#acoustic compression therapy

[ghostinthegem]

Finding Relief for My Plantar Fasciitis in Lake Mary FL

Are you suffering from plantar fasciitis, a common foot condition that causes pain and inflammation in the heel and bottom of the foot? If so, you are not alone. Many people suffer from this condition, but relief may be closer than you think.

I, myself, dealt with severe plantar fasciitis for many years. I tried everything from stretching exercises to orthotics, but nothing seemed to provide long-lasting relief. That is until I discovered Acoustic Compression Therapy in Lake Mary, FL.

I was skeptical at first, but after only 8 short sessions, my pain and inflammation significantly decreased. Acoustic Compression Therapy uses high-energy acoustic waves to stimulate the body's natural healing process, resulting in decreased pain and inflammation.

The sessions are painless, and the therapy can be applied to various areas of the body, not just the feet. The staff at the facility were knowledgeable, supportive, and understanding of my condition. They worked with me to create an individualized treatment plan that focused on my specific needs.

Now, I am able to enjoy activities such as hiking and running without the constant pain and discomfort. Acoustic Compression Therapy has truly been a life-changing experience for me, and I highly recommend it to anyone suffering from plantar fasciitis or any other chronic pain condition.

If you are interested in learning more about Acoustic Compression Therapy for plantar fasciitis treatment in Lake Mary FL, I encourage you to reach out to the knowledgeable staff at the facility. With their guidance and expertise, you too can find relief and start living your life to the fullest.

[runawayballista]

first recording in my voice recovery project lets gooooo

no amount of compression & EQ can change the fact that i recorded this in a tiny room with no acoustic treatment but i told myself i would post the first thing i was able to record NO MATTER WHAT

last year i had a relatively minor vocal injury that nonetheless meant i had to quit singing entirely for about 4 months until i began speech therapy. since then i've made a lot of progress in being able to sing again at all, but i (understandably) lost a lot of projection strength. i've been working on building back up, but i had never in my life stopped singing for more than a few days at a time so this has been hard!

the timing of this injury sucked especially as i was just about ready to start recording vocals for the first song for my & celene's band and i'm still not quite up to par, so i'm going back to my vintage tumblr practice of posting recordings of my self singing while i work on getting myself back to where i was. my hope is by doing this, i'll have a tangible record of my progress and something to look back on to encourage myself.

this means that a lot of these recordings will be subpar! you can quite easily hear in this recording precisely where in my range i start to lose strength. i can hear myself go off key in a few places, and i recorded this at night so it's not the freshest sound. but this is the first time i've been able to record something without strain, and it's already so much better than where i was last fall. i just have to keep working at it and i will eventually even surpass my old self!!

there is of course the fact that it sounds like i'm singing into a cardboard box the whole time but this is why we are getting an isolation shield

anyway. first song. tooi kono machi de from cardcaptor sakura :)

[punechelation1]

Heart Treatment Without Surgery

Heart and vascular care specialists at Poona Preventive Cardiology Center provide a variety of proven non-surgical treatments for heart disease. An important part of our success is tailoring strategies that meet the specific needs of patients. Therefore, it is important to have someone there to help you achieve your goals.

 Listed below are some treatments for heart blockage without surgery: 

 EECP:

An increasing number of patients have persistent anginal symptoms and have exhausted the standard treatments. Enhanced External Counterpulsation (EECP) can stimulate openings or forms of collaterals (small branches of blood vessels) to create a natural bypass around blocked arteries.

What happens during EECP treatment?

EECP is a non-invasive therapy. During treatment:

Patients lie down on a padded table in a treatment room.

The electrodes attach to the skin of the chest and are connected to an electrocardiograph (ECG) machine. The ECG tracks heart rhythm during treatment, and blood pressure is monitored.

People are put into restraints such as cuffs on the calves, thighs, and buttocks. They attach to hoses that connect through valves with the air. Patients experience a feeling of a strong “hug” moving up the spine when it inflates and then rapidly deflates again. This is synchronized with heartbeat and blood pressure using an electrocardiogram (ECG) and blood pressure monitors.

“EECP” is a type of non-invasive treatment for heart failure and resistant angina. It’s administered to patients over six days with sessions that last for one hour, for a total of about 35 hours. EECP improves energy levels, decreases rates of chest pain, decreases the need for medication, and improves the quality of life for patients.

How does EECP work?

The treatment gently but firmly compresses the blood vessels in the lower body, increasing blood flow to your heart by causing a decrease in resistance. Pressure waves are timed electronically while blood is pumped throughout the body and released at that moment.

Experts hypothesize that the electro cardioversion technique may cause blood vessels to open small channels that become different branches. These channels or collaterals may eventually become “natural bypass” vessels to allow the heart muscle to flow.

Chelation therapy

Chelation therapy is generally a process used to treat metal poisoning. However, recently It is being used in managing cardiovascular diseases. Chelation therapy involves six weekly dosages of ethylenediaminetetraacetic acid (EDTA) with some supplements of nutrients like magnesium sulfate, vitamin B, And B complex.  

It is a very complicated process, and all potential risks and side effects should be communicated and discussed well with the doctor. EDTA Chelation therapy can remove the plaque formation in blood vessels. It is also believed to decrease platelet aggregation, hence reducing complications from cardiovascular diseases.

ESMR

ESMR is one of the most successfully done methods where doctors can replenish the blood supply to the heart muscle without invasive surgeries. Sometimes it is also called Non-Invasive Cardiac Angiogenesis Therapy because doctors can create new arteries for the heart.

ESMR is often suggested because none of the other traditional treatment options have aided enough or have been successful independently. Despite this, ESMR offers a ray of hope welcomed by therapists and patients alike.

How Does ESMR Treatment Work?

Before beginning a surgical procedure, the physician locates the exact location of artery blockage using ultrasound imaging. While the name suggests shockwaves go through an anatomical acoustic window and stimulate increased blood flow to the affected area. The additional blood flow helps alleviate tissue damage otherwise seen during such successful procedures.

Heart blockage is a serious issue that can eventually lead to a heart attack. Hence it is important to take symptoms like chest pain seriously. This article provides a full view of various heart treatment without surgery. If you are feeling any chest pain, breathing difficulty, and frequent palpitations, you should book an appointment with your nearest cardiologist right away. If you reside in Pune and nearby, you can book an appointment with Poona Preventive Cardiology Center from our website.

https://punechelation.com/

[thefootworkclinic]

Unraveling the Mystery: Understanding and Alleviating Pain Under the Foot Arch

The human foot is a complex marvel of biomechanics, supporting our entire body weight and facilitating movement. Yet, even in this intricately designed structure, pain can emerge, disrupting our daily lives and activities. One common area of discomfort is under the foot arch, a region critical for weight distribution and shock absorption. In this article, we will explore the various causes of pain under the foot arch, delve into potential solutions, and gain insights from The Footwork Clinic, an institution at the forefront of addressing foot-related issues.

I. The Foot Arch: A Crucial Support Structure:

Understanding the Anatomy: The foot arch is formed by the tarsal and metatarsal bones, connected by tendons and ligaments. This architectural marvel acts as a natural shock absorber, distributing the forces exerted during walking, running, and standing. The arch comprises three main components: the medial (inner) arch, lateral (outer) arch, and transverse (across the foot) arch.

Importance of Arch Functionality: The proper functioning of the foot arch is vital for maintaining balance, stability, and efficient movement. When the arch is compromised, whether due to injury, strain, or underlying conditions, it can lead to pain and discomfort.

II. Causes of Pain Under the Foot Arch:

Plantar Fasciitis: Plantar fasciitis is a common culprit for arch pain. It involves inflammation of the plantar fascia, a band of tissue connecting the heel to the toes. The condition is often characterized by sharp pain under the heel or arch, especially during the first steps in the morning.

Flat Feet (Pes Planus): Flat feet occur when the arches collapse, causing the entire sole of the foot to make contact with the ground. This can lead to strain and discomfort under the arch, particularly during weight-bearing activities.

Overpronation: Overpronation is an abnormal inward rolling of the foot during walking or running. This motion can stress the arch and lead to pain. Individuals with flat feet are more prone to overpronation.

High Arches (Pes Cavus): Conversely, high arches can also contribute to pain. The elevated arches may not provide adequate shock absorption, resulting in increased pressure on certain areas of the foot.

Tendonitis: Inflammation of the tendons that support the arch can cause pain. This may be a result of overuse, improper footwear, or biomechanical issues.

Stress Fractures: Stress fractures, often caused by repetitive stress on the foot, can lead to arch pain. Athletes and individuals engaged in high-impact activities may be particularly susceptible.

III. Seeking Relief: Traditional and Innovative Approaches

R.I.C.E Protocol: The conventional Rest, Ice, Compression, and Elevation (R.I.C.E) protocol can provide initial relief for arch pain. Resting the foot, applying ice to reduce inflammation, using compression wraps, and elevating the foot can alleviate acute discomfort.

Footwear Modification: Choosing appropriate footwear is crucial for managing arch pain. Supportive shoes with proper arch support can help distribute pressure evenly and reduce strain. The Footwork Clinic emphasizes the significance of customized orthotic insoles to address specific foot biomechanics and provide optimal support.

Physical Therapy: Physical therapy exercises can strengthen the muscles supporting the foot arch and improve flexibility. A tailored exercise regimen, prescribed by a physical therapist, can contribute to long-term relief.

Stretching and Strengthening Exercises: The Footwork Clinic recommends specific stretching and strengthening exercises to enhance the flexibility and stability of the foot arch. These exercises aim to address underlying issues contributing to pain and prevent recurrence.

Shockwave Therapy: In cases of chronic arch pain, shockwave therapy may be considered. This non-invasive treatment involves the application of acoustic waves to stimulate healing and reduce inflammation. The Footwork Clinic may incorporate shockwave therapy as part of a comprehensive approach to address persistent arch pain.

IV. The Footwork Clinic: Leaders in Foot Health and Rehabilitation

Holistic Approach to Foot Health: The Footwork Clinic stands out as a beacon of expertise in foot health and rehabilitation. With a holistic approach, the clinic addresses not only the symptoms but also the root causes of foot-related issues, including pain under the foot arch.

