Comparing the Speech Perception of Cochlear Implant Users with Three Different Finnish Speech Intelligibility Tests in Noise

Background: A large number of different speech-in-noise (SIN) tests are available for testing cochlear implant (CI) recipients, but few studies have compared the different tests in the same patient population to assess how well their results correlate. Methods: A clinically representative group of 80 CI users conducted the Finnish versions of the matrix sentence test, the simplified matrix sentence test, and the digit triplet test. The results were analyzed for correlations between the different tests and for differences among the participants, including age and device modality. Results: Strong and statistically significant correlations were observed between all of the tests. No floor or ceiling effects were observed with any of the tests when using the adaptive test procedure. Age or the length of device use showed no correlation to SIN perception, but bilateral CI users showed slightly better results in comparison to unilateral or bimodal users. Conclusions: Three SIN tests that differ in length and complexity of the test material provided comparable results in a diverse CI user group.Peer reviewe

Comparing the Speech Perception of Cochlear Implant Users with Three Different Finnish Speech Intelligibility Tests in Noise

Background: A large number of different speech-in-noise (SIN) tests are available for testing cochlear implant (CI) recipients, but few studies have compared the different tests in the same patient population to assess how well their results correlate. Methods: A clinically representative group of 80 CI users conducted the Finnish versions of the matrix sentence test, the simplified matrix sentence test, and the digit triplet test. The results were analyzed for correlations between the different tests and for differences among the participants, including age and device modality. Results: Strong and statistically significant correlations were observed between all of the tests. No floor or ceiling effects were observed with any of the tests when using the adaptive test procedure. Age or the length of device use showed no correlation to SIN perception, but bilateral CI users showed slightly better results in comparison to unilateral or bimodal users. Conclusions: Three SIN tests that differ in length and complexity of the test material provided comparable results in a diverse CI user group</p

Sisäkorvaistute - kokeellisesta hoidosta arkipäivän kuntoutukseksi

Sisäkorvaistutehoito sopii sekä synnynnäisen vaikea-asteisen kuulovian että etenevän kuulovian hoidoksi. Istutteella voidaan saavuttaa hyvä puheentunnistuskyky vaikea-asteisessa kuulonalenemassa. Hoito on osoitettu kustannusvaikuttavaksi kaikissa ikäryhmissä. Nuorimmat potilaat ovat olleet 8–10 kuukauden ja vanhimmat yli 80 vuoden ikäisiä. Vanhusväestössä on paljon vaikea-asteisesta kuuloviasta kärsiviä potilaita, jotka hyötyisivät istutehoidosta. Heitä tulisi ohjata nykyistä aktiivisemmin leikkausarvioon.Peer reviewe

The development and evaluation of the Finnish digit triplet test

Objectives: The aim of the study was to develop a reliable and easily accessible screening test for primary detection of hearing impairment.Methods: Digits 0-9 were used to form quasirandom digit triplets. First, digit specific intelligibility functions and speech recognition thresholds (SRTs) were determined. To homogenize the test material digits with steep intelligibility function slopes were chosen and level correction up to 2dB were applied to the digits as needed. Evaluation measurements were performed to check for systematic differences in intelligibility between the test lists and to obtain normative reference function for normal-hearing listeners.Results: The mean SRT and the final slope of the test lists were -10.8 +/- 0.1dB signal-to-noise ratio (SNR) and 21.7 +/- 1.8%/dB, respectively (measurements at constant level; inter-list variability). The mean SRT and slope of the test subjects were -10.8 +/- 0.5dB SNR and 23.4 +/- 5.2%/dB (measurements at constant level; inter-subject variability). The mean SRT for normal-hearing young adults for a single adaptive measurement is -9.8 +/- 0.9dB SNR.Conclusion: The Finnish digit triplet test is the first self-screening hearing test in the Finnish language. It was developed according to current standards, and it provides reliable and internationally comparable speech intelligibility measurements.Peer reviewe

Improvements in Hearing and in Quality of Life after Sequential Bilateral Cochlear Implantation in a Consecutive Sample of Adult Patients with Severe-to-Profound Hearing Loss

