 yrs, respectively). Parents were asked to sign an informed consent. Berg balance scale was tested in one session by two therapists for interrater reliability (inter-rating) and repeated tests were tested for intrarater reliability (intra-rating). Results: Intraclass correlation coefficient (ICC) test was used for interrater (between two therapists, ICC= 0/985, P<0/001 and intra rater reliability repeated test by the same therapist, ICC= 0/994 , P<0/001 ). Conclusion: The result of this study suggests that inter-rater and intra-rater reliability of Berg balance scale is acceptable. Therefore, it could be used in clinic for the assessment of children with spastic diplegia as a reliable scale

A Comparative Study on the Contralateral Supression Effects of Acoustic Stimulations on Otoacoustic Emissions

Objective: Acoustic stimulation of auditory efferent system causes contralateral shift in the OAEs amplitude. In this study the contralateral suppression effect of pure tone & NBN at center frequencies of 1, 2 & 4 kHz Frequencies has been evaluated in the right ears of normal 19 to 27 years old adults.  Materials & Methods: The data were elicited from 37 subjects (15 males & 22 females) with normal hearing who participated in this study. After determining the level of NBN by loudness adjustment between pure tone at 70 dBHL at 1, 2 & 4 kHz in left ear, EOAEs was measured using tone burst at central frequencies of 1, 2 & 4 kHz in right ear. Then the amplitude shift of TBEOAEs was evaluated at the presence of contralateral pure tone & NBN stimuli. Results: There was a significant shift in the amplitude of TBEOAEs by contralateral stimulation of pure tone & NBN which was greater in NBN. The magnitude of amplitude shift was become greater at high frequencies of contalateral stimuli. Conclusion: There was a decrease in the amplitude of TBEOAEs by contralateral stimulation and the stimulus with greater frequency band had geater effects on contralateral suppression. The impact of this effect was highly depend on the spectrum & frequency of contralateral stimuli

Evaluation of the Slope of Amplitude Growth Function Changes of the Electrically Evoked Action Potential in Three Months after Receiving the Device in Children with Cochlear Implant

Objective: In neural response telemetry, intracochlear electrodes stimulate the auditory nerve and record the neural responses. The electrical stimulation is sent to the auditory nerve by an electrode and the resulted response, called electrically evoked compound action potential, is recorded by an adjacent electrode. The most important clinical applications of this test are evaluation and monitoring the intra and postoperative responses of auditory nerve and help to primary setting of speech processor. The aim of this study was evaluating the potential's slope of amplitude growth function changes three monthes after receiving the devise in pediatric cochlear implant recipients. Materials & Methods: This longitudinal study evaluated the potentials' slope of amplitude growth function changes in four given electrodes in four sessions after receiving the devise by approximately one month's intervals in all of the children who implanted in Amir Alam and Hazrat-e-Rasoul hospitals in 2007, July to December. Friedman test was used to analyse the results. Results: Electrically evoked compound action potential's mean slope of each electrode was more in later sessions relative to first session, while there was significant difference between the 1st and the other electrodes’ responses in every session (P<0.05). Conclusion: The reliabiliy of the responses results in more assurance of clinician to fit the speech processor for along time. Better responses in apical electrodes may lead to develope an effective coding strategy