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PubMed2002

Deciphering auditory processing disorders in children.

APD is not a label for a unitary disease entity but rather a description of functional deficits [3]. It is a complex and heterogeneous group of auditory-specific disorders usually associated with a range of listening and learning deficits [3,4]. Underlying APD is a deficit observed in one or more of the auditory processes responsible for generating the auditory evoked potentials and the following behaviors: around localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition, including temporal resolution, masking, integration, and ordering; auditory performance with competing acoustic signals; and auditory performance with degraded acoustic signals [2]. Comprehensive assessment is necessary for the accurate differential diagnosis of APD from other "look-alike" disorders, most notably ADHD and language processing disorders. Speech-language pathologists, psychologists, educators, and physicians contribute to this more comprehensive assessment. The primary role of otolaryngologists is to evaluate and treat peripheral hearing disorders, such as otitis media. Children with APDs may present to an otolaryngologist, thus requiring the physician to make appropriate referral for assessment and intervention. Currently, diagnosis of APD is based on the outcomes of behavioral tests, supplemented by electroacoustic measures and, to a lesser extent, by electrophysiologic measures [1]. Intervention for APD focuses on improving the quality of the acoustic signal and the listening environment, improving auditory skills, and enhancing utilization of metacognitive and language resources [2]. Additional controlled case studies and single-subject and group research designs are needed to ascertain systematically the relative efficacy of various treatment and management approaches.

Child↗
PubMed1998

Morphology and axonal projection patterns of auditory neurons in the midbrain of the painted frog, Discoglossus pictus.

Acoustic signals are extensively used for guiding various behaviors in frogs such as vocalization and phonotaxis. While numerous studies have investigated the anatomy and physiology of the auditory system, our knowledge of intrinsic properties and connectivity of individual auditory neurons remains poor. Moreover, the neural basis of audiomotor integration still has to be elucidated. We determined basic response patterns, dendritic arborization and axonal projection patterns of auditory midbrain units with intracellular recording and staining techniques in an isolated brain preparation. The subnuclei of the torus semicircularis subserve different tasks. The principal nucleus, the main target of the ascending auditory input, has mostly intrinsic neurons, i.e., their dendrites and axons are restricted to the torus itself. In contrast, neurons of the magnocellular and the laminar nucleus project to various auditory and non-auditory processing centers. The projection targets include thalamus, tegmentum, periaqueductal gray, medulla oblongata, and in the case of laminar neurons--the spinal cord. Additionally, tegmental cells receive direct auditory input and project to various targets, including the spinal cord. Our data imply that both auditory and premotor functions are implemented in individual toral and tegmental neurons. Their axons constitute parallel descending pathways to several effector systems and might be part of the neural substrate for differential audiomotor integration.

Animals↗
PubMed2004

The effect of auditory feedback on phonation threshold pressure measurement.

The effect of auditory feedback on phonation threshold pressure (Pth) measurement was investigated in 14 females with normal, untrained voices. Two measurement systems (Glottal Enterprises MS 100--circumferentially vented mask and Kay Elemetrics Aerophone II--non-circumferentially vented mask) were examined under three conditions: (1) masked, (2) no mask, and (3) masked with enhanced auditory feedback-acoustic signal placed at ears through headphones. Masked with enhanced auditory feedback, in addition to subject training, significantly lowered Pth values regardless of mask design. The amount of auditory feedback provided by different mask designs was investigated and revealed a significant difference. Clinical significance of different auditory feedback levels provided by the two mask designs was investigated. Direct comparison of the mean values between systems was not possible because of each system's design and calibration. Comparisons were accomplished by subtracting means of select-paired conditions (masked/no mask; masked/masked plus masked with enhanced auditory feedback) within each system and then comparing these difference scores from the same paired conditions between each system. No clinical significance in difference scores was revealed because of varying amounts of auditory feedback provided by the masks. Results support the use of enhanced auditory feedback, in addition to subject training, when measuring Pth.

Adult↗
PubMed1999

Auditory activation of cortical visual areas in cats after early visual deprivation.