Bilateral cochlear implantation is increasing worldwide. In adults, bilateral cochlear implants (BICI) are often performed sequentially with a time delay between the first (CI1) and the second (CI2) implant. The benefits of BICI have been reported for well over a decade. This study aimed at investigating these benefits for a consecutive sample of adult patients. Improvements in speech-in-noise recognition after CI2 were followed up longitudinally for 12 months with the internationally comparable Finnish matrix sentence test. The test scores were statistically significantly better for BICI than for either CI alone in all assessments during the 12-month period. At the end of the follow-up period, the bilateral benefit for co-located speech and noise was 1.4 dB over CI1 and 1.7 dB over CI2, and when the noise was moved from the front to 90 degrees on the side, spatial release from masking amounted to an improvement of 2.5 dB in signal-to-noise ratio. To assess subjective improvements in hearing and in quality of life, two questionnaires were used. Both questionnaires revealed statistically significant improvements due to CI2 and BICI. The association between speech recognition in noise and background factors (duration of hearing loss/deafness, time between implants) or subjective improvements was markedly smaller than what has been previously reported on sequential BICI in adults. Despite the relatively heterogeneous sample, BICI improved hearing and quality of life.Peer reviewe

Suomenkielinen puheaudiometria ja uudet hälypuhetestit

Väestön ikääntyessä kuulonalenemien esiintyvyys ja tarve vaikuttavaan kuulonkuntoutukseen kasvavat. Hyvän yleiskäsityksen kuulosta antavat äänieriön hiljaisuudessa tehtävät perustutkimukset, äänesaudiometria ja puheaudiometria. Ne eivät kuitenkaan välttämättä kuvasta kuulonaleneman aiheuttamaa haittaa hälyisissä tilanteissa. Uuden suomenkielisen hälylausetestin avulla voidaan tutkia aiempaa paremmin aikuisten kuntoutuspotilaiden kuulonvaraista selviämistä arjessa. Suomenkielisen lasten hälypuhetestin validointi on meneillään.Peer reviewe

Improvements in Hearing and in Quality of Life after Sequential Bilateral Cochlear Implantation in a Consecutive Sample of Adult Patients with Severe-to-Profound Hearing Loss

Bilateral cochlear implantation is increasing worldwide. In adults, bilateral cochlear implants (BICI) are often performed sequentially with a time delay between the first (CI1) and the second (CI2) implant. The benefits of BICI have been reported for well over a decade. This study aimed at investigating these benefits for a consecutive sample of adult patients. Improvements in speech-in-noise recognition after CI2 were followed up longitudinally for 12 months with the internationally comparable Finnish matrix sentence test. The test scores were statistically significantly better for BICI than for either CI alone in all assessments during the 12-month period. At the end of the follow-up period, the bilateral benefit for co-located speech and noise was 1.4 dB over CI1 and 1.7 dB over CI2, and when the noise was moved from the front to 90 degrees on the side, spatial release from masking amounted to an improvement of 2.5 dB in signal-to-noise ratio. To assess subjective improvements in hearing and in quality of life, two questionnaires were used. Both questionnaires revealed statistically significant improvements due to CI2 and BICI. The association between speech recognition in noise and background factors (duration of hearing loss/deafness, time between implants) or subjective improvements was markedly smaller than what has been previously reported on sequential BICI in adults. Despite the relatively heterogeneous sample, BICI improved hearing and quality of life

Clinical and Genetic Characteristics of Finnish Patients with Autosomal Recessive and Dominant Non-Syndromic Hearing Loss Due to Pathogenic TMC1 Variants

Sensorineural hearing loss (SNHL) is one of the most common sensory deficits worldwide, and genetic factors contribute to at least 50-60% of the congenital hearing loss cases. The transmembrane channel-like protein 1 (TMC1) gene has been linked to autosomal recessive (DFNB7/11) and autosomal dominant (DFNA36) non-syndromic hearing loss, and it is a relatively common genetic cause of SNHL. Here, we report eight Finnish families with 11 affected family members with either recessively inherited homozygous or compound heterozygous TMC1 variants associated with congenital moderate-to-profound hearing loss, or a dominantly inherited heterozygous TMC1 variant associated with postlingual progressive hearing loss. We show that the TMC1 c.1534C>T, p.(Arg512*) variant is likely a founder variant that is enriched in the Finnish population. We describe a novel recessive disease-causing TMC1 c.968A>G, p.(Tyr323Cys) variant. We also show that individuals in this cohort who were diagnosed early and received timely hearing rehabilitation with hearing aids and cochlear implants (CI) have reached good speech perception in noise. Comparison of the genetic data with the outcome of CI rehabilitation increases our understanding of the extent to which underlying pathogenic gene variants explain the differences in CI rehabilitation outcomes

Raskauden aikainen harjoittelu : opas liikuntaharjoitteluun viimeiselle kolmannekselle

