Core Stabilization Exercises in Hearing Impaired Children

Study Overview
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Brief Summary
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In this study the investigators will examine the effects of core stabilization exercises on respiratory muscle strength, respiratory functions and postural control in hearing-impaired children.

Detailed Description
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Hearing organs develop together with the vestibular system and work with close cooperation. Because of this close neuro-anatomic relationship; cochlear, semicircular canal, or both may cause damage to the vestibular dysfunction, resulting in imbalance. Sensory impairment in children with hearing loss may lead to decreased muscle strength and respiratory function with balance and coordination disorders. Core stabilization is provided anatomically with abdominal muscles at the front, spinal and gluteal muscles at the back, diaphragm at the top and pelvic floor and hip muscles at the bottom. Core stabilization training is a training to increase the strength, endurance and neuromuscular control of the aforementioned muscles. When the literature is checked, the invetigators find that postural control is being evaluated in children with hearing impairment, but there are few studies evaluating respiratory functions. However, they did not encounter a study in which respiratory muscle strength was assessed in these children. In this study the investigators will examine the effects of core stabilization exercises on respiratory muscle strength, respiratory functions and postural control in hearing-impaired children.

Official Title
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The Effect of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions and Postural Control in Hearing Impaired Children

Conditions
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Hearing Disorders in Children, Core Stabilization, Respiratory Muscle Strength, Respiratory Functions, Postural Control

Intervention / Treatment
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* Other: Core Stabilization Exercises
* Other: No Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between the ages of 7-16 Clinically diagnosed sensorineural hearing loss Prelingual hearing loss No neurological and orthopedic problems Absence of syndrome or disease that may lead to mental disorder, impaired development and impaired vision Not participating in any core stabilization, strengthening and balance program in the past six months No medication to affect respiratory functions in the past 3 months Parental permission for participation of child in the study Exclusion Criteria: Intellectual disability for participating to the evaluation and training program Presence of chronic respiratory disease Not to join the training for more than 3 days

Ages Eligible for Study
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Minimum Age: 7 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control Group<br>After recording the demographic and clinical information at the beginning of the study and after 8 weeks, respiratory muscle strength, respiratory functions and postural control evaluations will be performed to the children. They won't receive any intervention by this time. At the end of 8 weeks, they may be included in the 8-week physiotherapy program, which will be once a week and 45-60 minutes by supervision of physiotherapist and 4 days a week home exercise program. The program will include core stabilization exercise training. | Other: No Intervention<br>* Since no training is given to the control group during the study period, it is ethically necessary to give the same training to the control group if the benefit is achieved when the study is completed.<br>|
| Experimental: Training Group<br>After recording the demographic and clinical information at the beginning of the study, respiratory muscle strength, respiratory functions and postural control evaluations will be performed to the children. They will be included in the 8-week physiotherapy program, which will be once a week and 45-60 minutes by supervision of physiotherapist and 4 days a week home exercise program. The program will include core stabilization exercise training. After the eight week training program the evaluations will be repeated. | Other: Core Stabilization Exercises<br>* Jeffrey's core stabilization exercise training protocol will be performed to the training group. This protocol includes exercises progressing gradually from level 1 to level 3. Level 1; static contraction training on a stable surface, level 2; dynamic training on a stable surface, level 3; dynamic and resistant training on an unstable surface.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Respiratory muscle strength | Change from baseline maximum inspiratory pressure and maximum expiratory pressure at 8 weeks | Eight weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Respiratory Functions-FVC | Change from baseline Forced Vital Capacity (FVC) at 8 weeks | Eight weeks | 
| Respiratory Functions-FEV1 | Change from baseline Forced Expiratory Volume in 1 second (FEV1) at 8 weeks | Eight weeks | 
| Respiratory Functions-PEF | Change from baseline Peak Expiratory Flow (PEF) at 8 weeks | Eight weeks | 
| Postural control-postural stability | Change from baseline postural stability test score in Biodex Balance System at 8 weeks | Eight weeks | 
| Postural control-limits of stability | Change from baseline limits of stability test score in Biodex Balance System at 8 weeks | Eight weeks | 
| Postural control-sensory integration | Change from baseline sensory integration and balance test core in Biodex Balance System at 8 weeks | Eight weeks | 
| Postural control-BESS | Change from baseline Balance Error Scoring System (BESS) test scores at 8 weeks | Eight weeks |