Hearing Rehabilitation Program Research Articles

Impact of hearing rehabilitation programs on presbycusis management: a systematic review and meta-analysis of randomized controlled trials.

In the field of audiology, numerous studies have sought to understand and improve hearing rehabilitation programs for older adults afflicted with presbycusis. Despite this, the field lacks uniform standards pertaining to the intervention methods, frequency, and duration of such programs. These discrepancies have led to varying test results and inconsistent findings across multiple studies. This meta-analysis aimed to evaluate the efficacy of hearing rehabilitation programs in enhancing the utilization of hearing aids among older adults with presbycusis. We conducted a comprehensive exploration of PubMed, Embase, Cochrane Library, and Web of Science to identify randomized controlled trials assessing the role of hearing rehabilitation programs for patients with age-related hearing loss. The search period spanned from the inception of each database to September 12, 2024. Outcomes were synthesized using RevMan 5.4 software. Eight studies met the inclusion criteria, involving 598 patients (290 in the intervention group and 308 in the control group). It was observed that hearing rehabilitation programs significantly diminished self-perceived hearing impairment [MD = -5.80, 95% CI = (-8.16, -3.44), p < 0.00001] and negative emotional states [MD = -1.66, 95% CI = (-3.02, -0.29), p = 0.02], while enhancing hearing aid utilization [MD = 0.22, 95% CI = (0.08, 0.36), p = 0.002]. Nonetheless, these programs did not significantly augment patients' satisfaction with their hearing aids [MD = 0.09, 95% CI = (-0.17, 0.26), p = 0.66]. Hearing rehabilitation programs significantly improve hearing aid outcomes, reduce self-perceived hearing impairment, and alleviate negative emotional states in patients. However, the current body of evidence is insufficient to conclusively indicate that these programs enhance patient satisfaction with daily hearing aid usage.

Best practice in audiology: context matters

Historically, modern audiology evolved from the United States of America (USA) after the Second World War, where hearing rehabilitation programs were established across the country. Since then, audiology practice and the profession as a whole has expanded from the west to the far east and global south with considerable contextual variations. Thus, the purpose of this paper is to increase conversation and engagement on definitions and the drawbacks of a single lens approach to the use of best practice guidelines in Audiology. It is important to develop a more expansive lens as influenced by different contexts such as Africa, Asia, and South America that will in turn help facilitate a multidimensional approach to audiology practice and what is considered “best practice.”

Prevalence and predictors of self-reported hearing aid use and benefit in Norway: the HUNT study

BackgroundKnowledge on hearing aid use and benefit is important to ensure appropriate and effective treatment. We aimed to assess prevalence and predictors of hearing aid use and benefit in Norway, as well as possible birth cohort changes.MethodsWe analyzed two large cross-sectional, population-based hearing surveys of 63,182 adults in 1996–1998 and 2017–2019 (the HUNT study). We used multivariable regression models to examine independent predictors of hearing aid use and benefit, including demography, hearing-related variables, known risk factors for hearing loss and birth cohort.ResultsThe nationally weighted hearing aid use in the adult population increased from 4.2% in 1997 to 5.8% in 2018. The use among individuals with disabling hearing loss (≥ 35 dB HL) increased from 46.3% to 64.4%. Most users reported some (47%) or great (48%) help from their hearing aids. In addition to the level of hearing loss and birth cohort, factors associated with hearing aid use included lower age, tinnitus, childhood-onset hearing loss, higher education, marriage, having children, being exposed to occupational noise or impulse noise, recurrent ear infections, and head injury. In addition to the level of hearing loss, factors related to hearing aid benefit included younger age, female gender, and higher income. Being bothered by tinnitus reduced the benefit.ConclusionOur study shows an increase in self-reported hearing aid usage over time in Norway, with lower adoption rates and perceived benefits observed among the elderly. The results suggest that having a spouse and children positively influences the adoption of hearing aids. These findings emphasize the necessity of customized strategies to address demographic disparities and the need for innovative enhancements in hearing rehabilitation programs.