Odotusaikana äidin elimistössä tapahtuu paljon fysiologisia muutoksia, joiden tarkoituksena on turvata sikiön kasvu ja kehitys sekä valmistaa äidin elimistö raskausaikaan ja synnytykseen. Normaalisti edennyt raskaus ei ole este säännöllisen liikunnan aloittamiselle. Turvallisesti suoritetulla liikuntaharjoitelulla ei ole haittaa odottavalle äidille raskauden aikana. Raskauden aikaisesta liikkumisesta on hyötyä, vaikka ei olisi aikaisempaa liikuntataustaa. Opinnäytetyö toteutettiin toiminnallisena kehittämistyönä, jonka tavoitteena oli luoda opas neuvolan työntekijöille sekä odottaville äideille turvalliseen liikuntaharjoitteluun raskauden viimeiselle kolmannekselle. Kirjallinen opas tulee jaettavaksi neuvoloiden työntekijöille tukemaan odottavien äitien ohjausta. Sen avulla pyritään ennaltaehkäisemään raskaudesta johtuvia vaivoja, kuten kipua ja sen kroonistumista. Oppaan harjoitteet sisältävät turvallisia liikkeitä, joiden avulla odottava äiti voi valmistautua synnytykseen ja siitä palautumiseen. Oppaan harjoitteet valittiin tutkittuun näyttöön ja asiantuntijahaastatteluihin perustuen. Liikuntaharjoitteita sekä oppaan käytettävyyttä on testattu kohderyhmään kuuluvilla henkilöillä.Many physiological changes in woman’s system are happening during pregnancy. The purpose of those changes is to secure the growth and development of the fetus and to prepare the woman’s body for pregnancy and delivery. Pregnancy isn’t an obstacle to start a regular training, when pregnancy progresses normally. Safely performed exercise training doesn’t do any harm for a mother during pregnancy. There are many benefits of exercising, even though a mother hasn’t exercised before. This thesis was made as a functional development work whose goal was to create a guide about safe exercise training at third trimester. The guide is for maternity clinics employees and pregnant women. It is going to be shared with maternity clinics employees to support their guidance of pregnant women and to prevent physical troubles caused by pregnancy. The guide includes safe exercises which can help a mother to prepare for delivery and recovery. Exercises chosen in the guide were based on examined evidence and expert interviews. Training exercises and the usability of the guide have been tested with persons in the target group

The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients

Understanding speech is essential for adequate social interaction, and its functioning affects health, wellbeing, and quality of life (QoL). Untreated hearing loss (HL) is associated with reduced social activity, depression and cognitive decline. Severe and profound HL is routinely rehabilitated with cochlear implantation. The success of treatment is mostly assessed by performance-based outcome measures such as speech perception. The ultimate goal of cochlear implantation, however, is to improve the patient’s QoL. Therefore, patient-reported outcomes measures (PROMs) would be clinically valuable as they assess subjective benefits and overall effectiveness of treatment. The aim of this study was to assess the patient-reported benefits of unilateral cochlear implantation in an unselected Finnish patient cohort of patients with bilateral HL. The study design was a prospective evaluation of 118 patients. The patient cohort was longitudinally followed up with repeated within-subject measurements preoperatively and at 6 and 12 months postoperatively. The main outcome measures were one performance-based speech-in-noise (SiN) test (Finnish Matrix Sentence Test), and two PROMs [Finnish versions of the Speech, Spatial, Qualities of Hearing questionnaire (SSQ) and the Nijmegen Cochlear Implant Questionnaire (NCIQ)]. The results showed significant average improvements in SiN scores, from +0.8 dB signal-to-noise ratio (SNR) preoperatively to −3.7 and −3.8 dB SNR at 6 and12 month follow-up, respectively. Significant improvements were also found for SSQ and NCIQ scores in all subdomains from the preoperative state to 6 and 12 months after first fitting. No clinically significant improvements were observed in any of the outcome measures between 6 and 12 months. Preoperatively, poor SiN scores were associated with low scoring in several subdomains of the SSQ and NCIQ. Poor preoperative SiN scores and low PROMs scoring were significantly associated with larger postoperative improvements. No significant association was found between SiN scores and PROMs postoperatively. This study demonstrates significant benefits of cochlear implantation in the performance-based and patient-reported outcomes in an unselected patient sample. The lack of association between performance and PROMs scores postoperatively suggests that both capture unique aspects of benefit, highlighting the need to clinically implement PROMs in addition to performance-based measures for a more holistic assessment of treatment benefit.peerReviewe