Comprehensive insights into muscle strength and proprioception of children with hearing or visual impairments in comparison with individuals with typical development are yet to be achieved in literature. The purpose of this study was to investigate the proprioception and lower limb strength of children with hearing or visual impairments compared to those without disabilities (comparison).
Methods
This study featured a cross-sectional design with participants (N = 45) placed within one of three equally stratified purposive groups (hearing impaired, visually impaired, or comparison) within the age range of 9–13 years (Mean = 11.43, SD = 1.5). Joint angle-reposition test was used to measure proprioception and the Manual Muscle Testing (MMT) was used to measure the strength of the lower limb muscles.
Results
The results indicated that knee joint position sense error was greater for the comparison group in standing (p = .02) and sitting positions (p = .03) than those with hearing or visual impairments (p = .001). It was also greater for comparison in the dorsiflexion (p = .03) and plantarflexion (p = .03) than those with hearing or visual impairments (p = .001). Moreover, the results showed that the lower limb muscle strength of subjects with visual impairments was weaker than those with hearing impairments (p = .03), as well as with the comparison group (p = .001), although no significant difference was found between the lower limb strength of the hearing impaired and comparison groups (p>.05).
Discussion
The results demonstrated that the proprioception of children with hearing and visual impairments was significantly better than that of comparison. Furthermore, the muscle strength of children with visual impairments was significantly weaker than that of children with hearing impairments and comparison.
Implications for Practitioners
It is recommended that progressive physical activity programs be used to develop muscular strength of children with visual impairments.
AbdullahN. M.TumijanW.ParnabasV.ShapieM. N. M.HamidN. A.MohamedM.AhmadA. (2016). Predicting the physical fitness level among students with hearing impairment. Proceedings of the 2nd International Colloquium on Sports Science, Exercise, Engineering and Technology. 2015 (ICoSSEET 2015) (pp 67–77). https://doi.org/10.1007/978-981-287-691-1_7.
2.
AdeJ. D.HarleyJ. A.BradleyP. S. (2014). Physiological response, time–motion characteristics, and reproducibility of various speed-endurance drills in elite youth soccer players: Small-sided games versus generic running. International Journal of Sports Physiology and Performance, 9(3), 471–479. https://doi.org/10.1123/ijspp.2013-0390
3.
AugestadL. B.JiangL. (2015). Physical activity, physical fitness, and body composition among children and young adults with visual impairments: A systematic review. British Journal of Visual Impairment, 33(3), 167–182. https://doi.org/10.1177/0264619615599813
BlackburnT.GuskiewiczK. M.PetschauerM. A.PrenticeW. E. (2000). Balance and joint stability: The relative contributions of proprioception and muscular strength. Journal of Sport Rehabilitation, 9(4), 315–328. https://doi.org/10.1123/jsr.9.4.315
6.
BohannonR. W. (2018). Reliability of manual muscle testing: A systematic review. Isokinetics and Exercise Science, 26(4), 245–252. https://doi.org/10.3233/IES-182178
7.
BornsteinB.KonstantinN.AlessandroC.TreschM. C.ZelzerE. (2021). More than movement: The proprioceptive system as a new regulator of musculoskeletal biology. Current Opinion in Physiology, 20, 77–89. https://doi.org/10.1016/j.cophys.2021.01.004
8.
ClarksonH. M. (2005). Joint motion and function assessment: a research-based practical guide. Lippincott Williams & Wilkins.
9.
CohenJ. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Earlbaum Associates.
de Souza MeloR.da SilvaP. W. A.TassitanoR. M.MackyC.da SilvaL. V. C. (2012). Balance and gait evaluation: Comparative study between deaf and hearing students. Revista Paulista de Pediatria [Paulista Journal of Pediatrics], 30(3), 385–391. https://doi.org/10.1590/S0103-05822012000300012
12.