Auditory activation of the primary visual cortex (area 17) and two extrastriate visual cortical areas - the anterolateral lateral suprasylvian area (ALLS) and anteromedial lateral suprasylvian area (AMLS), was investigated in visually impaired cats. Impairment was accomplished shortly after birth by bilateral eyelid suturing (binocularly deprived cats, BD) or bilateral enucleation (binocularly enucleated cats, BE). In BE cats, the optic nerve and chiasm were entirely degenerated. No cortical atrophy or cytoarchitectural malformation was noticed in either BD or BE cats. In both normal and impaired cats we found auditory-responsive cells in the ALLS and AMLS, areas that are considered strictly visual. The most remarkable finding was an increase in the relative number of these auditory cells in the BD and BE cats, which was more prominent in the latter. Some auditory-responsive cells were also found in area 17 of BE cats. On the basis of formal calculation, it is tempting to suggest that the increase in relative number of auditory cells in these areas reflects the transformation of all the visual cells in the ALLS of BD and BE cats into auditory cells. In BE cats, all bimodal cells and an appreciable percentage of non-responsive cells also had transformed to auditory cells. In the AMLS of BD cats, it is primarily the bimodal cells that become auditory cells, whereas in BE cats all the visual and bimodal cells as well as non-responsive cells undergo this transformation. This assumption, however, is one possible interpretation of our results but not the only one. Other modes of neuronal plasticity that might yield similar results in the visually deprived cats can not be ruled out.

Acoustic Stimulation↗
PubMed1999

Growth factors, auditory neurones and cochlear implants: a review.

The total number and the integrity of the auditory neurones available for stimulation govern the benefits that patients can derive from cochlear implants. Although electrical stimulation of the cochlea has been reported to promote auditory neuronal survival, this trophic effect is insufficient to regenerate de novo fibres. Hence, any agent that can maximize the number of, or regenerate functional auditory neurones would be of great benefit. Several studies have identified various growth factors crucial to the normal development of auditory neurones. In addition, in vitro studies have demonstrated that several growth factors are important for the maintenance, rescue and repair of adult auditory neurones. In vivo studies confirm the in vitro findings, reporting that specific growth factors are able to support auditory neuronal survival following injury or trauma, and in lower species growth factors have been associated with regenerating auditory neurones. In addition to their trophic actions, several growth factors have also been reported to affect ion channels thus the electrical response of neuronal fibres. Indeed, growth factors have been reported to enhance neuronal excitation and to improve the efficacy of synaptic transmission. Taken in concert, these effects suggest that exogenous growth factors delivered to the cochlea may improve the transmission of the electrical stimuli from the implanted electrode to the auditory pathway. Further studies are warranted to investigate how the adjunct delivery of growth factors with the cochlear implant may constitute a better treatment for hearing-impaired individuals.

Adult↗
PubMed1984

Auditory and visual imagery in free recall.

Three experiments varied instructions and materials to compare the influence of auditory and visual imagery on free recall. Four kinds of words were presented: words with minimal imagery, words with both visual and auditory imagery, words with visual imagery, and words with auditory imagery. Experiment 1 (n = 48 volunteer college students) found instructions to form auditory images and words with auditory imagery to have the same advantage over control instructions and minimal imagery words as did visual imagery instructions and words with visual imagery. In Experiment 2 (n = 64 volunteer college students), groups instructed to form both auditory and visual imagery had incidental recall scores no greater than those of groups instructed to form only one kind of imagery. Experiment 3 (n = 64 volunteer college students) introduced augmented visual imagery (subjects drew a picture of the visual image) and augmented auditory imagery (subjects vocalized a sound modeled after the auditory image). Recall scores for the two augmented imagery groups were not significantly different from those for the two imagery groups. Results are discussed in terms of their implications for views of the cognitive representation of imagery.

Humans↗
PubMed2005

Aphasia and auditory extinction: Preliminary evidence of binding.

