Studies in Sport Medicine

The Effect of Eight Weeks of Cognitive–Balance Training on Biomechanical Gait Characteristics in Children with Congenital Deafness (Comparison with Healthy Children)

Document Type : Research Paper

Authors

Neda Boroushak 1
Mehdi Majlesi 2
Elaheh Azadian 3

1 Department of Sports Biomechanics, Sport Sciences Research Institute, Tehran, Iran.

2 Department of Sport Biomechanics, Ha.C., Islamic Azad University, Hamedan, Iran.

3 Department of Motor Behavior, Ha.C., Islamic Azad University, Hamedan, Iran.

https://doi.org/10.22089/smj.2026.18703.1839
Abstract
Due to deficits in auditory input and balance, deaf children often exhibit impairments in gait patterns and postural control compared to their healthy peers. The present study aimed to investigate the effect of an 8-week cognitive–balance training program on the biomechanical characteristics of gait—including spatiotemporal parameters, their variability, and ground reaction forces (GRF)—in children with congenital deafness, and to compare the outcomes with healthy children. To this end, 15 congenitally deaf boys and 15 age-matched healthy boys were purposefully selected. The deaf group underwent cognitive–balance training for 8 weeks (three sessions per week, approximately 70 minutes per session), while the healthy group received no intervention. Gait assessments under barefoot and self-selected speed conditions were conducted pre- and post-intervention using a Vicon motion analysis system and Kistler force plates. Results showed a significant reduction (p < 0.05) in the variability of certain spatiotemporal parameters such as gait speed, step length, and step time in the deaf group after training. Additionally, GRF analysis revealed increased propulsive force during push-off and improved mediolateral stability during mid-stance (p < 0.05). Overall, the cognitive–balance training program led to improvements in motor coordination, postural stability, and reduced gait variability in deaf children. These findings support the efficacy of cognitive–motor interventions in enhancing gait quality and balance in this population and may inform the design of targeted rehabilitation programs for children with special needs.