Comprehensive Assessment: A thorough assessment is the foundation of The Footwork Clinic's approach. The team, comprising experienced podiatrists and specialists, conducts a detailed examination to understand the individual's biomechanics, gait, and overall foot health.

Custom Orthotic Solutions: The Footwork Clinic is renowned for its commitment to personalized care. The clinic offers custom orthotic solutions tailored to the unique needs of each patient. These orthotics play a pivotal role in supporting the foot arch and addressing underlying issues contributing to pain.

Cutting-Edge Technologies: Leveraging cutting-edge technologies, The Footwork Clinic incorporates innovative treatments such as shockwave therapy to enhance the efficacy of their rehabilitation programs. This commitment to staying at the forefront of podiatric care sets the clinic apart.

Patient Education and Empowerment: Education is a cornerstone of The Footwork Clinic's approach. Patients are not only treated for their immediate concerns but are also empowered with knowledge about foot health, preventive measures, and ongoing self-care.

V. Lifestyle Considerations and Preventive Measures:

Maintaining a Healthy Weight: Excess body weight can exacerbate arch pain. Maintaining a healthy weight through proper diet and regular exercise can reduce the strain on the foot arch.

Proper Warm-up and Cool-down: Engaging in appropriate warm-up and cool-down activities before and after physical exercise can help prepare the muscles and prevent injuries that may contribute to arch pain.

Choosing the Right Footwear: Wearing shoes with proper arch support and cushioning is essential. The Footwork Clinic emphasizes the importance of selecting footwear that complements individual foot biomechanics and activities.

Regular Foot Checks: Regular self-checks of the feet for any signs of discomfort, swelling, or changes in appearance can help identify issues early. Seeking prompt attention for any abnormalities is crucial for preventive care.

VI. Future Trends in Foot Health:

Advancements in Orthotic Technology: The field of orthotics continues to evolve, with ongoing advancements in technology. Future trends may include the development of more sophisticated and personalized orthotic solutions, leveraging materials and designs for optimal support and comfort.

Integration of Telehealth Services: The integration of telehealth services is a growing trend in healthcare. The Footwork Clinic may explore telehealth options for initial consultations, follow-ups, and educational sessions, making foot health more accessible to a wider audience.

Conclusion:

Pain under the foot arch is a common ailment that can significantly impact daily life. Understanding the causes, seeking timely intervention, and adopting preventive measures are crucial steps towards alleviating discomfort and maintaining optimal foot health. The Footwork Clinic, with its commitment to excellence, personalized care, and innovative solutions, stands as a beacon of hope for individuals seeking relief from foot-related issues. As we navigate the dynamic landscape of healthcare, the insights and expertise provided by institutions like The Footwork Clinic pave the way for a future where foot health is prioritized, understood, and effectively addressed.

[alphasurgical]

Facial Nerve Tumor: What Are Its Symptoms, And How To Treat It?

Vestibular schwannomas, facial nerve tumors, or acoustic neuromas are rare tumors that develop on the nerve to control the facial muscles. Such tumors have some symptoms that vary based on the location and size of the tumor. Let's discuss the diagnosis, symptoms, and treatment for this tumor.

Symptoms of Facial nerve tumor

The facial nerve tumor can show mild to severe symptoms highlighted below.

·         Hearing loss

This tumor can cause tinnitus or hearing loss as it presses on the nerves responsible for hearing.

·         Difficulty swallowing

If the tumor is large, it can cause difficulty swallowing as it compresses the esophagus.

·         Facial weakness

The tumor on the facial nerve can cause facial weakness or droop on one side, also called facial palsy. As a result, it can cause difficulty in smiling, speaking, or closing the affected side-eye.

·         Headaches

The facial nerve tumor can cause headaches if it is located in the brainstem.

·         Dizziness or vertigo

It has been found that a tumor on the facial nerve controls balance, which can cause vertigo, dizziness, or difficulty with coordination.

Diagnosis of facial nerve tumor

The tumor on the facial nerve can be diagnosed with imaging tests like computed tomography (CT) scans or magnetic resonance imaging (MRI) scans. It can show the exact location and size of the tumor so that the right course of treatment can be determined.

Treatment for facial nerve tumor

The facial nerve tumor treatment is usually based on the growth rate, location, size of the tumor, and overall patient health. You may find many treatment options that are highlighted below.

·         Radiation therapy

Radiation therapy is considered helpful as a follow-up treatment or used for small tumors. It is conducted using stereotactic radiosurgery or external beam radiation that provides a high dose of radiation to the tumor.

·         Medications

Your doctor may recommend relieving symptoms like dizziness, pain, and nausea.

·         Watchful waiting

Your physician may opt for watchful waiting to monitor the growth rate in case of not causing symptoms or small tumors.

·         Surgery

The surgery for facial nerve tumors aims to remove the tumor by preserving the facial nerve's function.

Even though facial nerve tumors are rare, you can easily go for the treatment by consulting your physician. However, the treatment choice will be based on the location, size, and growth rate of the tumor and an individual's overall health.

[agentscullylicious]

Acoustic Compression Therapy: The Leading Pain-relieving Technique

Acoustic Compression Therapy is a method of using acoustic sound waves, to the human body to achieve the purpose of treatment of Myofascial Pain and damaged tissues. The scope of this therapy is becoming more and more extensive, and it has far exceeded the original general therapies in physiotherapies.

Sound wave compressions act on human tissues to produce mechanical, thermal, and cavitation effects. It has the following benefits

It improves blood circulation, which relieves the stiffness in muscles.

This acoustic sound therapy increases vascular wall peristalsis

It enhances the cell membrane permeability

It strengthens the strong hydrogen ions in the tissues by redistribution of ions

It increases the enzyme activity of the tissues

The accelerates the process of tissue regeneration, and tissue repairability  

It relaxes the muscles, by decreasing the muscle tone and hence relieves the muscle pain and knots.

Effects On The Skin

Acoustic Compression Therapy increases skin permeability. It enhances the sweat gland secretion, promotes skin excretion function, and enhances dermal regeneration ability. Regular use and increased timings of acoustic sound therapy can cause noxious inflammation of the skin.

How Acoustic Compression Therapy Is Performed?

The head of the compressing roller is directly in contact with the skin at the treatment site. Before using a roller device a coupling gel is applied to the skin, to effectively transfer the heat waves to the tissues deeply.

Following are the various methods to perform Acoustic Compression Therapy 

Direct Method 

Movement Method: This method is most commonly used by chiropractors Orlando FL. During the treatment, the acoustic head gently presses the skin and moves slowly over the treatment site at a 1-2 centimeters speed per second.

Fixed Method: This method is used in rare conditions. In this method, the physician holds the acoustic sound device head on the treatment site with proper pressure. This method is prone to overheat and a "periosteal pain reaction" occurs. 

Therefore, the therapeutic dose should be small. This fixed method is mostly used to break the muscle knots, which is blocking the blood flow.

Indirect Contact Method

Underwater method: During this method, the physician immerses the ultrasonic sound head and the targeted limbs at 36-38℃. The distance between the sound head and the skin is 1-5 cm. The dose is slightly larger than that of the direct contact method.

This method is often used for irregular body surfaces, local pain-sensitive parts, or parts that are inconvenient for direct contact with the acoustic head, such as fingers, toes, ankles, elbows, ulcers, etc.

Auxiliary therapy: This method is also known as the water funnel method, water pillow, or water bag method. The heating device is in the form of a bag made of a thin rubber film, filled with boiled warm water, and then coated with a coupling gel for massaging the treatment site. It is used on uneven areas such as the neck, joints, knees, ankles., etc

Concentrating irradiation method: This method is conducted by using a concave mirror and acoustic lens to highly concentrate ultrasound on a certain part to obtain the effect of high-energy ultrasound for special treatment. This method is mostly used in severe conditions like tumors.

Treatment Time

The total time is generally no more than 15-20 minutes. The fixed method has a shorter treatment time than the mobile method.

My Experience With Acoustic Compression Therapy

I was diagnosed with Myofascial Pain Syndrome by my physician. In this medical condition, there is the formation of muscle knots in the connective tissues mostly in the areas of joints. I was having muscle knots in my left ankle, and due to that, there was a decreased flow of blood, which leads to muscle pain.

According to the guidance of my physician, I decided to take Acoustic Compression Therapy. My first time of acoustic therapy felt like a normal massage but with a slightly higher temperature. My second visit for an acoustic massage was a completely different experience, this time the pressure of the roller device was increased, and the physician before starting the therapy applied a coupling gel on my ankles to equally transfer the heat in the deeper layers of the skin. This time the therapy was painful but effective. The next day after the therapy session, I felt that my pain was almost gone, but my physician advised me to continue this therapy for a week to stop the build-up of muscle knots again.

[uncle-motong]

All About Acoustic Compression Therapy

All that You Need To Know About Acoustic Compression Therapy From A Chiropractor

Acoustic Compression Therapy is otherwise called Extracorporeal Shockwave Therapy; this, so, is about essentially ultrasound waves that treat the aggravation caused in the chest. These incorporate the two the serious and steady delicacy and hurt occurring in the muscles, ligaments, or tendons situated in the chest of the human body. It works by invigorating the nerves near the space making torment the point that sends action signals to the cerebrum in the underlying stage.

How can it function? Does it wind up being a dependable methodology?

Here during the treatment, the little, weighty, and incredible wave gets made by the Acoustic compression of the device causing small vibrations in the phone dividers. Normally, as the course of treatment proceeds with these intense vibrations influencing the body and winds up breaking up tissues causing torment and works on the progression of blood in the body. The wave in the method stirs the nerves nearby, wins the signs of hurt, and offers alleviation to both the body and brain of the patient.

Changing to the unwavering quality of this relief from discomfort treatment, the Acoustic Compression Therapy is reasonable enough with regards to security, this is one non-obtrusive acquire and doesn't think twice about wellbeing or does no mischief to the body part that went through the treatment.