Background: McNeil, Odell, and Tseng (1991), and Murray and colleagues (Murray, 2000; Murray, Holland, & Beeson, 1997a, 1997b) have suggested that variability of performance in patients with aphasia may be due to nonlinguistic cognitive variables, such as attention (i.e., resources, capacity, effort), which affect language comprehension and production. Given the research that has supported the relationship between aphasia and attention deficits, it is important to determine what effect this breakdown in attention may have on cognitive processes for individuals with aphasia.Aims: This study aims to determine if auditory extinction is present in individuals with aphasia, and if so, if this is due to a breakdown in binding. If extinction is found for individuals with aphasia, it would further support the notion that auditory attention difficulties are present among individuals with aphasia, since visual and auditory research has attributed extinction to a breakdown in attention (Baylis, Driver, & Rafal, 1993; Deouell, Bentin, & Soroker, 2000; Deouell & Soroker, 2000). If binding is found to be deficient, the fact that individuals with both left and right hemisphere lesions demonstrate this phenomenon would lead to a number of implications regarding the relationship of attention and aphasia.Methods & Procedures: Auditory extinction, in which one stimulus is not perceived during double simultaneous stimulation (DSS) presentation, was examined in six individuals with aphasia (aged 42-74 years) and six age-matched healthy adults. Two different experiments were conducted in which the auditory stimuli, consisting of male and female voices speaking the letters "T" or "O", were systematically varied to investigate whether binding of identification to location contributes to extinction.Outcomes & Results: Participants with aphasia made more omission errors (extinction) than the control group, and extinction was significantly greater for binding versus nonbinding conditions, suggesting that binding may play a role in extinction for individuals with aphasia.Conclusions: These data provide preliminary results that auditory extinction exists in individuals with aphasia and may be due to deficits in binding together identification and localisation information. Research on this phenomenon and how it influences language would be a worthwhile endeavour for future studies. Moreover, little is known about assessment of auditory attention in patients with aphasia. Further research in this area can lead to advancements in theoretical and functional assessment for individuals with aphasia who have auditory attention and/or binding deficits and require speech-language pathology intervention.

Journal Article↗
PubMed2006

Auditory hallucinations in schizophrenia: intrusive thoughts and forgotten memories.

INTRODUCTION: This paper presents a new cognitive model of auditory hallucinations in schizophrenia. We suggest that auditory hallucinations are auditory representations derived from the unintentional activation of memories and other irrelevant current mental associations. Our model proposes that a combination of deficits in intentional inhibition and contextual memory is critical to the experience of auditory hallucinations. The failure in intentional inhibition produces unwanted and uncontrollable mental events which are not recognised because they have lost the contextual cues that would normally facilitate recognition. METHODS: This article amalgamates recently published data and presents a reanalysis of the findings on 43 patients with a diagnosis of schizophrenia (Badcock, Waters, Maybery, & Michie, 2005; Waters, Badcock, Maybery, & Michie, 2003a; Waters, Maybery, Badcock, & Michie, 2004a). Relative risk was also estimated to determine whether the combination of deficits increases the risk of having auditory hallucinations. RESULTS: Almost 90% of patients currently experiencing auditory hallucinations showed the predicted combination of deficits on both inhibition and context memory, compared to only a third of patients without hallucinations. In addition, the results showed that those patients with the specified cognitive deficits were at an especially increased risk of having auditory hallucinations relative to patients without the deficits. CONCLUSIONS: The results of our investigations strongly support the role of intentional inhibition and context memory in auditory hallucinations. Critical consideration of the findings also suggests that additional cognitive processes might be important for the expression of this symptom.

Cognition↗
PubMed2002

Auditory-visual speech perception and aging.

OBJECTIVE: This experiment was designed to assess the integration of auditory and visual information for speech perception in older adults. The integration of place and voicing information was assessed across modalities using the McGurk effect. The following questions were addressed: 1) Are older adults as successful as younger adults at integrating auditory and visual information for speech perception? 2) Is successful integration of this information related to lipreading performance? DESIGN: The performance of three groups of participants was compared: young adults with normal hearing and vision, older adults with normal to near-normal hearing and vision, and young controls, whose hearing thresholds were shifted with noise to match the older adults. Each participant completed a lipreading test and auditory and auditory-plus-visual identification of syllables with conflicting auditory and visual cues. RESULTS: The results show that on average older adults are as successful as young adults at integrating auditory and visual information for speech perception at the syllable level. The number of fused responses did not differ for the CV tokens across the ages tested. Although there were no significant differences between groups for integration at the syllable level, there were differences in the response alternatives chosen. Young adults with normal peripheral sensitivity often chose an auditory alternative whereas, older adults and control participants leaned toward visual alternatives. In additions, older adults demonstrated poorer lipreading performance than their younger counterparts. This was not related to successful integration of information at the syllable level. CONCLUSIONS: Based on the findings of this study, when auditory and visual integration of speech information fails to occur, producing a nonfused response, participants select an alternative response from the modality with the least ambiguous signal.

