Accuracy of polar F6 in estimating the energy cost of aerobic dance bench stepping in college-age females.

AIM: This study: 1) examined the accuracy of the Polar F6 for estimating energy expenditure (EE) in a sample of college-age women during aerobic dance bench stepping (ADBS) using predicted maximal oxygen consumption (VO2max) and maximal heart rate (HRmax), and 2) determined whether the use of actual measures of VO2max and HRmax improves the accuracy of the Polar F6 for estimating EE. METHODS: Thirty-two females had their VO2max and HRmax predicted by the Polar F6 heart rate monitor (HRM), and then performed a graded maximal exercise treadmill test to determine their actual VO2max and HRmax. The participants then followed a 20-min ADBS routine while stepping up and down off of a 15.24-cm bench at a cadence of 126 beats.min-1. During ADBS, the participants wore two F6 HRM that simultaneously collected data. To estimate EE, one HRM utilized their predicted VO2max and HRmax (PHRM) while the other HRM utilized their actual VO2max and HRmax (AHRM). RESULTS: The predicted HRmax significantly overestimated actual HRmax by 3.75 beats.min-1 on average, and the predicted VO2max overestimated actual VO2max by 2.63 ml.kg-1.min-1 on average (P<0.01). However, there were no significant differences between the PHRM and AHRM (P≥0.05). When compared to indirect calorimetry, the PHRM and AHRM significantly overestimated average EE by 28% (2.4 kcal.min-1) and 27% (2.0 kcal.min-1), respectively (P<0.05). CONCLUSIONS: Even when using actual measures of VO2max and HRmax, the Polar F6 is inaccurate in estimating EE during ADBS for college-age females.

Cochlear implants for deaf children.

Fifteen profoundly deaf patients under the age of 18 years have received a 3M/House cochlear implant. The surgical procedure employed is essentially the same as that used in adults with a few modifications to accommodate for the smaller dimensions of the mastoid process and the thinness of the scalp and temporal squama. Pediatric subjects receive timing and intensity information at similar thresholds as adults implanted with this device which contributes to improvement in speech production to various degrees. All subject groups demonstrated significant language delays as a result of their profound hearing losses. Postimplantation, more growth was seen in receptive than in expressive language skills. However, the growth observed did not exceed that expected in profoundly deaf children as reported in the literature. Language growth as a result of the cochlear implant alone is yet to be documented in our patients.

Long-term intracochlear implantation in man.

Whether long-term intracochlear implantation and direct electrical stimulation of the acoustic nerve will induce intracochlear bone growth or cause further degeneration of a severely compromised auditory system is an important clinical consideration. Thin-section CT evaluations of the cochleas of six subjects who have used their cochlear implant devices on a daily basis for 3 or more years demonstrated no evidence of osteoneogenesis of the cochlea in the vicinity of the active electrode. No corrosion of the electrode or insulation material was noted on electron microscopy of an explanted electrode system. Electrical threshold and dynamic range measurements have remained stable or even improved during the period of observation. Performance measures using a variety of audiologic tests and speech-tracking scores have demonstrated stability of performance.

Comparison of speech perception abilities in deaf children with hearing aids or cochlear implants.

The speech perception abilities of deaf children with a single- or multi-channel cochlear implant are compared with those of deaf children who derive substantial benefit from conventional hearing aids. The children with hearing aids have unaided pure-tone thresholds ranging from 90- to 110-dB HL through at least 2000 Hz, and aided thresholds of 30- to 60-dB HL. The group data show that the speech perception scores of the subjects with hearing aids were significantly higher than those of the subjects with implants on a range of speech perception measures. Although a few subjects with implants achieved scores as high as those who used hearing aids, the majority did not. Even though the children with implants receive substantial benefit from their devices, they continue to have limited auditory perception abilities relative to their peers who derive benefit from conventional hearing aids. The data highlight the importance of establishing hearing aid benefit in potential candidates for implant.

A FIT solution.

The Fusion at Inferred Threshold (FIT) test is a clinically useful procedure for assessing air-conduction pure-tone thresholds in any ear that may not be tested by conventional procedures with masking. It has not been widely reported in the literature. This article describes the FIT test procedure and provides four case studies where the FIT was used successfully to determine appropriate management strategies.

Comparison of sensory aids in deaf children.

A speech perception hierarchy has been developed and applied to assess the influence of cochlear implants and tactile aids on the acquisition of auditory, speech, and language skills in deaf children. Encouraging improvements were noted with both types of sensory aids at the detection level. The House 3M and Nucleus cochlear implant designs appear to offer advantages over the Tactaid II in providing ancillary speech perception cues to deaf children. Preliminary observations suggest that the multichannel cochlear implant design may be superior to the single-channel coding scheme.

Performance of deaf children with cochlear implants and vibrotactile aids.

A longitudinal study is under way to examine the speech perception and production skills of deaf children who use a single- or multi-channel cochlear implant, or a two-channel tactile aid. The speech perception data showed that the majority of subjects who achieved the highest scores on a range of measures used the multi-channel cochlear implant. The production data showed that all three types of sensory aids were effective in promoting production skills, with the cochlear implant users showing the greatest gains in this area.

Down syndrome: a multidisciplinary perspective.

Trisomy 21, a genetic disorder resulting from a chromosomal abnormality, is one of the most common forms of mental disability in the United States. Individuals with Down syndrome frequently present with a constellation of medical problems including conductive hearing loss and, to a lesser degree, sensorineural hearing loss. As part of a health care team, audiologists must be sensitive to and aware of medical conditions prior to establishing intervention strategies. Medical conditions, by necessity, precede audiologic interventions and, therefore, a close working relationship among team members is critical. Yet, audiologic and communication interventions should be established at the earliest possible time for maximizing an individual's development potential. This article stresses the importance of a multidisciplinary team in the provision of services so that prevention of further disabilities, improved outcomes of medical interventions, and appropriate habilitative and educational planning may ensue.