Chiropractors employ acoustic pressure treatment (ACT) during their training, this, adding to managing down and decreasing torment likewise lessens irritation, standards that in itself can initiate torment or throb in the human body. ACT further develops flow of blood in the space going through the treatment; it likewise offers supports bringing the greatest measure of oxygen and sound supplements to the influenced issues those outcome in velocity relieving.

This treatment has been perceived as one of the delicate medicines for reducing the aggravation in the body. All in all, it can treat the aggravation in the body. ACT can be regularly named as one type of Trigger Point Therapy including coordinating and establishing the floods of the incredible sound to the particular spot on the body where tense muscles or gatherings of muscles have disturbed the nerves, that might wind up creating torment or bothering in the body somewhere else also. The chiropractor in Orlando FL can regularly especially direct both the expansiveness and profundity of the waves, that is, oftentimes not that conceivable to accomplish with manual treatment, particularly in touchy regions, that have been hurt or may overcompensate to manual treatment. Normally expert says, these waves can be coordinated to enter the body's tissues from 1 mm to 30 mm and recurrence of 8Hz.

ACT can be utilized to treat torment or wounds toward the back and neck, sports wounds, dull use wounds, bursitis, and some other trigger focuses in the body. These medicines likewise fix past agony or treat degenerative issues in the digestive tract and liver.

[secretsweetsperfection]

Shockwave Therapy For Extracorporeal Discomfort

Extracorporeal shockwave therapy Physio is an outpatient alternative to surgery that sends acoustic shock waves into the bones and soft tissues of the affected area. Shockwave therapy breaks up scarring and reinjures the area on a cellular level. In addition, this non-invasive treatment can be effective for various conditions, including osteoarthritis and back pain. Read on to learn more about the benefits of shockwave therapy and how it can help you.

This therapy involves using a portable device or a machine to deliver high-energy acoustic waves to the area that is injured. The sound waves are created by compressing air and moving the device over the injured area. Before the treatment, an ultrasound gel is applied to the affected area. The sound waves stimulate the blood flow to the area and cause inflammation. This inflammation triggers the body's natural healing process, in which damaged cells and tissues begin to regenerate.

The effects of shockwave therapy on the tissues are not fully understood. Scientists have proposed several possible mechanisms for its action. One of the proposed mechanisms involves the stimulation of collagen and growth factors at the tendon-bone junction and the stimulation of osteoprogenitor differentiation. Shockwave therapy is also beneficial for treating common musculoskeletal conditions, including medial tibial stress syndrome and the greater trochanteric pain syndrome.

Although shockwave therapy is a safe and effective treatment, it is not suitable for everyone. Some people may be unsuitable for shockwave therapy because they suffer from circulatory or nerve disorders. People with severe heart conditions or a condition that causes blood to clot are not recommended for this treatment. Patients who are pregnant or are taking blood-thinning medications should not undergo this treatment. Further, people with a history of heart or respiratory conditions should not undergo shockwave therapy.

Although ESWT can produce dramatic results in the first few weeks, long-term research is needed to confirm its efficacy. For example, if shockwave therapy is not used in a long-term treatment plan, the effects may wear off quickly and may require additional sessions for continued relief. If you are unsure of whether shockwave therapy for ED is right for you, speak with your doctor before undergoing the treatment. They will be able to recommend the most appropriate course of action for your specific situation.

In a recent study, researchers found that shockwave therapy can help patients suffering from chronic tendinopathy. The treatment is most suitable for people with chronic tendinopathies - also known as tendinitis - which are caused by repetitive strain, overuse, and sports. There are several types of chronic tendinopathy, including Achilles tendinopathy, and shockwaves may be beneficial in both cases. The procedure can also be used as an alternative to surgery in some cases.

When a patient undergoes shockwave therapy, a medical device will be used to accelerate the healing process of the affected heel. The shockwaves stimulate blood flow to the area and stimulate healing. Shockwave therapy has been shown to be effective in treating heel pain in over 80% of cases, with only one treatment. Some patients report immediate relief after shockwave therapy, while others may take up to four weeks to feel results. The intensity of the shockwaves is adjusted for each individual patient's comfort.

Although the exact mechanism of how shockwave therapy works is still unknown, it is believed that the energy produced during shockwave therapy stimulates the body's natural healing response. Shockwaves also help break up disorganised tissue and calcifications. In addition to relieving pain, shockwave therapy can help athletes return to sports and normal daily activities. However, shockwave therapy should be used only after seeking medical advice from a physician.

Shockwave therapy works by targeting trigger points, the major cause of pain. The acoustic energy delivered to the targeted area will unblock the calcium pump and reverse the metabolic crisis of the affected tissue. A professional will use palpation to identify the specific area that needs treatment. A gel is then applied to the treatment area to make the transfer of the acoustic waves as smooth as possible. Once this gel has been applied to the affected area, the Shockwave applicator will be placed gently against it.

Extracorporeal shockwave therapy uses high-frequency acoustic waves to stimulate cell growth and repair damaged tissues. Patients can enjoy accelerated pain relief, regenerative capabilities, and improved quality of life after shockwave therapy. Shockwave therapy has also been shown to be a highly effective treatment for conditions related to tendon and muscle, including Achilles tendinopathy and tennis elbow. It has the advantage of being non-invasive, safe, and inexpensive, while delivering the benefits of surgery without the associated risks.

[decompression-table]

Essential Treatments to Get More Benefit From Spinal Decompression Therapy

When it comes to having healing for spinal issues, non-surgical spinal decompression works best. In some instances, patients may need to wait to see significant improvements. 

Due to this, many healthcare professionals do something else to make the treatment more effective. For this, they consider using other treatments with their decompression treatment plan. 

Besides offering spinal decompression therapy, they offer some complementary therapies to increase the effectiveness of ongoing treatment. After all, when you visit a medical practitioner, make sure they use the Best Decompression Table and offer additional treatments for fast healing of your health issues. 

Moreover, we have included some complementary treatments one can opt to help patients. Let's have a look at them. 

Heat and Cold   

Heat and cold are effective in reducing pain and improving spinal healing conditions. Medical professionals can use this treatment with non-surgical spinal decompression. While heat and cold treatments are not different in concept and ease of execution, there are still specific differences. 

Heat: When healthcare professionals offer heat treatment, they use hot water bottles, compresses, heating pads, and many other similar components. This eases the way a patient receives required treatments beyond the clinic. After all, if someone in your family is dealing with spinal pain or injury, you may need to apply warm heat treatments to the area of pain or injury for a particular period as guided by your healthcare provider. This treatment can give the patient immediate pain relief and reduction in muscle stiffness and also encourages blood flow for fast healing.

Cold: In cold therapy, ice massage treatment is involved. However, there are also some other methods of cooling the injured area, which also come under cold therapy. After all, ice massage treatment is used when a patient has muscle strain issues. This treatment can also be used along with heat treatment under the supervision of a doctor.   

Exercise

A medical professional can also prescribe exercise along with non-surgical spinal decompression because exercise is one of the best ways to promote healing and strengthen the spine. Exercises can be anything from stretches and cardiovascular exercises to resistance training. All these exercises are helpful in the recovery process. 

Whether a doctor will prescribe exercise depends on the patient's age and ability level. If an exercise plan doesn't work for a patient, it can cause some other health issues. Moreover, ensure you get treatment from a reliable medical professional who uses the Best Decompression Table. 

Acoustic Compression 

If you are experiencing pain and circulation problems, a spinal decompression practitioner can recommend going with Myofascial acoustic compression therapy (MyACT). 

This therapy works well for improving circulation in muscles, joints, and tendons. When this therapy is offered, targeted acoustic waves are generated to massage tissue up to a particular depth. It adds to good blood flow and reduces inflammation. 

When it is used along with spinal decompression therapy, it becomes helpful in treating compressed nerves. 

Massage 

Massage therapy brings many benefits to the patient, increasing the effectiveness of spinal decompression therapy. When massage is performed on the back muscles of a patient before and after treatment, it promotes a higher range of motion. However, it is crucial to ensure that massage doesn't harm and increase pain. 

Laser Therapy

Laser therapy is effective in encouraging cell reproduction and repair processes in the human body. That results in fast healing while offering relief from pain and inflammation. It is a safe practice for all kinds of patients of any demographic and conditions as it comes under non-invasive and non-drug treatment. 

Education

Educating patients doesn't seem important, but it plays a vital role in treating a particular health issue. For example, if a doctor is applying different treatment methods without informing the patient, it will make the patient stressed and frustrated and hamper the process of healing. So, if you want treatment with the Best Decompression Table, you can educate yourself about the same. 

Conclusion

You face different health challenges in your life. You visit a doctor, and they offer you some treatments to cure the condition. But sometimes, it is essential to have some complementary treatments that increase the effectiveness of the current treatment.

This means that if a healthcare practitioner uses the Best Decompression Table, they may need to use some other equipment to make the practice as effective as possible. 

The DOC Decompression Table provides the necessary things to make one's practice more powerful. Visit the website to learn more.  

[nextlevelinjuryandpostoprecovery]

America Cryo - Equine Shockwave | Equine SubZero Cryotherapy Device

Equine radial shockwave provides a highly effective treatment for orthopedic and soft tissue injuries in equine sports medicine.

Premier treatment for suspensory injuries and ‘kissing spines’

Rapid pain relief and stimulation of cellular regeneration

Five probe options enable varied treatment option

Acoustic wave 100x higher energy than ultrasound imaging

Achieves ‘bundled wave’ penetration of up to 6 cm

Handpiece supports over 2 million shockwave ‘shots’.

In veterinary or rehabilitation settings, Shockwave addresses musculoskeletal disorders and returns the horse to work within an optimal timeframe.

Shockwave is the leading choice of veterinarians, trainers and therapists for ligament and tendon injury, and post-work recovery in elite equine athletes.

How it Works

The radial shockwave therapy device uses compressed air to accelerate a projectile through a tube, creating a low intensity primary wave as it impacts on the applicator. A parabolic reflector then creates a secondary wave. These ‘bundled’ waves are directed through an applicator held against the skin, moving through the tissue towards a defined point at a penetration depth of up to 6 cm. This stimulates a cellular response, with improved blood supply and increased cell proliferation leading to regeneration of tendon, ligament and bone tissue. The exact mechanisms for this biological response are not yet fully known.

