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Background <p>Vestibular function is a key component of balance and motor control, together with hearing for spatial orientation. Vestibular impairment is often present in case of childhood deafness, which is frequently resolved with cochlear implant (CI). With this study, we aimed to explore (1) the relation between balance, physical activity and vestibular function in teenagers and young adults since infancy (TAYACI), (2) the influence on balance with CI on vs. off, and (3) balance tests’ possibility to screen vestibular impairment in paediatric standard care.</p> Methods <p>41 TAYACI, aged 12–22, and 20 normal hearing (NH) peers participated. Vestibular function was assessed with Video Head Impulse Test (vHIT). Balance was tested with the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) balance subtest, Kids Balance Evaluation Systems Test (Kids-BESTest) sections Sensory Orientation and Reactive Postural Responses, and a test of walking 10&#xa0;m with head turns (10mW). Self-reported questionnaires were used to report experience of balance and physical activity.</p> Results <p>vHIT ascertained vestibular impairment in 49% of TAYACI; balance was inferior in TAYACI compared to NH with lower scores on BOT2 subtest: mean (sd) 8.3 (4.0) vs. 15.1 (4.0) (<i>p</i> &lt; 0.001), and on Kids-BESTest section Sensory Orientation: median (min, max) 13 (13–15) vs. 15 (15–15) (<i>p</i> &lt; 0.001). Screening properties for vestibular impairment were found for BOT-2 balance subtest (AUC = 0.947; best score cut off: 9/25 – sensitivity: 100%, specificity: 89.7%), and singular items, especially BOT9 (standing on one leg on a balance beam with eyes closed) (AUC = 0.92, best cut off: 2.8/10 seconds – sensitivity:100% specificity:74%). None of the tests could distinguish between subjects with bilateral vestibular impairment or unilateral vestibular impairment, nor between TAYACI and NH with normal vestibular function. The CI activity (on/off) did not affect balance tests. 40% of TAYACI reported inferior balance than NH peers, but they were equally physically active.</p> Conclusion <p>vestibular impairment is prevalent in TAYACI and represents an important determinant for balance skills. Standing on one leg on a balance beam with eyes closed is an accessible test to screen for vestibular impairment in children. Physical activity was comparable between TAYACI and NH peers.</p> Trial registration <p>NCT 07079488.</p>

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Balance and physical activity in teenagers and young adults with cochlear implants: a Swedish cohort study

  • 期刊论文

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  • 发表日期：

    2026年3月5日

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  • Susanne Gripenberg,
  • Luca Verrecchia,
  • Cecilia Lidbeck

摘要

Background

Vestibular function is a key component of balance and motor control, together with hearing for spatial orientation. Vestibular impairment is often present in case of childhood deafness, which is frequently resolved with cochlear implant (CI). With this study, we aimed to explore (1) the relation between balance, physical activity and vestibular function in teenagers and young adults since infancy (TAYACI), (2) the influence on balance with CI on vs. off, and (3) balance tests’ possibility to screen vestibular impairment in paediatric standard care.

Methods

41 TAYACI, aged 12–22, and 20 normal hearing (NH) peers participated. Vestibular function was assessed with Video Head Impulse Test (vHIT). Balance was tested with the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) balance subtest, Kids Balance Evaluation Systems Test (Kids-BESTest) sections Sensory Orientation and Reactive Postural Responses, and a test of walking 10 m with head turns (10mW). Self-reported questionnaires were used to report experience of balance and physical activity.

Results

vHIT ascertained vestibular impairment in 49% of TAYACI; balance was inferior in TAYACI compared to NH with lower scores on BOT2 subtest: mean (sd) 8.3 (4.0) vs. 15.1 (4.0) (p < 0.001), and on Kids-BESTest section Sensory Orientation: median (min, max) 13 (13–15) vs. 15 (15–15) (p < 0.001). Screening properties for vestibular impairment were found for BOT-2 balance subtest (AUC = 0.947; best score cut off: 9/25 – sensitivity: 100%, specificity: 89.7%), and singular items, especially BOT9 (standing on one leg on a balance beam with eyes closed) (AUC = 0.92, best cut off: 2.8/10 seconds – sensitivity:100% specificity:74%). None of the tests could distinguish between subjects with bilateral vestibular impairment or unilateral vestibular impairment, nor between TAYACI and NH with normal vestibular function. The CI activity (on/off) did not affect balance tests. 40% of TAYACI reported inferior balance than NH peers, but they were equally physically active.

Conclusion

vestibular impairment is prevalent in TAYACI and represents an important determinant for balance skills. Standing on one leg on a balance beam with eyes closed is an accessible test to screen for vestibular impairment in children. Physical activity was comparable between TAYACI and NH peers.

Trial registration

NCT 07079488.