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The balance control of adolescents with hearing impairment in Singapore
Abstract
Balance control is integral to the fundamentals of stability, locomotion and manipulation throughout life. Poor balance control delays the development of motor skills and affects future motor performance. Optimal balance control requires the complex sensory-motor integration of Central Nervous System (CNS) with the various sensory systems (visual, somatosensory, vestibular & auditory systems). As a result of the individual constraints due to sensory disabilities, the adolescents with Hearing Impairment (HI) may exhibit poorer balance abilities and less developed motor skills than their peers with typical hearing. Motor intervention programmes have shown promising results in improving balance control. However, such programmes are not documented for the adolescents with HI. This study aimed to investigate the differences in the balance control between adolescents with HI and their peers with typical hearing, evaluate the effect of Balance Programme (BP) and examine the differences in the process of acquiring balance control during BP.
This study adopted a group-control experimental research design with repeated measures. Twenty-four female adolescents (age range: 12 – 16 years) participated in this study and were classified into three groups – the adolescents with HI who attended BP (HI group: n = 7), the adolescents with typical hearing who attended BP (Hearing group: n = 9) and the adolescents with typical hearing who did not attend BP (Control group: n = 8). The MAND instrument (McCarron, 1997) was used to assess the balance abilities of the participants. The balance control exhibited through the Balance Tasks selected for this study (Romberg stand, One-leg stand, Tandem stand, in-place Jump & in-place Hop) was measured using a portable force platform. The BP consisted of 12 practices (9 x 35-minute group practices & 3 x 45-minute individual practices), conducted three times a week over four weeks.
Overall, the pretest results of MAND tasks showed that the HI group scored significantly poorer Kinaesthetic Integration (KI) factor scores than the Hearing and Control groups (p ≤ .05; McCarron, 1997). In addition, the pretest results of Balance Tasks showed that there was no significant difference in static balance control (p > .05) but significant differences in dynamic balance control between HI group, Hearing and Control groups (p ≤ .05). Specifically, the adolescents with HI showed significantly poorer dynamic balance control than their peers with typical hearing (p ≤ .05).
After attending the BP, the pretest-posttest results showed that the HI and Hearing groups made significant improvements in KI factor scores which is an indication of improved balance abilities (p ≤ .05; McCarron, 1997). In addition, the HI and Hearing groups made significant improvements in their gross motor skills (p ≤ .05). The pretest-posttest results of Balance Tasks further reported that the HI and Hearing groups improved significantly in static (One-leg stand under eyes-open & eyes-closed) and dynamic balance control (in-place Jump & in-place Hop; p ≤ .05). With the exception of Romberg stand, the repeated measures results of balance control observed more significant improvements than deteriorations from the practice sessions during BP for all Balance Tasks (p ≤ .05).
Intra-individual analysis also corroborated with the statistical group analysis to support the positive effect of BP in improving balance abilities and balance control. Specifically, most of the participants with HI showed improved balance abilities and balance control after attending BP. Based on these findings, the BP was able to improve the balance control of adolescents with HI and their peers with typical hearing with varied balance proficiencies. It is recommended that similar balance-focused activities could be incorporated within the PE lessons of adolescents with HI to improve their balance control.
This study adopted a group-control experimental research design with repeated measures. Twenty-four female adolescents (age range: 12 – 16 years) participated in this study and were classified into three groups – the adolescents with HI who attended BP (HI group: n = 7), the adolescents with typical hearing who attended BP (Hearing group: n = 9) and the adolescents with typical hearing who did not attend BP (Control group: n = 8). The MAND instrument (McCarron, 1997) was used to assess the balance abilities of the participants. The balance control exhibited through the Balance Tasks selected for this study (Romberg stand, One-leg stand, Tandem stand, in-place Jump & in-place Hop) was measured using a portable force platform. The BP consisted of 12 practices (9 x 35-minute group practices & 3 x 45-minute individual practices), conducted three times a week over four weeks.
Overall, the pretest results of MAND tasks showed that the HI group scored significantly poorer Kinaesthetic Integration (KI) factor scores than the Hearing and Control groups (p ≤ .05; McCarron, 1997). In addition, the pretest results of Balance Tasks showed that there was no significant difference in static balance control (p > .05) but significant differences in dynamic balance control between HI group, Hearing and Control groups (p ≤ .05). Specifically, the adolescents with HI showed significantly poorer dynamic balance control than their peers with typical hearing (p ≤ .05).
After attending the BP, the pretest-posttest results showed that the HI and Hearing groups made significant improvements in KI factor scores which is an indication of improved balance abilities (p ≤ .05; McCarron, 1997). In addition, the HI and Hearing groups made significant improvements in their gross motor skills (p ≤ .05). The pretest-posttest results of Balance Tasks further reported that the HI and Hearing groups improved significantly in static (One-leg stand under eyes-open & eyes-closed) and dynamic balance control (in-place Jump & in-place Hop; p ≤ .05). With the exception of Romberg stand, the repeated measures results of balance control observed more significant improvements than deteriorations from the practice sessions during BP for all Balance Tasks (p ≤ .05).
Intra-individual analysis also corroborated with the statistical group analysis to support the positive effect of BP in improving balance abilities and balance control. Specifically, most of the participants with HI showed improved balance abilities and balance control after attending BP. Based on these findings, the BP was able to improve the balance control of adolescents with HI and their peers with typical hearing with varied balance proficiencies. It is recommended that similar balance-focused activities could be incorporated within the PE lessons of adolescents with HI to improve their balance control.
Date Issued
2014
Call Number
HV2391 Tan
Date Submitted
2014