Technical Specifications

Ballistic radial shockwave with electromagnetic generator

10 preset programs are adjustable to range of conditions

10.1” color touchscreen allows easy, real-time software operation

Rotary control for variable energy level and frequency settings

Stable and yard use is easy with handpiece and foot-switch control

Low weight at only 3kg, enabling operation from backpack

Seven durable, high quality transmitters support efficient treatments

Soundwave frequencies from 1-16Hz, stepping 1Hz

Precise energy adjustment from 60mJ to 210mJ, stepping 10mJ (equiv. 1Bar to 6Bar, adjustable per 0.25Bar)

Efficient power Consumption: 100 / 240 VAC / 50/60 Hz

Shockwave for  Optimal Outcomes:-

A high value investment for the clinic or training yard

Leading technology for treating and managing performance horses

Treat and rehabilitate multiple conditions with a single device

Versatile treatment options address varied conditions

Reduces sport horse time out through effective injury management

[americacryous]

America Cryo - Equine Shockwave | Equine SubZero Cryotherapy Device

Equine radial shockwave provides a highly effective treatment for orthopedic and soft tissue injuries in equine sports medicine.

Premier treatment for suspensory injuries and ‘kissing spines’

Rapid pain relief and stimulation of cellular regeneration

Five probe options enable varied treatment option

Acoustic wave 100x higher energy than ultrasound imaging

Achieves ‘bundled wave’ penetration of up to 6 cm

Handpiece supports over 2 million shockwave ‘shots’.

In veterinary or rehabilitation settings, Shockwave addresses musculoskeletal disorders and returns the horse to work within an optimal timeframe.

Shockwave is the leading choice of veterinarians, trainers and therapists for ligament and tendon injury, and post-work recovery in elite equine athletes.

How it Works

The radial shockwave therapy device uses compressed air to accelerate a projectile through a tube, creating a low intensity primary wave as it impacts on the applicator. A parabolic reflector then creates a secondary wave. These ‘bundled’ waves are directed through an applicator held against the skin, moving through the tissue towards a defined point at a penetration depth of up to 6 cm. This stimulates a cellular response, with improved blood supply and increased cell proliferation leading to regeneration of tendon, ligament and bone tissue. The exact mechanisms for this biological response are not yet fully known.

Technical Specifications

Ballistic radial shockwave with electromagnetic generator

10 preset programs are adjustable to range of conditions

10.1” color touchscreen allows easy, real-time software operation

Rotary control for variable energy level and frequency settings

Stable and yard use is easy with handpiece and foot-switch control

Low weight at only 3kg, enabling operation from backpack

Seven durable, high quality transmitters support efficient treatments

Soundwave frequencies from 1-16Hz, stepping 1Hz

Precise energy adjustment from 60mJ to 210mJ, stepping 10mJ (equiv. 1Bar to 6Bar, adjustable per 0.25Bar)

Efficient power Consumption: 100 / 240 VAC / 50/60 Hz

Shockwave for  Optimal Outcomes:-

A high value investment for the clinic or training yard

Leading technology for treating and managing performance horses

Treat and rehabilitate multiple conditions with a single device

Versatile treatment options address varied conditions

Reduces sport horse time out through effective injury management

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12 Possible Causes of Ringing in Ears, Dizziness, Pressure in Head

New Post has been published on https://depression-md.com/12-possible-causes-of-ringing-in-ears-dizziness-pressure-in-head/

12 Possible Causes of Ringing in Ears, Dizziness, Pressure in Head

Dizziness and ringing in the ears that interfere with your daily activities are also known by the medical terms vertigo and tinnitus. These symptoms can make it hard to work, relax, and even sleep. Pain and pressure in your head or sinuses can have the same effects.

These symptoms can sometimes be signs of minor issues, such as sinus infections or headaches. But when these symptoms are severe or won’t go away, they may need immediate medical attention.

Read on to learn 12 possible causes of ringing in your ears, dizziness, and pressure in your head, and what you can do about them.

Inflammation of your sinuses caused by infection is commonly known as sinusitis.

Short-lived sinusitis cases are often caused by viral infections, like the common cold. Chronic sinusitis may be the result of a bacterial infection.

The main symptoms of sinusitis are:

sinus pressure

thick, colored drainage from your nose

congestion

cough

fatigue

Home remedies

You can treat a minor case of sinusitis at home with rest, fluids, and OTC pain relievers, such as ibuprofen and acetaminophen.

Medical treatment

If your sinus infection persists, you may need to take antibiotics to treat it.

In some rare cases, chronic sinusitis results from polyps in the sinuses. Your doctor may recommend surgery to remove them.

The National Institutes of Health (NIH) reports that headache is the most common form of pain. Doctors have identified more than 150 types of headache disorders.

Common headache triggers include:

poor posture

dehydration

stress

weather or changes in air pressure

drinking alcohol

bright or strong lights

The type of pain you’re experiencing can often tell you what type of headache you have. For example, feeling like a tight band is stretched around your head might mean you have a tension headache. Tension headaches are often caused by pressure changes or poor posture.

Home remedies

Rest and OTC pain relievers can often help with minor headache symptoms. You can also try applying a cold compress across your forehead or the back of your neck.

Other treatments may include:

managing stress

avoiding headache triggers, such as alcohol or flashing lights

Medical treatment

Some prescription medications may help prevent or ease headaches, including:

Described by many as a “ringing in the ears,” tinnitus is often caused by damage to the middle or inner ear. Certain headache disorders can also cause a ringing in the ears.

Tinnitus can seem worse at night when you’re trying to sleep.

Home remedies

Distracting noises, including low-volume music or a fan, can sometimes make tinnitus feel more manageable.

Stress management and exercise may help, too.

Medical treatment

Biofeedback and antidepressant drugs may help ease tinnitus symptoms.

Hearing aids can also help if you’re having trouble with conversations and everyday sounds because of tinnitus.

Vertigo is a sense of dizziness that can feel like you or your surroundings are spinning.

Vertigo is more of a symptom than its own condition. But an inner ear disorder called benign positional vertigo (BPV) can bring on dizziness, nausea, and related symptoms.

Home remedies

If you’re experiencing vertigo, you can try resting or marching in place until the sensation goes away.

If BPV is the problem, you can learn exercises that are meant to restore balance within the ear. Talk with a medical professional about trying this therapy. They might teach you a head exercise to move the small crystals of calcium carbonate in your ear that cause BPV.

Medical treatment

Medications such as antihistamines and beta-blockers can help if your symptoms are severe.

Vestibular migraine is a type of migraine that doesn’t necessarily cause a headache but can cause symptoms such as vertigo and lightheadedness.

You won’t always know what causes vestibular migraine, but you can learn some of its common triggers. These include:

stress

fatigue

certain foods and beverages, like chocolate, red wine, and coffee

Home remedies

Stay hydrated and get enough sleep to help lower your risk of vestibular migraine episodes. Migraine triggers vary from person to person, so learning to identify and avoid your own triggers can provide further relief.

Medical treatment

Prescription drugs that treat migraine may also help reduce vestibular migraine symptoms, such as:

beta-blockers

triptans

anti-seizure drugs

calcium channel blockers

CGRP antagonists

Another condition that causes both vertigo and tinnitus is Meniere’s disease. According to the National Institutes of Health (NIH), this condition affects more than half a million people in the United States. Meniere’s disease is the result of fluid changes in the inner ear.

Home remedies

Rest and stress management can help with the symptoms of Meniere’s disease. You can also try making changes to your diet to limit your salt and sugar intake, and prevent fluid buildup.

Medical treatment

Motion sickness and anti-nausea medications can help. You might also benefit from diuretics that reduce fluid levels in your body.

Your symptoms might also be caused by Grave’s disease, an autoimmune disease that affects your thyroid gland. Grave’s disease can trigger feelings of pressure behind your eyes.

Medical treatment

Antithyroid drugs and radioactive iodine therapy may help reduce your symptoms.

You can get a concussion after a blow to the head, or after whiplash, an injury that causes your head to move back and forth unusually fast. A concussion is a mild traumatic brain injury that requires medical attention.

Home remedies

A doctor’s evaluation is critical if you think you might have a concussion.

During a concussion, rest and OTC pain relievers may help relieve the initial pain and disorientation. After a concussion, stay in a dark, quiet place, and avoid stimulation from lights and sounds.

Medical treatment

The only way to treat a concussion is to rest and avoid contact sports and other activities that may threaten the head. Your doctor will still want to monitor you for signs of bleeding or swelling while you recover. These signs might mean you need treatment for a more serious injury.

The thought of a tumor can be frightening, but not all tumors are cancerous.

For example, an acoustic neuroma is a benign tumor in the brain. While usually harmless, an acoustic neuroma can grow and put pressure on important nerves.

Medical treatment

Treatment isn’t always necessary, but radiation can sometimes help to shrink the tumor. This type of targeted radiation is called stereotactic radiosurgery.

Regular monitoring with an MRI scan is also important. This will make sure that the tumor doesn’t grow to a large size that can disrupt nerve activity and brain function.

An ischemic stroke happens when a blood vessel supplying blood to brain tissue is blocked or the arteries supplying blood narrow significantly.

An ischemic stroke is a medical emergency. Seek treatment right away if you believe you’re having the symptoms of this kind of stroke, such as:

Medical treatment

During an ischemic stroke, tissue plasminogen activators are given to dissolve blood clots. Surgical devices also exist that can break up clots and restore healthy blood flow.

General treatment approaches to prevent ischemic stroke include:

oral blood thinners, such as aspirin

blood pressure control

lowering cholesterol

certain lifestyle changes, like quitting smoking, losing weight, and increasing physical activity

An aneurysm is a weakness in the wall of a blood vessel. When an aneurysm bursts, the result is a hemorrhagic stroke.

An aneurysm is sometimes the result of high blood pressure. An aneurysm is much more dangerous than an ischemic stroke.

This condition must be treated as a medical emergency.

Medical treatment

Medications to reduce blood pressure and slow bleeding may help.

In severe cases, you may need surgery to repair the damaged artery.