DetterF.NilssonJ-ÅKarlssonC.DenckerM.RosengrenB. E.KarlssonM. K. (2014). A 3-year school-based exercise intervention improves muscle strength-a prospective controlled population-based study in 223 children. BMC Musculoskeletal Disorders, 15(1), 1–9. https://doi.org/10.1186/1471-2474-15-353
EllisM. K.LiebermanL. J.DummerG. M. (2014). Parent influences on physical activity participation and physical fitness of deaf children. Journal of Deaf Studies and Deaf Education, 19(2), 270–281. https://doi.org/10.1093/deafed/ent033
15.
EscolarD.HenricsonE.MayhewJ.FlorenceJ.LeshnerR.PatelK.ClemensP. (2001). Clinical evaluator reliability for quantitative and manual muscle testing measures of strength in children. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 24(6), 787–793. https://doi.org/10.1002/mus.1070
16.
FieldA. (2013). Discovering statistics using IBM SPSS statistics. Sage.
17.
FujimotoM.HsuW.-L.WoollacottM. H.ChouL.-S. (2013). Ankle dorsiflexor strength relates to the ability to restore balance during a backward support surface translation. Gait & Posture, 38(4), 812–817. https://doi.org/10.1016/j.gaitpost.2013.03.026
18.
GiagazoglouP.AmiridisI. G.ZafeiridisA.ThimaraM.KouveliotiV.KellisE. (2009). Static balance control and lower limb strength in blind and sighted women. European Journal of Applied Physiology, 107, 571–579. https://doi.org/10.1007/s00421-009-1163-x
19.
GilmanS. (2002). Joint position sense and vibration sense: Anatomical organisation and assessment. Journal of Neurology, Neurosurgery & Psychiatry, 73(5), 473–477. https://doi.org/10.1136/jnnp.73.5.473
20.
GopinathB.LiewG.BurlutskyG.MitchellP. (2020). Associations between vision, hearing, and olfactory impairment with handgrip strength. Journal of Aging and Health, 32(7–8), 654–659. https://doi.org/10.1177/0898264319843724
21.
HaegeleJ. A.BrianA.GoodwayJ. (2015). Fundamental motor skills and school-aged individuals with visual impairments: A review. Review Journal of Autism and Developmental Disorders, 2, 320–327. https://doi.org/10.1007/s40489-015-0055-8
22.
HäkkinenA.HolopainenE.KautiainenH.SillanpääE.HäkkinenK. (2006). Neuromuscular function and balance of prepubertal and pubertal blind and sighted boys. Acta Paediatrica, 95(10), 1277–1283. https://doi.org/10.1080/08035250600573144
23.
HallemansA.OrtibusE.TruijenS.MeireF. (2011). Development of independent locomotion in children with a severe visual impairment. Research in Developmental Disabilities, 32(6), 2069–2074. https://doi.org/10.1016/j.ridd.2011.08.017
24.
HérouxM. E.ButlerA. A.RobertsonL. S.FisherG.GandeviaS. C. (2022). Proprioception: A new look at an old concept. Journal of Applied Physiology, 132(3), 811–814. https://doi.org/10.1152/japplphysiol.00809.2021
25.
HillierS.ImminkM.ThewlisD. (2015). Assessing proprioception: A systematic review of possibilities. Neurorehabilitation and Neural Repair, 29(10), 933–949. https://doi.org/10.1177/1545968315573055
26.
HorvatM.RayC.CroceR.BlaschB. (2004). A comparison of isokinetic muscle strength and power in visually impaired and sighted individuals. Isokinetics and Exercise Science, 12(3), 179–183. https://doi.org/10.3233/IES-2004-0171
27.
HowardI. S.WolpertD. M.FranklinD. W. (2013). The effect of contextual cues on the encoding of motor memories. Journal of Neurophysiology, 109(10), 2632–2644. https://doi.org/10.1152/jn.00773.2012
28.
InoueS.KawashimaM.HiratsukaY.NakanoT.TamuraH.OnoK.MurakamiA.TsubotaK.YamadaM. (2018). Assessment of physical inactivity and locomotor dysfunction in adults with visual impairment. Scientific Reports, 8(1), 12032. https://doi.org/10.1038/s41598-018-30599-z
29.