Acoustic Stimulation↗
PubMed2001

Auditory scene analysis by echolocation in bats.

Echolocating bats transmit ultrasonic vocalizations and use information contained in the reflected sounds to analyze the auditory scene. Auditory scene analysis, a phenomenon that applies broadly to all hearing vertebrates, involves the grouping and segregation of sounds to perceptually organize information about auditory objects. The perceptual organization of sound is influenced by the spectral and temporal characteristics of acoustic signals. In the case of the echolocating bat, its active control over the timing, duration, intensity, and bandwidth of sonar transmissions directly impacts its perception of the auditory objects that comprise the scene. Here, data are presented from perceptual experiments, laboratory insect capture studies, and field recordings of sonar behavior of different bat species, to illustrate principles of importance to auditory scene analysis by echolocation in bats. In the perceptual experiments, FM bats (Eptesicus fuscus) learned to discriminate between systematic and random delay sequences in echo playback sets. The results of these experiments demonstrate that the FM bat can assemble information about echo delay changes over time, a requirement for the analysis of a dynamic auditory scene. Laboratory insect capture experiments examined the vocal production patterns of flying E. fuscus taking tethered insects in a large room. In each trial, the bats consistently produced echolocation signal groups with a relatively stable repetition rate (within 5%). Similar temporal patterning of sonar vocalizations was also observed in the field recordings from E. fuscus, thus suggesting the importance of temporal control of vocal production for perceptually guided behavior. It is hypothesized that a stable sonar signal production rate facilitates the perceptual organization of echoes arriving from objects at different directions and distances as the bat flies through a dynamic auditory scene. Field recordings of E. fuscus, Noctilio albiventris, N. leporinus, Pippistrellus pippistrellus, and Cormura brevirostris revealed that spectral adjustments in sonar signals may also be important to permit tracking of echoes in a complex auditory scene.

Animals↗
PubMed2003

Extending the domain of center frequencies for the compressive gammachirp auditory filter.

The gammatone filter was imported from auditory physiology to provide a time-domain version of the roex auditory filter and enable the development of a realistic auditory filterbank for models of auditory perception [Patterson et al., J. Acoust. Soc. Am. 98, 1890-1894 (1995)]. The gammachirp auditory filter was developed to extend the domain of the gammatone auditory filter and simulate the changes in filter shape that occur with changes in stimulus level. Initially, the gammachirp filter was limited to center frequencies in the 2.0-kHz region where there were sufficient "notched-noise" masking data to define its parameters accurately. Recently, however, the range of the masking data has been extended in two massive studies. This paper reports how a compressive version of the gammachirp auditory filter was fitted to these new data sets to define the filter parameters over the extended frequency range. The results show that the shape of the filter can be specified for the entire domain of the data using just six constants (center frequencies from 0.25 to 6.0 kHz and levels from 30 to 80 dB SPL). The compressive, gammachirp auditory filter also has the advantage of being consistent with physiological studies of cochlear filtering insofar as the compression of the filter is mainly limited to the passband and the form of the chirp in the impulse response is largely independent of level.

Attention↗
PubMed2004

Effect of a central fixation light on auditory spatial responses in area LIP.

A recent report demonstrated that, while fixating a central light, lateral intraparietal area (LIP) neurons are not modulated by the location of auditory stimuli until monkeys learn to saccade to the location of an auditory stimulus. This finding suggests that auditory spatial responses in area LIP are dependent on auditory-saccadic training. We found that, in monkeys that had not been trained to make behavioral responses to auditory stimuli, LIP neurons are modulated by auditory-stimulus location when a central light is not present in the environment. These results indicate that LIP auditory responses are not wholly dependent on behavioral training with auditory stimuli.

Acoustic Stimulation↗
PubMed1994

Exposure of the lateral extremity of the internal auditory canal through the retrosigmoid approach: a radioanatomic study.