According to the American Cancer Society, the chance for a person of developing a malignant brain tumor in their lifetime is less than 1 percent. In other words, it’s a pretty rare occurrence.

That said, regular brain scans are critical to detect brain tumors early on. This is especially true if you have a family history of brain cancer or are undergoing treatment for a cancer that may have spread to your brain.

Talk with a doctor if you have any concerns.

Medical treatment

Surgery is the most common treatment for brain cancer. If the tumor cannot be safely removed surgically, chemotherapy or radiation therapy may be necessary.

The Centers for Disease Control and Prevention (CDC) reports that an intense headache is a possible symptom of COVID-19.

COVID-19 is a rare and unlikely cause of your symptoms. But this is possible, especially if you live in an area with major COVID-19 outbreaks and are not vaccinated.

A 2020 study in the Journal of Headache and Pain found that headaches associated with COVID-19 tended to be:

long-lasting

on both sides of the head

resistant to OTC pain relievers

associated with loss of taste or smell

associated with digestive symptoms

Pay close attention to the signals your body sends you, especially when you’re feeling dizzy or lightheaded, or feeling pain or pressure in your head.

These symptoms are often signals of conditions that could affect your brain function. Discuss them with a doctor if they happen often or continuously throughout the day or week.

If you can’t see a primary care physician, go to the emergency room or an urgent care center for severe symptoms or symptoms that won’t go away.

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Lupine Publishers | Performance of Hearing-Impaired Children with Hearing Aid and Cochlear Implant in Auditory Verbal Therapy

Lupine Publishers | Journal of Otolaryngology

Abstract

A Cochlear Implant (CI) is a surgically implanted device, which is a small but complex device that helps a severe-profoundly deaf individual to hear the sound. Inner ear is the innermost region in the human ear that consists of Cochlea, Balance system and the Auditory nerve; in which Cochlea is the most important part of the Inner ear. Once the sound reaches the inner ear, the cochlea transforms the sound waves into electrical impulses that are sent through the Auditory nerve to the brain. The cochlear implant restores the inner ear functions and the acoustic consciousness of pre and postlingually deaf individuals is increased. The hearing aid is an electronic device that comes in different styles that are worn behind the ear and few are worn inside the ear. The comparison is done with Behind the Ear (BTE) hearing aids. The scientific literature is reviewed on the performance of hearing impaired children with BTE hearing aids and CI. The performance is compared with the BTE hearing aids, as the children with severe-profound hearing loss are fitted with BTE hearing aids due to its wide dynamic range characteristic. The comparison is made for right ear, left ear and bilateral. ‘Categories of Auditory Performance’ (CAP) test was performed on a group of children wearing BTE hearing aids and CI as it is performed on both wearing BTE hearing aids and CI. The comparison was also made with high frequency sounds, level of understanding and with the duration of therapy attended. The available data show a great benefit with CI as compared to Hearing Aid from the results measured. The post-implant linguistic performance is critically affected by several variables. The full development of linguistic competence is allowed by CI and marked benefits in a wide range of psychological and social abilities is provided, whereas with Hearing Aid the children may have delayed language or the command on language may be imperfect.

       Introduction

Humans at birth, and even before in utero, are prepared to acquire and learn speech and language from their environment [1]. Language acquisition and production is maximized by the early interactions with the environment and gives humans the opportunity to process sounds. Mainly, hearing is what helps these interactions possible. Auditory perception is closely related to interactions between human biological mechanisms and their environment from the time sound reaches the utero to until a single word is uttered. Language acquisition is also related to other domain developments; like motor and cognitive development, etc. since, when speech is not achieved, children tend to use gestures to express and fulfill their needs. Language acquisition is a combination of experience-dependent and independent mechanisms. Neural mechanisms and innate factors may be responsible for the interaction between the listening experience, the listening environment and the interpretation of environmental information. For some children, the normal development of language is disturbed by lack of acoustic feedback and essential auditory information, and from auditory deprivation. For some deaf children, the artificial stimulation of the auditory system provides them with an opportunity to acquire verbal skills. Hearing aids are small wearable electronic devices, which enable a person to hear sounds better and understand speech more clearly providing an overall improvement in communication ability. The Hearing Aid functions as follows: Sound is first taken in through a miniature microphone where the sound is converted into an electronic digital signal. Then, the signal is processed, amplified and modified according to the needs of the user and his hearing loss. Finally, a receiver, which is a miniature loudspeaker, sends the processed sound through the type of ear fitting/ear mould, which is appropriate for your hearing aid system. A CI is a neuroprosthetic device that is surgically implanted which provides a person with severe-profound sensorineural hearing loss a sense of sound. The CI has two major parts, the internal part, which acts as the receiver, and an external part that acts as a speech processor. Cochlear implantation and hearing aids help to hear and acquire language, and the present study focuses on the comparison of the performance between Cochlear implants and hearing aids. Several hearing aids are made with certain electroacoustic properties which includes frequency response, saturation sound pressure level and various aspects of compression [2]. With the application of universal newborn hearing screening programs and the rapid increase in birthing facilities conducting UNHS, the average age of identification of newborns with hearing loss over the last 20 years has decreased from approximately 30 months of age [3] to approximately 6 months of age. The identification of infants and young children having hearing loss at an earlier age has increased and those who do not receive appropriate rehabilitation are likely to have delayed language, cognition, and social-emotional development than their hearing peers. When infants who have hearing loss or are deaf receive treatment before six months of age, they typically maintain language development with their cognitive abilities until 5 years of age [4] Amplification is a method that consists of increasing the sound volume in a device like in the case of hearing aids, amplifiers inbuilt inside the hearing aid performs the function of amplification. Amplification is considered the most important intervention to help children with hearing loss. Amplification will provide children the ability to access residual hearing, so that their speech and language could be developed at or near age-appropriate milestones. Amplification for infants and young children may not enable children with hearing loss to perform at the level consistent with their normal hearing peers in all situations. The goal of amplification for children with hearing loss is to help them with their speech audibility at a comfortable level, and to provide them with as many acoustic cues as possible, without over-amplifying sounds, especially those sounds that are loud. Hearing aid fitting has to be done at a proper/earlier age or else the children would face problems in developing language, as there would be no sound input to the child, and thus results in poor speech intelligibility. As the child will not be given with proper amplification, there is a lack in learning appropriate language at a correct age and consequently it results in poor language development and poor speech intelligibility. A study was conducted [5], where different groups of children were taken based on the age of hearing aid fitting (<6 months old, >6 months, 2 years and 3 years) and were checked for speech intelligibility. The result was that the group of children fitted during their first 6 months of life had much better speech intelligibility as compared with other group of children fitted later in life. We can place in the amplification protocol into these following six steps, which are carried on one after the other in a sequence:

a) Taking ear impressions/obtaining ear molds.

b) Measuring the real ear coupler difference (RECD).

c) Using a prescriptive approach to determine target hearing        aid gain and output.

d) Choosing the hearing aid.

e) Verifying the chosen instruments.

f) Fitting the devices and providing a follow-up schedule.

This protocol can be simplified into these steps:

a) Assessment

b) Selection

c) Verification

d) Validation

Auditory handicap of hearing impairment happens when there is very limited usage from the hearing aids. There is already loss of a sense that the individual faces and thus gets the help of the amplification device. Therefore, if the amplification device gives a minimum help or minimum benefit the outcome will be negative. The hearing aid has to be beneficial during understanding of speech; if this is attenuated, the hearing aids can help by compensating the loss and helping them to hear. Nevertheless, if there is reduction in both speech signal and noise, the hearing aids are not beneficial. The minimum amount of handicap they could have is 24dB [6]. The individual has to be satisfied with the amplification device. They need to get acclimatized to the changes they are facing within and from the environment after wearing the hearing aid. Cognition plays a very important role in this; better cognitive abilities allows individuals get more benefit with hearing aids as compared to those with low cognitive abilities [7]. The major topic that includes cognition is Top-Down (TD) and Bottom-Up (BU) systems. Top-down (TD) systems receive, evaluate, and interpret bottom-up (BU) input. TD systems assign meaning. They determine psychological and emotional composition, and include cognition, executive functions, speech, language and auditory processing, and other self-driven analyses and interpretations. BU systems transfer and transmit “raw” externally derived sensory input (light, temperature, sound, smells, pressure, etc.) to the central auditory nervous system. The hearing loss plays a very significant role in the quality of life. Individuals with hearing loss usually report a greater rate of depression and greater feelings of social isolation than those who do not have hearing loss [8]. Other emotional issues of the hearing-impaired individuals include anger and withdrawal [9]. So, hearing loss usually results in poor mentalhealth. Listening is influenced by listener’s characteristics influences such as motivation, expectations and personality.

In case of children, the child has to be motivated to hear, as it becomes the most essential part of living, as it has its future based completely over that from learning the language, studies, etc. Only if the innate communication capabilities are acknowledged and treated upon, the cognitive development of children with Hearing Impairment will be similar to that of normal hearing children. In case of congenital deafness, the parents’ feelings of guilt and sorrow has to be checked upon during the prenatal diagnosis and during the first few months. Parents should be provided with psychological support, as it is important for them to accept the child, since he or she is developing and to overcome the unexpected loss. The child has to be trained to perceive the existence of sounds, and visual contact has to be encouraged. The parents should show lot of affection and care towards the child, and physical and gestural contact should be maintained in abundance. As behavioral psychology states, learning mainly occurs through environmental stimuli. As the children grow and start with their schooling, the hearing aid has to help them in different ways. The hearing aid technology has to help in difficult to listen situations like in classroom, market, etc., as the amount of noise is excessive, which results in poor understanding of speech, and hence results in poor communication. Current hearing aids are designed to face the difficult to listen situations, and therefore includes several technologies like directional microphones, noise reduction, and fast acting amplitude compression systems. Signal processing depends on working memory and is designed to improve speech understanding that may have positive and negative consequences [10]. As we move on further with the different technologies for children with hearing loss, we have the Cochlear Implant (CI), which is a surgically implanted neuro-prosthetic device that helps for the severe-profound hearing-impaired children to hear and acquire language. The development of auditory speech perception, speech production, and language skills are affected in children having profound hearing loss. Some children having profound hearing loss develop good oral communication skills with conventional hearing aids but most fail to. The reason for some children to develop communication skills with hearing aids is that the aided performance with the hearing aid falls within the speech range (speech banana: the speech banana is a region where all the phonemes of the world’s language fall on an audiogram), and therefore the child gets benefitted with the hearing aid. If the child fails to develop adequate oral communication skills, it can have significant negative effect on the education of the child.