LiebermanL. J.Houston-WilsonC.KozubF. M. (2002). Perceived barriers to including students with visual impairments in general physical education. Adapted Physical Activity Quarterly, 19(3), 364–377. https://doi.org/10.1123/apaq.19.3.364
30.
LiebermanL. J.McHughE. (2001). Health-related fitness of children who are visually impaired. Journal of Visual Impairment & Blindness, 95(5), 272–287. https://doi.org/10.1177/0145482X0109500503
31.
LiebermanL. J.PonchilliaP. E.PonchilliaS. K. V. (2013). Physical education and sports for people with visual impairments and deafblindness: Foundations of instruction. American Foundation for the Blind.
MackeyD. C.RobinovitchS. N. (2006). Mechanisms underlying age-related differences in ability to recover balance with the ankle strategy. Gait & Posture, 23(1), 59–68. https://doi.org/10.1016/j.gaitpost.2004.11.009
34.
MajlesiM.FarahpourN.AzadianE.AminiM. (2014). The effect of interventional proprioceptive training on static balance and gait in deaf children. Research in Developmental Disabilities, 35(12), 3562–3567. https://doi.org/10.1016/j.ridd.2014.09.001
35.
MalwinaK. A.KrzysztofM.PiotrZ. (2015). Visual impairment does not limit training effects in development of aerobic and anaerobic capacity in tandem cyclists. Journal of Human Kinetics, 48(1), 87–97. https://doi.org/10.1515/hukin-2015-0095
36.
MeloR. S.LemosA.RaposoM. C. F.MonteiroM. G.LambertzD.FerrazK. M. (2021). Repercussions of the degrees of hearing loss and vestibular dysfunction on the static balance of children with sensorineural hearing loss. Physical Therapy, 101(10), 1–10. https://doi.org/10.1093/ptj/pzab177
37.
MohammadiF.BayatiM.AbbasiH.AllafanN. (2019). Better functioning of the somatosensory system in postural control of blind athletes compared to non-athletes. Scientific Journal of Rehabilitation Medicine (SJRM), 8(3), 179–187.
38.
MohantyS.MurtyP. V. R.PradhanB.HankeyA. (2015). Yoga practice increases minimum muscular fitness in children with visual impairment. Journal of Caring Sciences, 4(4), 253–263. https://doi.org/10.15171/jcs.2015.026
39.
MuehlbauerT.BesemerC.WehrleA.GollhoferA.GranacherU. (2013). Relationship between strength, balance and mobility in children aged 7–10 years. Gait & Posture, 37(1), 108–112. https://doi.org/10.1016/j.gaitpost.2012.06.022
40.
MuehlbauerT.GollhoferA.GranacherU. (2015). Associations between measures of balance and lower-extremity muscle strength/power in healthy individuals across the lifespan: A systematic review and meta-analysis. Sports Medicine, 45, 1671–1692. https://doi.org/10.1007/s40279-015-0390-z
41.
MüürseppI.ArjokesseR.ErelineJ.PääsukeM.GapeyevaH. (2018). Impact of visual impairment on static and dynamic postural control and habitual physical activity in children aged 10–16 years. British Journal of Visual Impairment, 36(3), 227–237. https://doi.org/10.1177/0264619618780918
42.
ÖzerM.KaynakH.AtikA.ŞililM. K.AltunM.AksekiD. (2014). Comparison of ankle proprioception between blind and healthy athletes. Orthopaedic Journal of Sports Medicine, 2(11)(suppl. 3), 1. https://doi.org/10.1177/2325967114S00156
RajendranV.RoyF. G.JeevananthamD. (2012). Postural control, motor skills, and health-related quality of life in children with hearing impairment: A systematic review. European Archives of Oto-Rhino-Laryngology, 269, 1063–1071. https://doi.org/10.1007/s00405-011-1815-4
45.
RashidH. F.ZarandiZ.NorashtehA. A. (2017). Comparison of knee proprioception between congenitally and late blind people. Medicina Dello Sport [Sports Medicine], 70(1), 93–103. https://doi.org/10.23736/S0025-7826.16.02762-9
46.
