Assessing the influence of sensory interaction and vestibular compensation on postural control in young females with sensorineural hearing loss

Hearing impairment is a common sensory deficit in humans. Sensorineural hearing loss [SNHL] may be associated with involvement of vestibular system, especially due to near location of anatomical structures in the inner ear, The aim of the study was to investigate the postural control under altered sensory conditions in young females with SNHL to assess their effect and in predicting a possibility of vestibular insufficiency. The study was conducted on 20 deaf females [age range wasl8:24 years] with bilateral permanent SNHL compared to 25 normal hearing matched females. Modified Clinical Tests of Sensory Interaction on Balance were done for both groups under sensory altered conditions by using The Computerized Smart Balance Master System. The results revealed a statistical significant increase in the postural sway velocities precluding the maintenance of the upright stance with removal of visual stimuli and modification of somatosensory input in SNHL females in comparison to normal-hearing subjects. The study suggests that young females with SNHL are at risk of peripheral vestibular loss as they primarily use visual and somatosensory information to maintain their postural control. The findings allow us to confirm that the postural control tests should be done for subjects with SNHL for detecting and rehabilitating vestibular dysfunction

Influence of regular closed chain exercises for lower limbs on bone mineral density of femoral neck in stroke patients

Stroke patients have high prevalence of osteoporosis. Over activity of the unaffected side, asymmetrical weight distribution with a shift in the body's center of pressure towards the unaffected side unload the skeleton at affected hip. These factors may result in high risk of falling and an early hip fracture. The purpose of this study was to investigate the effect of regular closed chain exercises for lower limbs on bone mineral density [BMD] of femoral neck post stroke. Forty hemiplegic male patients with mean age of 59.8 +/- 3.2 years participated in this study. They were assigned to two equal groups [study and control]. Both groups received conventional physical therapy program [tone reduction, trunk control, mobilizing, strengthening and coordination exercises] for ten months as three sessions per week. The study group received an additional closed chain exercises program. Bone mineral density of femoral neck was measured by dual-energy x-ray absorptiometry [DXA] pre and post treatment for both groups. In addition, percentage body weight distribution on feet during standing was assessed by force platform. The study group demonstrated a statistically significant improvement in the percentage body weight distribution on both lower limbs and the BMD value of the paretic femoral neck post treatment program as compared with the control group. This study provides clear evidence that redistribution of weight bearing and relearning of loading response on paretic side by using closed chain exercises in addition to conventional program are effective in minimizing bone loss post stroke