The multichannel cochlear implants are recognized by the American Academy of Audiology in 1990 [11] as sensory aid options for children with profound hearing loss who have limited or no functional benefit from conventional hearing aids amplification. Multichannel cochlear implants are useful for children with congenital or acquired hearing loss. Further, the parents (or legal guardian) have the right to choose a cochlear implant if they decide that it is the most appropriate option for their child. In one of the studies conducted [12] it was observed that the children who were implanted at age <2.5years, there was a greater improvement in consonant speech production and vocabulary outcomes. As age increases, the rate of learning and improvement decreases. Hearing-impaired adults and children who wear hearing aids and cochlear implants provide an opportunity to examine the direction and characteristics of plasticity in the central auditory system. Plasticity is the ability of the brain to reorganize itself by forming new connections between brain and cells (neurons). A period of maximal synaptogenesis in the auditory cortex is the sensitive period in the early childhood [13]. Sensitive period is a time or stage in a person’s development when they are more responsive to certain stimuli and quicker to learn particular skills, like for children the sensitive period for the development of Central Auditory System in children is 3.5 years or less. Implantation within this sensitive period provides the children with the opportunity of the auditory experience needed for the improvement of essential synaptic pathways. Generally, the changes in P1 cortical auditory evoked potential taken up in humans after the CI gives us an impression about the re-organization and plasticity in children. The P1 component of the cortical auditory evoked potential (CAEP) shows clearly documented age-related decreases in latency and changes in morphology in normal hearing children, providing a biomarker for development of the auditory cortical pathways in humans.

Early implantation will be plasticity, and consequently it helps in proper organization and cortex development. Cortical development is based on learning through stimulation. In case of congenital hearing loss, the absence of sensory input from birth affects normal growth and the connectivity of the functional sensory system, resulting in a lack of oral language learning. Cochlear implants bypass cochlear damage by directly stimulating the auditory nerve and brain, and consequently many of the deleterious effects of sensory deprivation are avoided. There is a sensitive period for the development of central auditory system in children and it is 3.5 years or less. As observed by Sharma et al. [14], plasticity is higher at this age, and as a result learning is increased in this period. For some, up to 7 years old plasticity will be present, but it is usually reduced by 3.5 years or above it. To learn words and acquire language, children must be able to discriminate and correctly perceive phonemes. Early word learning and speech perception skills have different sensitive periods. The very early implantation may affect later vocabulary outcomes more than the speech perception outcomes. Early implantation (<3.5 years old) gives a good central auditory evoked potentials (CAEP), and P1 latency while that of late implanted (>7 years old) shows decrease in the waveforms. If both ears are simultaneously implanted, there is a good development in language skills as well, but when a child is being implanted for one ear at <3.5 years old and other ear at >7 years old, it shows different CAEP waveforms and P1 latency [15]. Age appropriate linguistic competence development is a goal for the educational programs for children who are hard of hearing. The role of language competence in the development of education is important for the children with hearing loss, as they have to match with their peers in school. Language competence also helps them to build their social skills, for their constructive thinking in this world and in several other crucial domains. If early intervention during ‘critical period’ for speech development is not given, then the child gets handicapped. This handicap is characterized by poor speech comprehension and language communication. Cochlear implantation helps to improve auditory perception in severe to profound hearing-impaired children. Auditory skills of hearing-impaired children are variable due to different etiologic factors.

The reasons for the hearing loss vary from one individual to another and thus affects the child’s auditory skills and learning. Children implanted with Cochlear Implant have good listening skills, and this consequently helps in learning the language. There is a significant improvement in the language with Cochlear implanted children by attending regular Auditory Verbal Therapy (AVT) sessions [16]. Auditory-verbal therapy is a method for teaching hearing-impaired children to listen and speak using their residual hearing in addition to the constant use of amplification devices such as hearing aids, FM devices, and cochlear implants. Auditory-Verbal practice emphasizes listening to auditory information, and thus helps the children to develop intelligible speech and spoken language. Auditory-Verbal practice supports the one-to-one diagnostic therapy and involves the parent participation, guidance, education and support by an Auditory-Verbal specialist. The AVT is given three times or two times in a week for around 45 minutes to 1 hour for almost 3 years. The major goal of AVT is to enable children with hearing loss to grow up in regular learning and living environments, and helps them to become independent, participating and contributing citizens in the society. As early hearing impairment restricts a child to learn to speak and listen without the use of gestures to communicate, AVT helps the child to learn to speak with the help of regular Auditory Verbal Therapy [17]. AVT was found to be highly effective method in the language development and accelerating the spoken language. Regular and effective AVT helps in the correct development of language skills [18]. Parental involvement is a crucial part in child’s learning and takes many forms that is good parenting at home, provision of a safety and stable environment, intellectual stimulation, parent-child discussion, constructive social and educational values and high values relating to become a good citizenship, participation in school events, participation in the work of the school, and participation in school governance. The family social class, maternal and paternal level of education, maternal and paternal psychosocial health and single parent status and family ethnicity influences parental involvement. Children implanted at a very young age have the capability to achieve nearly normal language skills after AVT sessions. However, this is not achieved only with the therapy given at the therapy center, but rather it has to be followed regularly at home by parents. Therefore, the parents have to be guided, educated, and counseled regarding the steps to be followed at home for the development of child’s speech and language skills [19]. AVT has proved to be a successful intervention for Hearing Impaired children, [20] though a certain group might not have been useful with the AVT. Just by attending the AVT sessions, it is not possible to have a very good improvement, but home training given by parents is very essential and gives a much better improvement in their speech and language skills. The rate of language growth in children with CI through AVT is comparatively faster. Intervention program has helped many children to achieve age appropriate language skills, and when compared with their peer group age, the language skills were almost similar. Based on the time spent in the intervention program, it is suggested that the more time spent; the greater was the contribution to language growth [21].

       Hearing Aids

                                                   What is a Hearing Aid?        

Hearing aids are small wearable electronic devices, which enable a person to hear sounds better and understand speech more clearly providing an overall improvement in communication ability. Different signal processing strategies implemented in modern digital Hearing Aid are explained. Algorithms ranging from dynamic-range compression and directional microphones to sound classification and binaural noise suppression are clearly explained. Processing strategy is accompanied by a summary of its effectiveness [22].

               Function of Hearing Aid        

Sound is first taken in through a miniature microphone where it is converted into an electronic digital signal. Then, the signal is processed, amplified and modified according to the needs of the user and his hearing loss. Finally, a receiver, which is a miniature loudspeaker, sends the processed sound through the type of ear fitting/ear mould, which is appropriate for your hearing aid system. The major disadvantage with hearing aids is that its properties are related to noise reduction. Background noise is particularly damaging to speech intelligibility for people with hearing loss. They used many simple techniques ranging from relatively simple forms of filtering to advanced signal processing methods. Non-technical language issues are involved, and various approaches are conducted to solve the problem [23]. The presence, or threat, of acoustic feedback has long been one of the major problems in the fitting and wearing of hearing aids. Acoustic feedback occurs when some of the amplified sound leaks from the ear canal and is picked up by the hearing aid microphone and then re-amplified.

Different techniques have been investigated to reduce this effect like by using adaptive notch filter, novel method for feedback cancellation with adaptation during quiet intervals. Based on the study they suggest that novel system provides the best overall performance [24]. The improvement in terms of signal to ratio (SNR) which is the primary factor for speech intelligibility in background noise is provided by directional microphone of digital hearing aids, which relatively enhances sensitivity of microphones to signals arriving from front direction than other. A study was done with different reverberation time and having monaural/binaural hearing aids with directional/omnidirectional microphones. The result was that the signal to noise ratio is optimized when binaural hearing aids with directional microphones are used in rooms with short reverberation times [25].

               Performance of a Hearing Aid        

The microphone of hearing aid picks up the sound from the environment and the sound is passed to the external ear, then to the middle ear, then to the inner ear and Auditory nerve. The transmission takes a longer route and hence for the patient with severe-profound hearing loss, the sound reaching the inner ear is not very much audible and hence the interpretation by the Auditory nerve is not very clear. Here it depends on the anomaly of the parts of the inner ear and depending on that, the resultant listening graph may change. Majorly, in severe-profound hearing-impaired children the hair cells corresponding to high, mid and low frequencies will be absent (preserving some of the low frequency hair cells).

       Cochlear Implant

                                                   What is a Cochlear Implant?        

A CI is a neuroprosthetic device that is surgically implanted which provides a person with severe-profound sensory-neural hearing loss a sense of sound. CIs bypass the normal acoustic hearing process, instead replacing it with electric hearing. A prosthesis was required for the profoundly hearing-impaired individuals; hence, a lot of engineering work was involved in the development of the prosthetic device and its parts. Many different specialists were involved, in which the most important seemed to be the rehabilitationist, wherein they mentioned regarding the methods, goal set, etc. Finally, it was implanted in the individuals and the functioning was checked further along with rehabilitation [26].

               Function of A Cochlear Implant        

It mainly consists of two parts:

a) Internal part which is the Receiver.

b) External part which is the Speech processor.

               Internal part        

The internal part is implanted surgically and has a receiver and tiny electrodes. The receiver is imbedded under the skin behind the ear. The electrode array is inserted into the cochlea.