The recent trend toward earlier diagnosis of acoustic neuroma has substantially increased the number of candidates suitable for surgery with an attempt at hearing preservation. Although the retrosigmoid approach affords the possibility of saving hearing in selected cases, it is associated with a somewhat greater morbidity that other approaches, in terms of persistent headache, cerebrospinal fluid leakage, and cerebellar dysfunction. For this reason, it is best used selectively, when the probability of success in hearing conservation is high. Only a portion of the internal auditory canal can be exposed through the retrosigmoid approach without violating the inner ear, a maneuver that greatly reduces the chance of preserving residual hearing. Substantial variability exists between individuals as to just how far laterally the internal auditory canal may be opened without compromising labyrinthine integrity. To assess the magnitude of this variability, measurements were obtained from 60 high-resolution temporal bone computed tomography scans with a schema intended to model the surgical angle of view used during the retrosigmoid procedure. Intraoperative measurements in a series of cases established that the actual surgical point of view is situated along a line that passes approximately 1.5 cm behind the sigmoid sinus. In this typical surgical position, these data predict that an average of 3.0 mm (32% of the internal auditory canal length) must be left unexposed to avoid labyrinthine injury, with a range between 1.1 mm and 5.3 mm (9% to 58% of the internal auditory canal). Each additional 1-cm retraction on the cerebellum beyond that customarily used affords approximately 1 mm (10% of the internal auditory canal) further exposure of the canal. When considering the retrosigmoid approach to an acoustic neuroma, the clinician is urged to evaluate each patient individually to estimate the amount of internal auditory canal accessible without the removal of a portion of the inner ear. This can be ascertained from an axially oriented, gadolinium-enhanced magnetic resonance imaging scan in the internal auditory canal plane by drawing a line that originates 1.5 cm behind the posterior margin of the sigmoid sinus and passes tangential to the most medial extent of the labyrinth. If this line intersects the posterior margin of the internal auditory canal at least 2 mm lateral to the deepest point of tumor penetration, then adequate exposure with preservation of the labyrinth is likely an achievable goal.

Craniotomy↗
PubMed2006

Auditory temporal processing deficits in patients with insular stroke.

OBJECTIVE: To assess central auditory function in a series of patients with stroke of the insula and adjacent areas. METHODS: The authors recruited eight patients with stroke affecting the insula and adjacent areas and eight neurologically normal controls (matched to the patients for age, sex, handedness, and hearing thresholds). The lesion spared the adjacent auditory areas in three patients and included other auditory structures in five cases. The authors conducted pure-tone audiometry and tympanometry and a central auditory test battery, which included the dichotic digits, and three temporal tests, the duration pattern, frequency pattern, and gaps in noise tests. They collected information from the hospital notes on symptoms at presentation and neuropsychological assessment data during the acute phase. RESULTS: The central auditory tests gave normal results in all controls. The temporal tests gave abnormal results in all three cases in which other auditory areas were spared, as well as in the other five cases. Results of the gaps in noise test were abnormal contralaterally to the lesion in three and bilaterally in five cases. The central auditory deficits did not cosegregate with the presence of cognitive impairment during the acute stage. CONCLUSION: Insular lesions may affect central auditory function and, in particular, temporal resolution and sequencing, consistent with neuroimaging studies.

Adult↗
PubMed2000

A new method to identify the internal auditory canal during the middle cranial fossa approach: a preliminary report.

A new method which facilitates identification of the internal auditory canal during the middle cranial fossa approach is described. This method uses illumination of the external auditory meatus as a guide to the internal auditory canal. When the external auditory meatus is illuminated by a light source system such that used for a flexible fiberscope, areas of the middle ear air cell system are illuminated and observable through the plate of bone constituting the base of the middle cranial fossa. In the case of ordinary pneumatization of the middle ear system, the attic is the site of the most intense illumination. Knowledge of the exact location of the attic obtained by this new method is extremely useful when performing drilling to expose the internal auditory canal in the middle cranial fossa approach. This is because the internal auditory canal is located medial to the attic, and also because such knowledge is helpful in identifying the two conventional landmarks of this approach, i.e., the arcuate eminence and the greater superficial petrosal nerve, as the locations of these structures are intimately related to the attic. The method described is very simple, timesaving and inexpensive, and is very helpful in detecting the internal auditory canal. Further anatomical study is being undertaken to establish a method of pinpointing the internal auditory canal, starting from the attic which is readily identifiable by use of this method.

Ear, Inner↗
PubMed1993

Naftidrofuryl affects neurite regeneration by injured adult auditory neurons.