Cochlear implantation in the Mondini inner ear malformation.

We report the case of a profoundly deaf 4-year-old boy with congenital deafness as a result of Mondini's dysplasia. The Mondini inner ear malformation is the result of arrested labyrinthine development during embryogenesis and is characterized by both bony and membranous anomalies of the inner ear. The dysplastic cochlear anatomy does not preclude successful cochlear implantation, and electrical threshold measurements are similar to those recorded in pediatric subjects deafened as a result of other causes.

The role of cochlear implants in deaf children.

Advances in technology regarding cochlear implantation and electroacoustic stimulation of the inner ears of deaf children has created cautious enthusiasm. The safety of cochlear implantation is now reasonably well established and language performance measures made over time are encouraging. When coupled with an effective (re)habilitation program, the cochlear implant promises to favorably influence the potential of deafened children.

Relationships among selected measures of single-channel cochlear implant performance.

Relationships among a number of pre- and postimplant variables measured in 20 adults implanted with a single-channel cochlear implant were examined through a variety of univariate and multivariate statistical techniques. A large number of variables were analyzed to yield information on the relationships between pre- and postimplant performance, and among a variety of postimplant measures. Variables included: age; etiology and nature of deafness; type of implant worn; pre- and postimplant warble tone and speech detection thresholds; postimplant performance on the Monosyllable-Trochee-Spondee (MTS) and Environmental Sounds tests; postimplant electrical thresholds, uncomfortable loudness levels, and dynamic range; I.Q. scores; and postimplant discourse tracking performance with and without the implant. The difference score on the discourse tracking task, representing the auditory advantage over performance with lipreading alone, related substantively to a combination of variables including type of unit worn (Sigma versus Alpha), nature of deafness (progressive versus sudden), and etiology (meningitis versus nonmeningitis). Additionally, MTS and Environmental Sounds test scores were found to relate to one another and to etiology and nature of deafness.

Longitudinal evaluation of communication skills of children with single- or multichannel cochlear implants.

Performance on speech perception, speech production, and language tests was measured over time in children who used the 3M/House or the Nucleus cochlear implant. The speech perception and production results demonstrated higher performance levels and faster rates of learning for the multichannel than for the single-channel users. The performance of the children with the single-channel implant on the speech perception and production measures reached a plateau by 1.5 years post implant, whereas the children using the multichannel device continued to show improvement after 2 or more years of implant use. Changes in language were limited over time with no obvious difference in performance as a function of type of implant.

Cochlear implant candidate selection.

In recent years there has been an increased acceptance of the cochlear implant as an appropriate sensory aid for selected hearing-impaired individuals with profound losses. With the Food and Drug Administration's release of the 3M/House single channel cochlear implant on November 29, 1984 and the Nucleus 22-channel cochlear implant on October 31, 1985 it is anticipated that many new groups of otologists and audiologists will have direct involvement in this exciting new approach to the management of patients with profound hearing impairments. This report reviews our cochlear implant selection protocol for the severe to profound adult hearing-impaired population.

Speech perception abilities of children with cochlear implants, tactile aids, or hearing aids.

The purpose of this experiment was first, to compare the performance of three matched groups of experimental subjects who used either a single-channel cochlear implant, a multichannel cochlear implant, or a two-channel vibrotactile aid on a battery of speech perception measures, and second, to compare the performance of subjects with residual hearing who used hearing aids to that of the three groups of experimental subjects. The results revealed that the subjects using hearing aids achieved the highest scores on all measures. The performance of the group of multichannel implant users was significantly higher than that of the single-channel implant users on tests involving discrimination of speech features, categorization of stress patterns, closed-set identification of familiar words, and identification of common phrases with and without visual cues. The performance of the subjects using 3M/House and Tactaid II devices was similar on all tests except those requiring integration of auditory or tactile cues and visual cues, on which the 3M/House device users achieved significantly higher scores than did the Tactaid II device users.

Pediatric cochlear implant candidacy issues.

Children with progressive sensorineural hearing impairment represent a special challenge to the audiologist and the otologist. These are patients with some residual auditory abilities that deteriorate with time as the hearing loss progresses. No doubt, the unnecessary implantation of an ear that significantly benefits from amplification needs to be avoided at all costs. By the same token however, there appears to be no advantage to waiting an inordinate amount of time after the loss of functional auditory abilities before recommending implantation. At times when a complete loss is predictable, implantation may be advantageous before the onset of complete auditory deprivation. Steps the clinicians should take to manage these patients effectively are briefly summarized below: Implementation of rigorous and frequent audiologic monitoring. If, for instance, a significant progressive loss of hearing has occurred over a 6-month period, resulting in a complete absence of open-set speech recognition abilities in the auditory-alone mode with appropriate hearing aids, it is probably counterproductive to wait to the point of a complete absence of aided speech detection. Implantation at a critical point in time will prevent complete auditory deprivation. Parental counseling concerning various management strategies, such as use of vibrotactile devices, changing communication skills, and issues involving cochlear implants need to be undertaken early. Parents need to be involved in every phase of the evaluation process because they are the ones who make the final decision concerning the implantation of their child. Relatively early implantation should be considered in light of what is known concerning the effects of disruption in a child's linguistic, cognitive, and emotional development resulting from complete auditory deprivation.(ABSTRACT TRUNCATED AT 250 WORDS)