               External part        

The external portion, which is called the speech processor can, comes in variety of sizes and wearing options. Cochlear implants help the hearing impaired to listen better by receiving and processing sounds and speech. The sound is changed into electrical signals that in turn stimulate the hearing nerve and this change is worked together by the internal and external devices. First, the microphone located on the external device picks up the sound. Then the speech processor filters, analyzes, and converts the sound into a digital code. The signal is then sent, where it is transmitted across the skin to the internal receiver, via radio frequencies through the cable to the headpiece. The signal is being distributed to the electrodes along the array by the internal receiver, which has been placed inside the cochlea. The electrodes that stimulate the auditory nerve, which is connected to the cochlea, send the tiny electrical charges. As the CI stimulates the auditory nerve directly, it bypasses the damaged parts of the cochlea that cause hearing loss. The electrical signals to the brain are carried by the auditory nerve where they are interpreted as sound. This process occurs so fast that the listener hears the speech and other sounds without any delay.

CI users can achieve very good speech understanding, though there can be great differences in outcomes that is partially accounted by age, residual hearing, and duration of hearing loss. The Cochlear Implant individuals with high performance in speech recognition performed better as the number of channels increased. Nevertheless, the CI individuals with low performance in speech recognition did not have any better performance even if the channels increased [27]. In one of the studies, different strategies in the methodology were observed and one strategy that is compressed analogue (CA) strategy processor users were taken and were checked for performance. There was large improvement in the scores of speech reception tests for all subjects [28]. The sound localization in the auditory system and better understanding of speech in noisy situations are achieved with binaural hearing when the source of speech and noise are presented from different locations in the horizontal plane. Sound localization in the horizontal plane relies on two binaural cues: Interaural level difference (ILD) and Interaural time difference (ITD). Bilateral implantation has greater benefit in localization and lateralization. It helps in speech perception in noise as well as quiet. In a study, when the performances of ILD and ITD were tested, ILD seemed to be much better compared to that of ITD [29]. Binaural integration is likely to influence the performance with CI and Hearing Aid. In presence of noise, speech was not audible or difficult to identify with Hearing Aid. Whereas, with CI speech was audible and was understood [30].

             Performance  of A Cochlear Implant        

In CI, the microphone picks up the sound from the environment and is directly sent through the Auditory nerve bypassing other parts of the ear including external ear, middle ear and inner ear and if cochlea has any sorts of anomaly it would be bypassed. The information is heard faster and hence interpreted faster and without much hassle. When the child starts with speech therapy and listening training, the information travels faster and helps the child to learn and understand concepts faster.

       Guidelines for Determining Candidacy for a Cochlear Implant    

The critical factor in the determination of implant candidacy is the accurate assessment of hearing impairment by an audiologist. An age-appropriate combination of behavioral and physiological measures has to be used by the audiologist to determine hearing status of the child. A pure tone audiogram, acoustic reflex data and if needed, auditory brainstem responses to both clicks and tonal stimuli has to be performed before confirming bilateral severe-to-profound sensorineural hearing loss. Behavioral audiological tests should be performed to provide appropriate electroacoustic amplification and training. After the child has had a sufficient trial with hearing aid amplification, a cochlear implant is indicated. The audiological criteria for implantation is when the child has congenital or acquired profound sensorineural hearing loss (A pure tone average (500, 1000, 2000 Hz) of 90dB HL or greater in both ears is indicated) and limited or no functional benefit from electroacoustic hearing aid amplification. The limited benefit from functional hearing aid is by the performance results of pediatric multichannel cochlear implant users. Hearing aid benefit is put up in terms of:

i. Aided thresholds with conventional hearing aids relative      to aided results in the high frequencies where important    consonants occur, and

ii. Performance on word recognition tasks, administered    with auditory cues only in a closed- or open-response set.

The selection of the ear to be implanted is chosen based on Transtympanic promontory stimulation. Candidates for cochlear implantation require medical evaluation by an otolaryngologist, including history, physical examination and imaging studies of the temporal bone. The patient should be free of active ear disease, have an intact tympanic membrane, and be acceptable candidate for general anesthesia. High resolution computed tomography (CT) scan, magnetic resonance imaging (MRI), or both, are necessary to identify the implantable cochlea and patent internal auditory canal. When auditory nerve integrity is in doubt, electrical promontory stimulation is indicated. The implant components and function, the risks, limitations, and potential benefits of implantation, the surgical procedure, and the postoperative follow-up schedule should be discussed with parents (or guardians), and the child, if age appropriate. The child has to be educated based on the use of auditory prostheses and the development of auditory and speech skills. It is further recommended that parents (or guardians), and the child, if age appropriate, be fully informed about alternatives to implantation.

   Auditory-Verbal Therapy

                           What is Auditory Verbal Therapy    

AVT is a specialized type of therapy to teach a child to use the hearing provided by a hearing aid or a cochlear implant for understanding speech and learning to talk. The child is taught to hear and have intelligible speech. An integral part of communication, recreation, socialization, education and work by Hearing and active listening. The goal of AVT is helping the hard of hearing children to grow up in a regular learning environment, helping them to become independent, participating, and contributing citizens in the society. AVT encourages the use of naturalistic conversation and the use of spoken language to communicate and is a parent centered approach. It is a method that emphasizes on the use of residual hearing and helps children learn to listen, process verbal language, and speak. AVT maximizes the use of the child’s aided residual hearing for the detection of sound and to acquire language. The common language delays associated with hearing impairment is reduced by early identification of hearing loss with immediate fitting with amplification, as well as prompt intervention. The parents are taught during their child’s individual therapy sessions, are asked to emphasize on residual hearing, and are taught to interact with their child using the auditory-verbal approach. With normal-hearing peers, AVT encourages from the beginning the interaction and mainstreaming of children. Participation in playgroups and in community schools can provide children high motivation for the natural language models. AVT teaches the child to develop self-monitoring skills. The natural voice quality is promoted as the child learns to listen to his/her own voice as well as to others during natural conversations. The parent, therapist, and child engage in play activities that teach the child to use his or her amplified residual hearing to learn auditory-verbal communication like children with normal hearing. In a study the author, [31] emphasizes on the development of the child in speech and language after the optimal fitting of the audiological devices. When there is residual hearing, the first intervention comes AVT and then diagnostic teaching. Parents are assisted to create a listening environment.

       How it is Different from Speech Therapy    

Speech therapy is majorly corresponding to the language taught using lip movement/visual cues. The child is encouraged to lip read and learn to speak the language with the correct production of individual sound. The child is encouraged to learn through visual cues. It does not encourage the child to hear. Speaking using simple language. Parents are majorly observers. It can be practiced in-group sessions. It is mainly through drill based. In AVT, the child is encouraged to learn language mainly through child’s listening abilities. It is majorly learning through listening. Listening has high expectations. The child is made to achieve clear speech. Natural language is provided. Parents play the role of teachers. The child has to be given individual therapy. It’s mainly conversation based.

       Importance of Auditory-Verbal Therapy    

Children with even profound hearing losses can detect most of the speech most if not all, when aided properly. A child who has a hearing impairment has to be an auditory learner and need not automatically be a visual learner (i.e., sign language). Children learn language in a supportive environment most effectively through consistent meaningful learning interactions. As verbal language is developed through audition, reading skills are also developed. In AVT programs, parents are not taught sign language. AVT uses and encourages the maximum use of hearing, and stresses listening rather than visual cues. AVT uses a team approach to therapy that allows for a more complete education environment. Auditory Verbal Therapy has proved to be effective for children with hearing loss. With respect to speech, language and self-esteem there was no much difference between the groups taken [32]. Early identification of Hearing Impairment helps in early intervention. Therefore, it further helps to start the AVT early.

It helps them to grow up in regular living and learning environment so that they all can become independent individuals participating and contributing in the society [33]. In a study conducted, every child was tested for different outcomes after the implantation with the help of AVT. Several multi-center researches required to get the correct impression regarding the AVT intervention [34]. The focus of AVT comprises of intensive early intervention therapy sessions on audition, technological management and involvement of the child’s caregivers in therapy sessions; it is the only therapy approach, which has avoidance or exclusion of non-auditory visual communication. The primary goal of AVT is to achieve age-appropriate spoken language. AVT programs are expanded and are present throughout the world but little evidence is found on the effectiveness of the intervention. AVT has shown a significant benefit for school aged children and good improvement in speech and language skills. Therefore, it shows that not just in the initial years, AVT is required but also during the later stages, that is, during school age. Therefore, it shows that continuous AVT/Rehabilitation is required for better performance [35].

   Methods

                           Research Objectives    

The objective of the current study is to check the performance of children implanted with CI and children fitted with Hearing Aid in AVT. The following areas were assessed:

a) Understand the difference in performance in AVT for the    two groups of children wearing CI and Hearing Aid using CAP

b) Understand the difference in the level of understanding of    the concept taught in AVT.

c) Understand the difference in the ability to hear highfrequency sounds.

d) Understand the effect of the duration of therapy attended    by children wearing CI and Hearing Aid.

       Inclusion Criteria    

a) subjects were taken who were implanted with CI at the      same time, same age (approx.) and having the same degree of    hearing loss.

b) 3 subjects were taken who were fitted with Hearing Aid at      the same time, same age (approx.) and having the same degree    of hearing loss.

c) All subjects were children between the age of 3 years to 4    years.

d) All participants had severe-profound hearing loss.

e) All the subjects had pure sensorineural pathology.

       Exclusion Criteria    

a) Children having mild, moderate and moderately-severe    degree of hearing loss were excluded.

   b) Children having normal hearing sensitivity were excluded.    

c) Children with mixed hearing loss or with Middle ear    pathology were excluded.

d) Children with poor mental abilities were excluded (like:    Mental retardation, Autism, etc).

e) Teenagers and Adults with severe-profound hearing loss    were excluded.

       Comparison of performance with Cochlear Implant and Hearing Aid using CAP    

A group (A) of 3 subjects who were implanted with Cochlear Implant (CI) were taken having the same degree of hearing loss, same age (approximately) and same time at which CI was implanted and Auditory Verbal Therapy was started at the same time which is as shown in Table 1.

Table 1. Case details of group ‘A’ subjects.

                 Background      

Case 1

The child was brought to this clinic with a complaint of delayed speech and language development secondary to hearing loss. The child was born through normal delivery in a private hospital. The parents reported no other significant history (it was a full term delivery with immediate birth cry and correct birth weight). Detailed audiological evaluation (Pure tone Audiometry, Immittance, and Auditory reflex) was done and the child was diagnosed with bilateral severe to profound hearing loss. The case underwent cochlear implantation for right ear and left ear simultaneously. The child is a Bilateral Kanso user. The child attends 2 sessions/week regularly for 45 minutes to 1 hour. The duration of the therapy was 1 year.