Keywords

Congenital deafness, cognitive&‌‌ndash
balance training, gait
Subjects
1.       Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. Effects of proprioception and core stability training on gait parameters of deaf adolescents: a randomized controlled trial. Scientific Reports. 2023;13(1):21867. https://doi.org/10.1038/s41598-023-49335-3  
2.       Azadian E, Majlesi M, Jafarnezhadgero AA, Granacher U. The impact of hearing loss on three-dimensional lower limb joint torques during walking in prepubertal boys. Journal of Bodywork and Movement Therapies. 2020;24(2):123-9. https://doi.org/10.1016/j.jbmt.2019.10.013
3.       Sokolov M, Gordon KA, Polonenko M, Blaser SI, Papsin BC, Cushing SL. Vestibular and balance function is often impaired in children with profound unilateral sensorineural hearing loss. Hearing Research. 2019;372:52-61. https://doi.org/10.1016/j.heares.2018.03.032
4.       Yaghoubi Hamraz F, Majlesi M. Comparing Gait variability between deaf and normal-hearing children after proprioception training. Journal of Sport Biomechanics. 2020;5(4):262-71. https://doi.org/10.32598/biomechanics.5.4.6
5.       Majlesi M, Azadian E, Farahpour N, Jafarnezhad AA, Rashedi H. Lower limb muscle activity during gait in individuals with hearing loss. Australasian Physical and Engineering Sciences in Medicine. 2017;40:659-65. https://doi.org/10.1007/s13246-017-0574-y
6.       Jafarnezhadgero AA, Majlesi M, Azadian E. Gait ground reaction force characteristics in deaf and hearing children. Gait and Posture. 2017;53:236-40. https://doi.org/10.1016/j.gaitpost.2017.02.006
7.       Aman JE, Elangovan N, Yeh I-L, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Frontiers in Human Neuroscience. 2015;8:1075. https://doi.org/10.3389/fnhum.2014.01075
8.       Hiyamizu M, Morioka S, Shomoto K, Shimada T. Effects of dual task balance training on dual task performance in elderly people: a randomized controlled trial. Clinical Rehabilitation. 2012;26(1):58-67. https://doi.org/10.1177/0269215510394222
9.       Hedayatjoo M, Rezaee M, Alizadeh Zarei M, Mirzakhany N, Nazeri A, Akbarzadeh Baghban A, et al. Effect of balance training on balance performance, motor coordination, and attention in children with hearing deficits. Archives of Neuroscience. 2020;7(1):e84869. https://doi.org/10.5812/ans.84869
10.    Kamel RM, Khaireldin A, Gad Allah MA, Bakhoom RYF, Abdelhakiem NM, Mehrem ES. Efficacy of balance exercises intervention on postural control-related impairment in children with sensorineural hearing loss. NeuroRehabilitation. 2024;54(3):349-58. https://doi.org/10.3233/NRE-230284
11.    Kolasa S, Magnussen LH, Nilsen RM, Wilhelmsen KT, Goplen FK, Nordahl SHG, et al. Walking and balance in older adults with age-related hearing loss: a cross-sectional study of cases and matched controls. Gait and Posture. 2024;113:398-406. https://doi.org/10.1016/j.gaitpost.2024.07.301
12.    Melo RS, Tavares-Netto AR, Delgado A, Wiesiolek CC, Ferraz KM, Belian RB. Does the practice of sports or recreational activities improve the balance and gait of children and adolescents with sensorineural hearing loss? A systematic review. Gait and Posture. 2020;77:144-55. https://doi.org/10.1016/j.gaitpost.2020.02.001
13.    Majlesi M, Farahpour N, Azadian E, Amini M. The effect of interventional proprioceptive training on static balance and gait in deaf children. Research in Developmental Disabilities. 2014;35(12):3562-7. https://doi.org/10.1016/j.ridd.2014.09.001
14.    Soori Z, Heyrani A, Rafie F. Exercise effects on motor skills in hearing-impaired children. Sport Sciences for Health. 2019;15(3):635-9. https://doi.org/10.1007/s11332-019-00564-y
15.    Duffell LD, Hope N, McGregor AH. Comparison of kinematic and kinetic parameters calculated using a cluster-based model and Vicon’s plug-in gait. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 2014;228(2):206-10. https://doi.org/10.1177/0954411913518747
16.    McCallister E, Russell N. Comparison of kinematic outputs and reliability of plug-in gait versus conventional gait model 2 during cycling. International Journal of Exercise Science. 2025;18(7);712. https://doi.org/10.70252/DMWA1583
17.    Sorkheh E, Majlesi M, Jafarnezhadgero AA. Frequency domain analysis of gait ground reaction forces in deaf and hearing children. Journal of Sport Biomechanics. 2018;4(2):17-27. https://doi.org/10.3389/fphys.2022.876974
18.    Zhou Y, Qi J. Effectiveness of interventions on improving balance in children and adolescents with hearing impairment: a systematic review. Frontiers in Physiology. 2022;13:876974. https://doi.org/10.3389/fphys.2022.876974
19.    Büyükçelik NM, Yiğit S, Turhan B. An investigation of the effects of dual-task balance exercises on balance, functional status and dual-task performance in children with Down syndrome. Developmental Neurorehabilitation. 2023;26(5):320-7. https://doi.org/10.1080/17518423.2023.2233031
20.    Jahanbakhsh H, Sohrabi M, Saberi Kakhki A, Khodashenas E. The effect of task-specific balance training program in dual-task and single-task conditions on balance performance in children with developmental coordination disorder. Acta Gymnica. 2020;50(1):28-37. https://doi.org/10.22059/jmlm.2021.283379.1455
21.    Sakurai R, Suzuki H, Ogawa S, Takahashi M, Fujiwara Y. Hearing loss and increased gait variability among older adults. Gait and Posture. 2021;87:54-8. https://doi.org/10.1016/j.gaitpost.2021.04.007
22.    Leech KA, Kinnaird CR, Holleran CL, Kahn J, Hornby TG. Effects of locomotor exercise intensity on gait performance in individuals with incomplete spinal cord injury. Physical Therapy. 2016;96(12):1919-29. https://doi.org/10.2522/ptj.20150646
23.    Peterson CL, Kautz SA, Neptune RR. Braking and propulsive impulses increase with speed during accelerated and decelerated walking. Gait and Posture. 2011;33(4):562-7. https://doi.org/10.1016/j.gaitpost.2011.01.010
24.    de Jesus Oliveira VA, Slijepčević D, Dumphart B, Ferstl S, Reis J, Raberger A-M, et al. Auditory feedback in tele-rehabilitation based on automated gait classification. Personal and Ubiquitous Computing. 2023;27(5):1873-86. https://doi.org/10.1007/s00779-023-01723-2
Studies in Sport Medicine
Volume 18, Issue 47
Spring 2026
Pages 106-128

  • Receive Date 05 January 2026
  • Revise Date 21 May 2026
  • Accept Date 14 June 2026

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