Afferent auditory neurons are essential for the transmission of auditory information from Corti's organ to the central auditory pathway. Auditory neurons are very sensitive to acute insult and have a limited ability to regenerate injured neuronal processes. Therefore, these neurons appear to be a limiting factor in restoration of hearing function following an injury to the peripheral auditory receptor. In a previous study nerve growth factor (NGF) was shown to stimulate neurite repair but not survival of injured auditory neurons. In this study, we have demonstrated a neuritogenesis promoting effect of naftidrofuryl in an vitro model for injury to adult auditory neurons, i.e. dissociated cell cultures of adult rat spiral ganglia. Conversely, naftidrofuryl did not have any demonstrable survival promoting effect on these in vitro preparations of injured auditory neurons. The potential uses of this drug as a therapeutic agent in acute diseases of the inner ear are discussed in the light of these observations.

Animals↗
PubMed2003

Microanatomical and neuroendoscopic studies of the internal auditory meatus and its surrounding structures.

OBJECTIVE: To observe the morphology of the internal auditory meatus in relation with its surrounding structures in Chinese people, for the purpose of providing microanatomical reference for surgeries adopting retro-sigmoid approach. METHODS: The retro-sigmoid surgical approach was simulated on 5 fresh specimens of human head, in which the internal auditory meatus and its surrounding structures were observed through a neuroendoscope and a surgical microscope. The distances from the posterior inferior edge of the internal auditory meatus to the central point of the posterior edge of the sigmoid sinus and to the posterior edge of the posterior semicircular canal were measured. RESULTS: The internal auditory meatus was located at the center of the medial surface of the petrous bone, and the cranial nerve VII ran through its anterior-superior part while the cranial nerve VIII through its posterior-inferior part. After forming an arterial loop at the internal auditory meatus, the anterior-inferior cerebellar artery branched into 1 to 3 internal auditory arteries. The distance from the posterior-inferior edge of the internal auditory meatus to the central point of the posterior edge of the sigmoid sinus was 32.15+/-1.76 mm on the left side, and 33.34+/-1.57 mm on the right, and the distance to the posterior edge of the posterior semicircular canal was 12.51+/-2.15 mm on the left side, and 13.26+/-2.44 mm on the right. CONCLUSION: Thorough knowledge of the microanatomy of the internal auditory meatus and its surrounding structures is of crucial importance to preserve the functions of the cranial nerves VII and VIII in the surgical removal of acoustic neuroma.

Asian People↗
PubMed2005

The balance control of bilateral peripheral vestibular loss subjects and its improvement with auditory prosthetic feedback.

OBJECTIVES: We investigated whether long-term bilateral vestibular loss subjects could combine auditory biofeedback of trunk sway with their remaining natural sensory inputs on balance to provide an improved control of trunk sway. A successful integration of natural and artificial signals would provide a basis for a balance prosthesis. METHODS: Trunk sway of 6 bilateral peripheral vestibular loss subjects (BVL) was recorded using either angular position- or velocity-based auditory feedback or no feedback during stance and gait tasks. Roll and pitch trunk movements were recorded with angular velocity transducers mounted just above the waist and feedback without a delay to 4 loudspeakers placed at the left, right, front and rear borders of the 5 m long by 4 m wide test environment. The two types of auditory feedback or no feedback were provided to the subjects in random order. In the feedback modes, sway greater than a preset angle (ca. 0.5 deg) or velocity (ca. 3 deg/s) thresholds caused a tone to be emitted from the speaker towards which the subject moved. The tone volume increased with increasing angle or angular velocity amplitude. RESULTS: For all stance tasks BVL subjects without auditory feedback had a significantly different balance control with respect to that of normal controls. BVL sway values eyes open on a normal surface were reduced with auditory feedback with the greatest reductions in the roll plane. Specifically for the task of standing on 1 leg eyes open with position-auditory- feedback, amplitudes of pitch and roll angles and angular velocities were indistinguishable from those of normal controls. Sway during stance tasks on foam with eyes closed showed no improvement with feedback, remaining greater than normal. For some gait tasks there was a decrease in trunk sway with velocity feedback. CONCLUSION: These initial results indicate that subjects with vestibular loss could incorporate the auditory prosthetic sensory information into their balance commands, particularly in the roll plane if the balance task is performed with eyes open. Position information appears more useful than velocity information in reducing trunk sway during stance tasks. Future work will need to determine the effect of a training time on the improvement in balance control using such a prosthetic device and the ideal position and velocity auditory feedback combination.

Adult↗