Case 2

The child was brought to this clinic with a complaint of delayed speech and language development secondary to hearing loss. The child was born through caesarian delivery in a private hospital. The child had low birth weight and no other significant history (it was a full-term delivery with immediate birth cry) was reported by the parents. Detailed audiological evaluation (Pure tone Audiometry, Immittance, and Auditory reflex) was done and the child was diagnosed with bilateral severe to profound hearing loss. The case underwent simultaneous cochlear implantation for both ears. The child is a Bilateral Kanso user. The child attends 2 sessions/week regularly for 45 minutes to 1 hour. The duration of the therapy was 10 months.

Case 3

The child was brought to this clinic with a complaint of delayed speech and language development secondary to hearing loss. The child was born through normal delivery in a private hospital. The parents reported no other significant history (it was a full term delivery with immediate birth cry and correct birth weight). Detailed audiological evaluation (Pure tone Audiometry, Immittance, and Auditory reflex) was done and the child was diagnosed with bilateral severe to profound hearing loss. The case underwent simultaneous cochlear implantation. The child is a Bilateral Kanso user.  The child attends 2 sessions/week regularly for 45 minutes to 1 hour. The duration of the therapy was 11 months. - A group (B) of three subjects who were fitted with hearing aid were taken having the same degree of hearing loss, same age (approximately) and same time at which Hearing aid was fitted and Auditory Verbal Therapy was started at the same time which is as shown in Table 2.

Table 2. Case details of group ‘B’ subjects.

Case 4

The child was brought to this clinic with a complaint of delayed speech and language development secondary to hearing loss. The child was born through caesarian delivery in a private hospital. The parents reported no other significant history (it was a full term delivery with immediate birth cry and correct birth weight). Detailed audiological evaluation (Pure tone Audiometry, Immittance, and Auditory reflex) was done and the child was diagnosed with bilateral severe to profound hearing loss. The case was fitted with hearing aids for the right ear and left ear simultaneously. The child attends 2 sessions/week regularly for 45 minutes to 1 hour. The duration of the therapy was 1 year and 1 month.

Case 5

The child was brought to this clinic with a complaint of delayed speech and language development secondary to hearing loss. The child was born through caesarian delivery in a private hospital. The child had delayed birth cry and no other significant history (it was a full-term delivery with normal birth weight) was reported by the parents. Detailed audiological evaluation (Pure tone Audiometry, Immittance, and Auditory reflex) was done and the child was diagnosed with bilateral severe to profound hearing loss. The case was fitted with hearing aids for both the ears simultaneously. The child attends 2 sessions/week regularly for 45 minutes to 1 hour. The duration of the therapy was 11 months.

Case 6

The child was brought to this clinic with a complaint of delayed speech and language development secondary to hearing loss. The child was born through normal delivery in a private hospital. The parents reported no other significant history (it was a full term delivery with immediate birth cry and correct birth weight). Detailed audiological evaluation (Pure tone Audiometry, Immittance and Auditory reflex) was done and the child was diagnosed with bilateral severe to profound hearing loss. The case was fitted with hearing aids for both ears simultaneously. The child attends 2 sessions/week regularly for 45 minutes to 1 hour. The duration of the therapy was 10 months. Having all the characteristics similar, child’s intelligence quotient (IQ) level, Cognitive skills, Intellectual skills. Home training may vary from individual to individual.

           Categories of Auditory Performance (CAP)      

Categories of Auditory Performance (CAP) is an index consisting of eight performance categories arranged in order of increasing difficulty. The test starts with sounds, words, phrases and then sentences. Both the ears can be tested with the same test which is as shown in Table 3 [36].

Table 3. Case details of group ‘B’ subjects.

                 Therapeutic Approach      

a) The therapy is given in a closed soundproof room in which        the clinician sits beside the child and AVT is given. The parent        will be present, is involved in the therapy sessions so that they        understand the procedure of therapy, and helps them with      home training.

b) Different materials will be used like flash cards, models,      toys, etc., in order to teach a concept to the child.

c) The concept is taught by introducing a single object (e.g.,        apple) in the form of model first and then is taught by telling        its name. Then in a more natural situation by showing the real        ‘apple’ and describing its color, shape, taste, etc. Similarly, it is      taught in the same way for all the objects in every topic.

d) There are 6 major levels in AVT

i. Auditory Awareness level.

ii. Auditory Discrimination level.

iii. Auditory Identification level.

iv. Auditory Memory and Sequencing level.

v. Auditory Comprehension level.

vi. Auditory Cognition level.

e) One subject from each group was taken and was tested        for the level of AVT in which they were already trained. All the      students from both the groups were tested.

f) For e.g., Different topics of Auditory Identification were      taken as:

i. Ling’s sounds: /a/, /i/, /u/, /m/, /s/, /sh/

ii. Nouns: Fruits, Vehicles, Body parts, Colors, etc.

iii. Verbs: Sitting, Eating, Running, Sleeping, Drinking, etc.

iv. Prepositions: Above, Below, Inside, Outside, Besides, etc.

           Comparison of Level of Understanding of Concepts for CI and Hearing Aid      

All the six cases were made to identify the nouns and verbs with the help of respective flash cards presented in front of them only through auditory mode in a closed soundproof room where the clinician sits beside the child and AVT is given. These are individual therapy sessions. The results were noted in terms of trials which is as shown in Table 5

           Comparison of performance for CI and Hearing Aid with high frequency sounds      

All the six cases were made to identify the six ling sounds only through auditory mode in a closed soundproof room where the clinician sits beside the child and AVT is given. These are individual therapy sessions. The results were noted in terms of trials which is as shown in Table 6.

     Results

The individual ear is first tested (right ear and left ear) and then both the ears (bilateral).

Table 4. Case details of group ‘B’ subjects.

Table 5. Case details of group ‘B’ subjects.

Table 6. The following are the results for the high frequency        sounds.

     Discussions

The first objective was to understand the difference in the performance in AVT for the two groups of children wearing CI and Hearing Aid using CAP. The results in Table 4 shows that, the CAP scores are higher for CI as compared to that for Hearing Aid. The CI implanted children have better scores for individual ear and hence helps the child to comprehend and express language in a much easier way as compared to that of children implanted with Hearing Aid. The children with CI take much lesser time to learn language as compared to that of children fitted with hearing aid. A study was conducted [37] on a group of children wearing CI and hearing aid, where they were made learn English language and it was observed that CI participants performed much better than the participants wearing hearing aid in the acquisition of English language. This supports the current study that the performance with CI is better than performance with hearing aid. The second objective was to understand the difference in the level of understanding the concept taught in AVT. The results from Table 5 shows that the amount of time taken by CI children to learn language (nouns and verbs) is much lesser as compared to children with hearing aids.

Hence, the speech production, the intelligibility and the language of children with CI is much better than children with hearing aids. In a study [38], they assessed the novel-word learning by varying word forms, stimulus level and observed that the children with hearing aid scored 41% when compared to normal hearing children who scored 60% in the same test. The third objective was to understand the difference in the ability to hear the high frequency sounds. The results from Table 6 shows that the scores obtained for the ling sounds /s/ and /sh/ are much lesser as compared to other ling sounds. Thus, which clearly shows that the children with hearing aids have difficulty listening to these high frequency sounds, which in turn affects them in the production of these sounds. These affect the children with hearing aids in the articulation of the high frequency words and hence the intelligibility is reduced as compared to that of children with CI. In a study [39], a group of children wearing CI and hearing aid were compared with the overall intelligibility, articulation, resonance and voice and found that the children with CI had much better intelligibility as compared to children with hearing aid. It was even observed that children with hearing aid had more phonetic and phonological disorders. This supports the current study that CI implantees perform better than children with hearing aid for high frequency sounds. The fourth objective was to understand the effect of the duration of therapy attended by the children wearing CI and Hearing Aid. The results from Tables 4-6 suggest that longer the therapy was attended, the better the learning. The scores (CAP, high frequency sounds and level of understanding) for the cases that has attended therapy for longer duration are much better compared to that for the cases which has attended for much lesser duration. We can see from Tables 4-6 that case 1 has better score compared to case 2 and case 3 for children wearing CI and case 4 has better scores compared to that for case 5 and case 6 who are wearing hearing aid.

     Conclusion

Language comprehension and expression are important in a child’s life for his/her future living. Proper articulation and intelligibility in speech are important for communication, where in AVT plays a major role in the acquisition of language. So, it is important that the child hears all the sounds of the word (high, mid and low frequency sounds) to acquire and articulate correct language. As we have seen, in case of CI wearing children sound is transmitted directly to the inner ear and then to the auditory nerve bypassing the outer and middle ear. Whereas, in case of hearing aids sound is not transmitted directly and has longer pathway for sound transmission. Hence, this results in the delay of information flow in case of hearing aids as compared to that of CI. Better hearing helps to understand and learn language in a much easier way.  From the current study, we can conclude that children wearing CI are much more benefitted compared to that of children wearing Hearing aids. However, there are some limitations to the current study. First, the relatively small sample size of participants limited the current study to detect the performance of hearing impaired children with hearing aid and CI in AVT, while additional participants would have strengthened the findings. Second, the study was done on a group of children whose age range was less than 5 years old, so it could be that older children (of more than 5 years old) with hearing aid could have performed better than children implanted with CI. Third, the study was done on cases having a pure sensorineural component. Thus, we cannot comment about the performance of the cases having mixed hearing loss. Finally, the test used in the study was only one, that is ‘CAP’, which had a limited set of questions. Despite these limitations, the research goes some way towards providing a benchmark for the better performance of children with CI compared to that of children with hearing aid in AVT. This study has provided a research model, and this should be replicated in future studies and also more methodological approaches should be used to have a better understanding about the performance with CI and hearing aid in AVT.

For more Otolaryngology Journals please click on below link https://lupinepublishers.com/otolaryngology-journal/

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