Hearing loss & rehab, stroke & depression among topics of Vol. 39, Iss 5, JRRD

November 18, 2002

A cost-utility analysis of adult group audiologic rehabilitation
Compares the cost-effectiveness of hearing aid use alone and hearing aid use with group post-fitting audiologic rehabilitation. A total of 105 veterans, 67 males and 38 females, were tested before and after treatment to determine if there was a significant difference in quality of life between hearing aid or hearing aid and audiologic rehabilitation intervention study groups. Data indicate that adding an audiologic rehabilitation component to treatment improved outcome for the participants and is cost effective.

Early detection of medication induced hearing loss
Evaluates a technique for rapid and early detection of ototoxicity, which results from medications that may cause hearing and balance damage. Twenty-one hospitalized male patients ranging in age from 33 to 79 years who were not receiving any known ototoxic medications were administered two behavioral protocols: a full-frequency baseline audiometric test using standard clinical protocol and a rapid identification protocol. The study suggests that patients prescribed ototoxic medications can benefit from early detection of ototoxicity in the high frequencies before the ability to understand speech is impaired.

Patient education improves pressure ulcer prevention knowledge in veterans with spinal cord dysfunction
Analyzes the effect of education and structured follow-up on knowledge of pressure ulcers in veterans with spinal cord dysfunction after pressure ulcer surgery. Forty-one males with spinal cord injury (SCI) or multiple sclerosis (MS) were randomized before surgery to either an intervention or a control group. A test on knowledge of pressure ulcer prevention was administered before surgery and at discharge from the hospital. The intervention group received 4 hours of structured, individualized pressure ulcer prevention education during hospitalization. The control group received standard education. Data demonstrated that enhanced, individualized education was effective in improving pressure ulcer knowledge.

Depressive symptoms and independence in activities of daily living
Investigates the relationship between depressive symptoms and time in achieving independence in basic activities of daily living (BADL) and instrumental activities of daily living (IADL). 459 patients who had a stroke were assessed for depression at 1, 3, and 6 months after stroke. The Geriatric Depression Scale was used to determine depressive status. Patients who had a stroke and depressive symptoms progressed slower in achieving independence of BADL and IADL compared to patients without depressive symptoms.

Footwear used by individuals with diabetes and a history of foot ulcer
Describes the footwear preferences of people with diabetes and a history of foot ulcers from two large western Washington State health care organizations. 400 study participants reported their footwear preferences; use of optimal, adequate and dangerous types of footwear; and the cost of footwear used during the year prior to study enrollment. Women spent an average of 51% of their time in dangerous shoes compared to 27% men. Providing patients with information on good footware choices may help them avoid dangerous shoes.

Computer tomography scans used to create a 3D model of bone
Identifies a method to build accurate three-dimensional (3D) models of the bones within the lower limb using computer tomography (CT) scans. Currently, CAD/CAM (computer-aided design/computer-aided manufacturing) computer programs use the shape of the residual limb to aid in fabricating the prosthetic socket. A 3D model of a shinbone was created from a CT scan of a volunteer with an amputation. The method overcame difficulties in creating shape models from CT scans, is rapid, and can process CT scans from different individuals. Addition of display of bone shapes could provide additional information to enhance the quality and fit of the prosthesis.

Modified diagnostic tool holds promise to enhance prosthetic prescription and skin exams
Explains the modification of a tool to measure the response of human soft tissue to load, including measures of tissue perfusion. Tests were conducted on the calf of 19 healthy subjects to demonstrate the utility of the device and identify potential uses. Data identified several potential perfusion measures that may assist future evaluation of prosthetic fit and dermatological risk for individuals with lower-limb amputations and peripheral vascular disease.

Time-expanded speech and speech recognition in older adults
Investigates the effects of speech rate on speech recognition in older adults. Eighteen adults, assigned to three different groups, were tested at two rates of time-expanded speech. Their task was to repeat sentences from the Connected Speech Test that had been processed by a nonuniform time-compression algorithm. All three groups performed better on sentence recognition tests with normal speech. Noise was detrimental to older participants. When speech rate was slowed in a noisy background, speech recognition was enhanced, but slow speech had an adverse effect in speech recognition in a quiet background.
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The Journal of Rehabilitation Research and Development is the only peer-reviewed, scientifically indexed publication covering all rehabilitation research disciplines: neurology, orthopedics, engineering, audiology, ophthalmology and optometry, outcomes, restorative, prosthetics, geriatrics, psychiatrics, and community reintegration. Formerly the Bulletin of Prosthetics Research, the Journal debuted in 1983 to include cross-disciplinary findings in rehabilitation. The Rehabilitation Research and Development Service, Department of Veterans Affairs, accepts original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers who investigate disability rehabilitation.

Veterans Affairs Research Communications

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