Analysis of Research Trends on Older Adults with Hearing Loss in Korea: Using the ICF Core Set

Purpose: This study aimed to analyze trends of research on older adults with hearing loss, based on the framework of the International Classification of Functioning, Disability and Health (ICF) core set for hearing loss in Korea, and to present implications for the direction and challenges of research on older adults with hearing loss in the future. Methods: A total of 54 studies related to older adults with hearing loss, published in academic journals from 2000 to July 2023 in Korea, were analyzed.Results: In the analysis of research methods, quantitative studies accounted for 97.0%, among which survey studies accounted for 56.7%, more than experimental studies. As a result of the analysis by research theme, studies related to ‘quality of life and satisfaction (21.1%)’ and ‘psychological and emotional characteristics (18.3%)’ were frequent. As a result of the analysis by the classification of the ICF core set, among the components of the ICF, studies related to ‘activities and participation’ and ‘body functions’ were the most. By subcategory, ‘hearing functions (12.0%)’ and ‘emotional functions (11.7%)’ of the body functions sub-area, and ‘listening (10.9%)’ of the activities and participation subarea were frequent.Conclusion: The results of this study will be useful as a foundational reference for the evaluation of hearing impairments of older adults with hearing loss, the development of hearing rehabilitation programs, and the establishment of various health and welfare policies.

Hearing Aid Interventions and Its Effect on Hearing Handicap Inventory for Elderly Score Among Elders with Bilateral Hearing Impairment

Background: Several elderly populations face impairment in hearing, difficulty in following discussions in the presence of multiple talkers, understanding the speech of unfamiliar people, understanding fast speech, and understanding speech in noisy environments. Many hearing rehabilitation programs came into the picture for the help of the elderly population. The aim of the meta-analysis was to assess the effect of hearing aid interventions on hearing handicap inventory for elderly (HHIE) scores among elders with bilateral hearing impairment in randomized controlled trials (RCTs). Materials and Methods: Two independent reviewers searched for full-text RCTs from worldwide online databases named PubMed and Google Scholar. Studies from January 2000 to January 2022 in the English language conducted among humans were considered. The search strategy contains PICO format in which P-elders with bilateral hearing impairment, I-hearing aid intervention, C-placebo, O-HHIE scores as outcome measures. Results: A total of 28 trials were identified from online databases using PICO format further on evaluation 8 trials with a total of 445 participants were included for the final meta-analysis of the study. The pooled results after sensitivity analysis revealed that 7 trials had a significant reduction in mean difference (MD) of HHIE score among elders with bilateral hearing impairment (MD-2.21 (95% confidence interval [CI] = −4.24 to −0.19), P = 0.03 with heterogeneity (I 2 = 48%, P = 0.07) in the fixed-effect model. The Stratified analysis was also done between subgroups as HHIE-social/situational and HHIE-emotional scores shows no significant difference among subgroups for the reduction in a MD of scores −5.34 (95% CI −7.05, −3.64), P = 0.03 without any heterogeneity (I 2 = 0%, P = 0.97) with use of fixed-effect model. Conclusion: The findings of the meta-analysis revealed that any type of hearing aids interventional program is found to be effective in reducing HHIE scores. It indicates that these interventions result in a reduction in social and emotional consequences due to hearing loss among elders with bilateral hearing impairment. Adherence to the hearing rehabilitation programs is highly recommended by the researchers to improve social and emotional aspects of life among elders.

Profiling hearing aid users through big data explainable artificial intelligence techniques.