RayC. T.HorvatM.CroceR.MasonR. C.WolfS. L. (2008). The impact of vision loss on postural stability and balance strategies in individuals with profound vision loss. Gait & Posture, 28(1), 58–61. https://doi.org/10.1016/j.gaitpost.2007.09.010
47.
RayC. T.WolfS. L. (2008). Review of intrinsic factors related to fall risk in individuals with visual impairments. Journal of Rehabilitation Research & Development, 45(8)., 1117–1124. https://pubmed.ncbi.nlm.nih.gov/19235114/
48.
ReeseN. B. (2020). Muscle and sensory testing (4th ed.). Elsevier Health Sciences.
49.
RoggeA.-K.HöttingK.NagelV.ZechA.HöligC.RöderB. (2019). Improved balance performance accompanied by structural plasticity in blind adults after training. Neuropsychologia, 129, 318–330. https://doi.org/10.1016/j.neuropsychologia.2019.04.005
50.
RönnbergJ.BorgE. (2001). A review and evaluation of research on the deaf-blind from perceptual, communicative, social and rehabilitative perspectives. Scandinavian Audiology, 30(2), 67–77. https://doi.org/10.1080/010503901300112176
51.
SaradjianA. (2015). Sensory modulation of movement, posture and locomotion. Neurophysiologie Clinique/Clinical Neurophysiology, 45(4–5), 255–267. https://doi.org/10.1016/j.neucli.2015.09.004
52.
SchmidM.NardoneA.De NunzioA. M.SchmidM.SchieppatiM. (2007). Equilibrium during static and dynamic tasks in blind subjects: No evidence of cross-modal plasticity. Brain, 130(8), 2097–2107. https://doi.org/10.1093/brain/awm157
53.
SeyediM.SeidiF.MinoonejadH. (2015). An investigation of the efficiency of sensory systems involved in postural control in deaf athletes and non-athletes. Journal of Exercise Science and Medicine, 7(1), 111–127. https://doi.org/10.22059/jsmed.2015.53806
54.
SieljacksP. S.SøbergC. A.MichelsenA.-S.DalgasU.HvidL. G. (2020). Lower extremity muscle strength across the adult lifespan in multiple sclerosis: Implications for walking and stair climbing capacity. Experimental Gerontology, 139, 111025. https://doi.org/10.1016/j.exger.2020.111025
55.
SmithT. O.DaviesL.HingC. B. (2013). A systematic review to determine the reliability of knee joint position sense assessment measures. The Knee, 20(3), 162–169. https://doi.org/10.1016/j.knee.2012.06.010
56.
StuartM. E.LiebermanL.HandK. E. (2006). Beliefs about physical activity among children who are visually impaired and their parents. Journal of Visual Impairment & Blindness, 100(4), 223–234. https://doi.org/10.1177/0145482X0610000405
Walicka-CupryśK.PrzygodaŁCzenczekE.TruszczyńskaA.Drzał-GrabiecJ.ZbigniewT.TarnowskiA. (2014). Balance assessment in hearing-impaired children. Research in Developmental Disabilities, 35(11), 2728–2734. https://doi.org/10.1016/j.ridd.2014.07.008
59.
WangH.JiZ.JiangG.LiuW.JiaoX. (2016). Correlation among proprioception, muscle strength, and balance. Journal of Physical Therapy Science, 28(12), 3468–3472. https://doi.org/10.1589/jpts.28.3468
60.
WyattL.NgG. Y. (1997). The effect of visual impairment on the strength of children's hip and knee extensors. Journal of Visual Impairment & Blindness, 91(1), 40–46. https://doi.org/10.1177/0145482X9709100107
61.
ZebrowskaA.GawlikK.ZwierzchowskaA. (2007). Spirometric measurements and physical efficiency on children and adolescents with hearing and visual impairments. Journal of Physiology and Pharmacology, 58, 847. https://doi.org/https://pubmed.ncbi.nlm.nih.gov/17072075/
