Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT05719610 |
| Other study ID # |
REC/RCR&AHS/22/0731 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
January 27, 2023 |
| Est. completion date |
July 3, 2023 |
Study information
| Verified date |
July 2023 |
| Source |
Riphah International University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
Balance and weak postural control are most common in children with severe to profound hearing
deficits. Children with hearing deficits also indicate behavioral problems related to impulse
control, distraction, and disability to maintain attention in the visual modality. Hearing
deficit is mostly defined as a communication deficit. Although the communication deficit is
an important disorder, hearing deficit co-occurs with other physical impairments such as
vestibular disorders. Development and control of the posture are important prerequisites for
skill motor function. Children with hearing deficits and impaired sensory organization had
weak balance and motor efficiency in many fields. Various studies on motor skills in deaf
children have reported deficits in balance, general dynamic coordination, visual-motor
skills, ball catching ability, and some disturbances in reaction time and speed of movements.
Teachers of children with hearing impairment often complain of non-coordination, clumsiness,
and balance deficit in such children, preventing the child from the desired function. So the
aim of the study is to determine the effects of Cawthorne Cooksey Exercises on Balance and
quality of life in children with hearing deficit It will be a Randomized Controlled Trial and
children fulfilling exclusion-inclusion criteria will participate in the study. They will be
divided randomly into two groups, using computer generated randomization, into control group
and experimental group. After performing the pre-test measurements, the control group will
perform Swiss Ball Exercises for 45 minutes and the interventional group will perform
Cawthorne Cooksey Training Program Swiss Ball Exercises in addition, will also perform of 45
min session three times a week for 8 weeks of training. the study subjects will be evaluated
again by Pediatrics Berg Balance Scale, Four-Step Square test and Quality of life
questionnaire for children to measure the quality of life. Results will be compared with the
pretest measurements. Data will be analyzed by using SPSS scale windows software version 25.
Description:
In children, vestibular function plays an important role in the gross motor development and
postural control. Infants and children with congenitally profound hearing loss commonly
suffer vestibular dysfunction in both ears, and poor balance. However, there have been very
few studies have investigated the effect of exercises on balance and quality of life in
children with the profound hearing deficit. The development and maintenance of balance is a
multisystem process that also depends on vestibular input believe that as labyrinths and
cochlea are anatomically and developmentally interrelated, there is a potentiality for
vestibular impairment when the hearing mechanism is impaired.
In a study using Barany Rotary test and caloric stimulation, found that 82% of 89 children
with severe acquired hearing deficits and 34% of 129 children with hereditary hearing
deficits had abnormal responses to vestibular tests. Since the vestibular system activates
vestibular reflex mechanisms trying to stabilize the eyes, head, and body in the space,
impairment of this mechanism may affect postural sensitivity. Maturational changes in visual
and proprioceptive, central nervous system processing, and coordination of motor output are
responsible for the changes in postural skills observed through adolescence . From the
sensory systems perspective, Infants and young children are dependent on the visual system to
maintain balance; as they grow older, begin to use somatosensory and vestibular information
appropriately. Between the 3 sensory inputs in children, the vestibular system seems to be
the least effective in postural control.
Children with profound bilateral vestibular dysfunction present with delayed gross motor
development. These children stand and walk later than their peers with typical development
Difficulties in maintaining balance can lead to challenges in normal childhood activities,
such as riding a bicycle or hopping. Reduced ability to participate in normal play with other
children may result in social isolation. So, the mechanisms responsible for the lack of
balance in children with profound hearing impairment need to be established, and holistic
management including both auditory and vestibular function is needed. Sensory organization
dysfunction is more prevalent in children with hearing loss and vestibular dysfunction which
may result in a problem with balance. These children in situations needs an early address to
their balance through balance training activities. Most children with bilateral vestibular
dysfunction. These results suggest that due to multi-modal sensory interdependence, the
development of visual and somatosensory effectiveness in maintaining balance is impaired
secondary to vestibular dysfunction since birth. There is ample support for the efficacy of
vestibular rehabilitation therapy through different exercises in adults, but very few data
exist regarding its results in children.
Balance is major problem associated with vestibular system specifically in the patients with
sensory neural hearing deficits. Since vestibular rehabilitation is an important factor that
must be achieved for balance in hearing deficits. Cawthorne Cooksey exercises may be
considered as an effective technique to gain balance and improve quality of life.