Debilitating hearing loss (HL) affects ~6% of the human population. Only 20% of the people in need of a hearing assistive device will eventually seek and acquire one. The number of people that are satisfied with their Hearing Aids (HAids) and continue using them in the long term is even lower. Understanding the personal, behavioral, environmental, or other factors that correlate with the optimal HAid fitting and with users' experience of HAids is a significant step in improving patient satisfaction and quality of life, while reducing societal and financial burden. In SMART BEAR we are addressing this need by making use of the capacity of modern HAids to provide dynamic logging of their operation and by combining this information with a big amount of information about the medical, environmental, and social context of each HAid user. We are studying hearing rehabilitation through a 12-month continuous monitoring of HL patients, collecting data, such as participants' demographics, audiometric and medical data, their cognitive and mental status, their habits, and preferences, through a set of medical devices and wearables, as well as through face-to-face and remote clinical assessments and fitting/fine-tuning sessions. Descriptive, AI-based analysis and assessment of the relationships between heterogeneous data and HL-related parameters will help clinical researchers to better understand the overall health profiles of HL patients, and to identify patterns or relations that may be proven essential for future clinical trials. In addition, the future state and behavioral (e.g., HAids Satisfiability and HAids usage) of the patients will be predicted with time-dependent machine learning models to assist the clinical researchers to decide on the nature of the interventions. Explainable Artificial Intelligence (XAI) techniques will be leveraged to better understand the factors that play a significant role in the success of a hearing rehabilitation program, constructing patient profiles. This paper is a conceptual one aiming to describe the upcoming data collection process and proposed framework for providing a comprehensive profile for patients with HL in the context of EU-funded SMART BEAR project. Such patient profiles can be invaluable in HL treatment as they can help to identify the characteristics making patients more prone to drop out and stop using their HAids, using their HAids sufficiently long during the day, and being more satisfied by their HAids experience. They can also help decrease the number of needed remote sessions with their Audiologist for counseling, and/or HAids fine tuning, or the number of manual changes of HAids program (as indication of poor sound quality and bad adaptation of HAids configuration to patients' real needs and daily challenges), leading to reduced healthcare cost.

The Relationship Between Reaction Time of Electrical Stapedius Reflex and Auditory Performance in Cochlear-implanted Children

Objectives: A common concern in some cochlear-implanted children is the lack of desired progress in auditory and listening skills. Such a concern remains despite proper verbal processor programming, additional disabilities, and continuous participation in hearing rehabilitation programs. A more detailed assessment of pathways and centers of the auditory processing at the lower end of the brain stem by measuring the time of the Electrical Stapedius Reflex (ESR), and investigating its relation to auditory perception skills can provide significant information about choosing the appropriate rehabilitation method. Methods: In total, 20 unilateral cochlear-implanted children (3-7-year-olds) participated in this research. All of them were implanted for ≥2 years and participated for ≥1 year in the auditory-verbal rehabilitation program. The ESR reaction time was measured for 3 electrodes in the apex, middle, and basal areas. The Categories of Auditory Performance (CAP-II) test score was used to assess the progress of auditory skills. Then the correlation between CAP-II test score and ESR reaction time was investigated per each electrode. Results: There was a significant inverse correlation between the ESR reaction time and the CAP II test scores in the apex electrodes (r=-0.5, P&lt;0.05). However, no such correlation was observed in the middle (r=0.34, P&gt;0.05) and basal (r=-0.06, P&gt;0.05) electrodes. Discussion: There was a significant correlation between the shorter reaction time of ESR in the apex electrode and the higher scores in the CAP-II test for auditory skills in children. Therefore, examining the ESR reaction time can be useful for prediction of the benefits of cochlear implantation as well as choosing a better rehabilitation approach for cochlear-implanted children.

Hearing Loss in Children: Clinical-Epidemiological Data from Two Different Provinces of the Same Region.

Background: In many countries, neonatal hearing screening programs (NHS) have been available for many years; however, because of the presence of hearing loss at late onset, early hearing detection programs (EHDP) have been implemented. The aim of this study was to evaluate all cases of infantile hearing loss under the care of two different provinces of a regional health service since the introduction of NHS. Methods: Clinical data (the presence of audiological risk factors, age at which children are placed under the care of health service, entity of hearing loss, treatment, and exposure to bilingualism) were retrospectively collected during the period from 1 January 2012 to 31 December 2018, starting from the IT management system used in all of the regional neuropsychiatric services. Results: In total, 124 children were included—116 cases failed the screening, 1 case had an untraceable result, and 7 cases (5.6%) had hearing screening that passed. Most of the children were placed under the care of a neuropsychiatric infantile and adolescence (NPIA) service within the first year of life. The main differences across the two provinces concerned the percentages of audiological risk factors and the number of unilateral hearing loss cases. Conclusion: In order to plan and manage hearing rehabilitation programs for children in the best way, it is very important to know the local clinical-epidemiological features of the population.

A normative study of auditory perception in Mandarin-speaking children with categories of auditory Performance-II

ObjectiveThe aim of this study is to investigate the development of auditory skills in Mandarin-speaking children with normal hearing using CAP-II, and to establish the baseline data for evaluating the auditory performance of children with hearing loss on which designs of appropriate hearing rehabilitation programs can be based. Materials and methodsA total of 223 children participated in this study of which 200 children aged from 1 to 60 months were finally included. Their normal hearing was confirmed by examination of hearing history and high-risk registers for hearing loss, as well as by hearing screening. All children were divided into 10 groups with 20 children in each group based on age. The CAP-II scale was administered to evaluate their development of auditory skills. ResultsThe categories of auditory performance scores of children with normal hearing improved with their age, the best-fit regression function for prediction of scores from age was Score = 0.94 × ln(age) + 0.08 × (age) + 1.16 and prediction of age from score was Age = 0.65 × (score)2–0.14 × (score)–0.23. The overall CAP-II scale exhibited good reliability and validity. Conclusionsand Significance: An improvement in auditory skill with age in children with normal hearing was observed. Ceiling performance in auditory skills was found at the age of 51 months for normal children. A conversion table between age and scores obtained from the data of this study can be used as a reference for the assessment of clinical hearing ability in children.

A comparative study on the general health of the mothers of children with cochlear implant, hearing aid, and normal hearing

Background and Aim: The general health of the mothers of children using hearing aids is highly important, and can affect their children’s progress in hearing rehabilitation programs. This study aimed to compare the general health of the mothers of children using cochlear implants (CIs), mothers of children using hearing aids (HAs), and mothers with normal hearing (NH) children. Methods: In this descriptive-comparative study conducted on the mothers of children using CIs (n = 19), HAs (n = 19), and NH (n = 15). Their general health was measured by the 28-item general health questionnaire (GHQ-28) in four areas of physical symptoms, anxiety symptom, social dysfunction symptom, and depression symptom. Results: The general health of the mothers of children using CIs was significantly higher than that of the mothers with children using HAs (p = 0.02), while it was lower than that of the mothers with NH children, but it was not statis­tically significant (p = 0.5). Conclusion: Mothers of children using CI chil­dren have higher general health than the mothers with children using HA, and its level was close to that of the mothers with NH children. Cochlear implantation and consequently improved comm­unication is effective in improving the general health of the hearing-impaired children’s moth­ers. Keywords: Hearing aid; cochlear implant; general health questionnaire; mothers

Long-term Benefit of Unilateral Cochlear Implantation on Quality of Life and Speech Perception in Bilaterally Deafened Patients.

Cochlear implantation (CI) is a common treatment modality for unilaterally and bilaterally deafened patients as well as patients with severe to profound hearing loss. The aim of our study is the complex evaluation of the improvement and influence of health related quality of life (HRQoL) and auditory performance in cochlear implant patients during a long-term follow-up. Sixty-one bilaterally, postlingually deafened patients with unilateral CI were included in this prospective study. Assessment tools for auditory performance and HRQoL included the Freiburg Monosyllabic Speech test, Oldenburg Inventory (OI) questionnaire, Nijmegen Cochlear Implant Questionnaire (NCIQ) and 36-item Short Form Survey (SF-36). Data were collected before CI, at 6, 12, and 24 months postoperatively. The assessment tools for speech perception yielded a statistically significant improvement in the Freiburg Monosyllabic Speech test scores and of all subdomain scores of the OI during the 6-month follow-up period. The subdomain scores of the NCIQ and the psychological score of the SF-36 also improved significantly during this follow-up period. All results remained stable thereafter during the 12- and 24-month follow-up. There was a statistically significant correlation between subjective speech perception and HRQoL after CI. This is the first prospective study to show results in regard to speech perception and HRQoL and their correlation during a 2-year follow-up after unilateral CI in bilaterally deafened patients. Our results for speech perception and HRQoL showed a significant improvement during the 6-month follow-up that remained stable thereafter during a 24-month follow-up, even after finishing the hearing rehabilitation program.

Hearing rehabilitation through telemedicine to enhance public policies in Brazil

Since 2004, the Brazilian government has run one of the most all-inclusive hearing rehabilitation program based on hearing aids worldwide. In 2007 this investment in hearing aids topped U$ 68 million, apart from covering the cost of physicians and audiologists. Nearly 140 centers are certified by the government to dispense fitted hearing aids, figures which are still low when one considers the size of the country. Telemedicine can represent a field of knowledge which broadens hearing rehabilitations services in Brazil, for it may help increase the number of hearing rehabilitation centers, enable remote training and provide for an "online second opinion". As far as public administration is concerned, it may enable process standardization and the very control over this hugely complex operation. The present article aimed to consider Telemedicine a powerful ally to improve hearing health care policies in Brazil.

Hearing threshold assessment in young children with electrocochleograpy (EcochG) and auditory brainstem responses (ABR): Experience at the University Hospital of Ferrara

Objective Electrophysiological evaluation is a fundamental procedure for the diagnostic assessment of hearing loss during infancy; in these cases, information concerning threshold level and auditory perception is particularly useful to establish a correct hearing rehabilitation program (hearing aids and cochlear implants). Purpose of this study is to underline the role of auditory brainstem responses (ABR) and electrocochleography (EcochG) in the definition of hearing loss in a selected group of children, referred to the Audiology Department of the University Hospital of Ferrara, for a tertiary level audiological assessment. Methods A retrospective study of the paediatric patient database at the Audiology Department of the University Hospital of Ferrara has been performed. In a period between January 2000 and December 2007, a total of 272 paediatric cases have been identified (544 ears). An EM 12 Mercury apparatus has been used for the electrophysiological threshold identification (ABR and EcochG). Recordings were carried out under general anaesthesia, in a protected enviroment. Results In 19 of the 272 paediatric cases selected—38 ears (7%), the results of threshold evaluation through ABR were uncertain. The Ecochg recording resulted crucial for the final diagnosis in terms of definition of the hearing threshold level, and it was then possible to ensure the better hearing rehabilitation strategy. Conclusions ABR has to be considered the first choice in hearing assessment strategy, either for screening or for diagnosis in newborns as well as in non-collaborating children; ECochG still may be considered a reliable diagnostic tool.

Formal auditory training in elderly hearing aid users

SummaryIt is of paramount importance to install hearing rehabilitation programs for the elderly. Aim: to check the efficacy of a forma auditory training program for elderly patients fitted with hearing aids for at least three months, by means of speech recognition tests and self-assessment questionnaires. Methods: longitudinal contemporary cohort study. We selected 13 elderly hearing aid users, using intra-canal hearing aids in both ears, from both genders, with average age of 65.3 years. This group was randomly divided in Experiment Group and Control Group. The Experiment Group underwent seven formal auditory training sessions, aiming at stimulating their hearing skills for hearing closing, memory, attention, background figure and binaural integration. The participants were assessed by three behavioral tests and one self assessment questionnaire. Results: The elderly from the Experiment Group had significantly better performance in the assessments after auditory training in comparison to the Control Group. Conclusion: the formal auditory training program in a soundproof booth, associated with the use of hearing aids, improves speech recognition performance and reduces the perception of auditory handicap for the elderly who use intra-canal hearing aids.

Effects of Age and Degree of Hearing Loss on the Agreement and Correlation Between Sound Field Audiometric Thresholds and Tone Burst Auditory Brainstem Response Thresholds in Infants and Young Children

Early hearing rehabilitation programs eventually require measurement of the hearing threshold cutoff values over the whole range of speech frequencies. With tone burst auditory brainstem responses, excellent agreement and correlation between evoked-potential and behavioral thresholds have been demonstrated by previous studies. This study investigated the effects of different ages and degrees of hearing loss on the agreement and correlation in a large series of infants and young children in Taiwan. Medical records were reviewed from a large series of 1281 infants and young children aged from 3 months to 3 years who had undergone diagnostic audiometry, including sound field audiometry and tone burst auditory brainstem response measurements. The effects of age and hearing loss on the agreement and correlation between two measured thresholds were studied. Significant correlations (p < 0.001) were seen between the two measured thresholds across groups of different ages and different degrees of hearing loss greater than 20 dB HL. However, the degree of correlation deteriorated at lower degrees of hearing loss. Correlations for hearing thresholds less than 20 dB HL were not significant at 1000, 2000 and 4000 Hz. The evoked-potentials test, properly obtained and interpreted with respect to the effects of age and degree of hearing loss, may provide a very informative hearing threshold reference to help in behavioral audiometric evaluation in infants and young children with hearing loss.

The efficacy of a structured group therapy intervention in improving communication and coping skills for adult cochlear implant recipients

This paper reports on an evaluation of a structured group therapy intervention for adult cochlear implant (CI) recipients designed to improve overall communication and coping skills. 33 adult CI recipients (14 males, 19 females; mean age 61; 1–14 years since CI) participated in a 2-day structured group therapy intervention with a follow-up session 4 weeks later. Measures were: communication behaviors (CPHI), assertiveness (Rathus), depression (DASS), and behavior during conversation (Dyalog). TCI personality traits were utilized as predictors of change. Repeated measures analyses showed that participants demonstrated significant improvements on measures of assertiveness, emotional well-being, and coping behaviors at 3 months post-intervention that persisted at a 12-month follow-up. Several personality traits predicted change. Although subjects had presumably adapted to their cochlear implants and had learned communication strategies in hearing rehabilitation programs, the improvements on several measures suggest that a structured group therapy intervention can enhance outcome following cochlear implantation.

Reabilitação auditiva no idoso

Dentre as alterações sensoriais que acompanham o processo de envelhecimento, a deficiência auditiva, conhecida como presbiacusia, é uma das mais incapacitantes. Esta alteração diminui o contato social, gerando alterações emocionais muitas vezes devastadoras. Além da limitação auditiva decorrente da deficiência auditiva adquirida, verifica-se o aparecimento do handicap auditivo, relacionado a aspectos não auditivos e às alterações emocionais e sociais desencadeados pela deficiência auditiva. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO:Fizeram parte deste estudo 7 Sujeitos, 3 do sexo masculino e 4 do sexo feminino, com idades que variaram de 60 a 77 anos e portadores de perda auditiva sensorioneural bilateral usuários de aparelho de amplificação sonora unilateral. Foram realizadas 7 sessões de reabilitação auditiva com duração de 1 hora cada, semanal e em grupo, nas quais foram treinados Leitura Orofacial de todos os fonemas da língua portuguesa e trabalhadas estratégias situacionais e comportamentais. RESULTADOS: Foi verificada uma redução significativa da percepção do handicap auditivo em todos os sujeitos após o término das 7 sessões, observados a partir da aplicação do questionário HHIE-S pré- e pós-reabilitação auditiva. CONCLUSÃO: Para minimizar as reações psicossociais do idoso decorrentes da deficiência auditiva, faz-se necessário a seleção, indicação e adaptação de AASI conjuntamente a programas de reabilitação auditiva, auxiliando o idoso portador de deficiência auditiva e seus familiares a lidarem de forma positiva frente às dificuldades de comunicação. Através de programas de reabilitação auditiva é possível reduzir a percepção do handicap auditivo da população idosa que irá refletir na melhora de qualidade de vida, promoção de contatos sociais e diminuição do isolamento.

HEARING PROBLEMS IN A HOME FOR THE AGED.

A full time speech and hearing rehabilitation program is now in operation at the Menorah Home and Hospital. To evaluate the auditory problems of the population, pure tone testing has been performed on approximately one fourth of the residents. Results of this study are reported and analyzed and the nature and possible etiology of presbyacusic hearing loss are considered.