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The aim of this clinical study is to investigate whether six months of music therapy immediately after CI implantation helps to improve speech intelligibility in noise. To investigate the effect of music therapy, a randomized study will be conducted with a "start group A" and a "delayed group" B (control group 1). Group A will start six months of music therapy immediately after cochlear implantation, group B six months later. A further control group 2 will not receive any music therapy. The speech intelligibility values resulting from the OLSA sentence test will be compared between the three groups after six and twelve months.
Improved speech perception is a main objective for any hearing rehabilitation using hearing devices. Even more challenging is speech comprehension in noisy environments.
Music therapy is one of the approaches that can assist users with achieving better performance in situations of difficult listening comprehension such as speech perception in noisy environments. One such music therapy concept developed in Heidelberg is based on the parallelism of language and music, whereby targeted training using musical parameters such as rhythm, pitch and timbre can have an impact on the ability to perceive speech. At present, the fact that music therapy can help improve speech intelligibility is primarily based on research with normal hearing listeners.
Nowadays, cochlear implant technology has the primary goal to restore functional hearing and speech perception in people with bilateral severe-to-profound sensorineural hearing loss. Good results will be achieved by post lingually deafened CI users regarding the understanding of open-set sentences presented in quiet. But our surroundings are rarely quiet. Therefore, the goal of good rehabilitation must be to ensure that CI users also can cope well in our noisy environment. Music therapy is thus intended to be the crucial piece in the puzzle that enables such understanding in noisy situations.
This study aims to investigate the benefits of music therapy for cochlear implant users in terms of their speech intelligibility performance in noise. This is an explorative study to determine suitable parameters such as the time point of starting the music.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Experimental | Group A will begin six months of music therapy immediately after cochlear implantation. |
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| Group B | Experimental | Group B is the delayed group and will start music therapy six months after group A. |
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| Group C | Experimental | Group C won't receive any music therapy and serves as a control group. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| music therapy after Cochlear Implantation | Other | The music therapy is specially designed for the rehabilitation of CI-patients. It focuses on learning to distinguish different sound sources, especially when they occur at the same time. Training involves familiarization with different aspects of music such as rhythm, melody, and pitch while at the same time also getting to know the sound of different musical instruments, including singing. The training is also aimed at learning to concentrate on spoken instructions while the music is going on. This latter aim is fundamental to the goal of this study and plays a central role in the therapy. |
| Measure | Description | Time Frame |
|---|---|---|
| Speech recognition threshold (SRT50) six month after Cochlear Implantation | The variable of primary interest is the speech recognition threshold (SRT50), measured in dB SNR (Signal-to-Noise Ratio), which leads to 50% speech understanding, as obtained using the OLSA-test following six months of music therapy immediately after implantation. | six month after Cochlear Implantation |
| Measure | Description | Time Frame |
|---|---|---|
| values of SRT50 of group A and B at twelve months | The question should be clarified as to whether the two groups A and B demonstrate the same improvement after 1 year. The values of the SRT50 of both groups will be compared at twelve months. The results could provide information on whether it makes a difference whether therapy is started immediately after the operation or only after six months. | twelve months |
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Inclusion Criteria:
Exclusion Criteria:
1. Patients with congenital deafness
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Armina Kreuzer, Dr. tech. | Contact | +412055059 | Armina.Kreuzer@luks.ch |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lucerne Cantonal Hospital | Recruiting | Lucerne | Canton of Lucerne | 6000 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Digeser F, Hast A, Hessel H, Hoppe U (2008): Einfluss von Obertönen auf die Frequenzdiskrimination bei Cochlear Implant Trägern | ||
| Background | Wagener KC, Kühnel V, Kollmeier B (1999b) Entwicklung und Evaluation eines Satztests für die deutsche Sprache III: Evaluation des Oldenburger Sprachtests. Z Audiol 38:86-95. | ||
| Background | Wagener KC, Kühnel V, Kollmeier B (1999a) Entwicklung und Evaluation eines Satztests für die deutsche Sprache I: Design des Oldenburger Satztests. Z Audiol 38:4-15. | ||
| 10686177 | Background | Schuppert M, Munte TF, Wieringa BM, Altenmuller E. Receptive amusia: evidence for cross-hemispheric neural networks underlying music processing strategies. Brain. 2000 Mar;123 Pt 3:546-59. doi: 10.1093/brain/123.3.546. |
| Label | URL |
|---|---|
| PMID: 24975453 | View source |
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This is GCP compliant.
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This is a randomized study with a "start group A" and a "delayed group" B. Group A will begin six months of music therapy immediately after cochlear implantation, group B six months later. Another group consists of persons who do not receive any music therapy, will form the control group. The speech intelligibility values resulting from the OLSA sentence test are compared between the three groups after six and twelve months.
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| no music therapy after Cochlear Implantation | Other | Group C consists of persons who do not receive any music therapy after Cochlear Implantation. |
|
| Values of SRT50 of all groups at 12 months | It is also of interest whether the values of the SRT50 at twelve months of group C are really significantly different compared to A and B. This will give us an overview regarding the general benefits of music therapy for speech intelligibility in noise for CI users. | 12 months |
| subjective improvements of speech intelligibilty | Subjective improvements in speech intelligibility after music therapy is determined using the HISQUI (Hearing Implant Sound Quality Index) questionnaire. This is a validated questionnaire consisting of 19 items scored on a 7-point Likert scale, for quantifying the self-perceived level of auditory benefit that cochlear implant users experience in everyday listening situations. A total of between 19 and 133 points can be achieved, and, depending on the result, 5 subjective sound quality categories are determined. | 6 and 12 months |
| 38353294 | Background | Schauwecker N, Patro A, Holder JT, Bennett ML, Perkins E, Moberly AC. Cochlear Implant Qualification in Noise Versus Quiet: Do Patients Demonstrate Similar Postoperative Benefits? Otolaryngol Head Neck Surg. 2024 May;170(5):1411-1420. doi: 10.1002/ohn.677. Epub 2024 Feb 14. |
| 21589653 | Background | Parbery-Clark A, Strait DL, Anderson S, Hittner E, Kraus N. Musical experience and the aging auditory system: implications for cognitive abilities and hearing speech in noise. PLoS One. 2011 May 11;6(5):e18082. doi: 10.1371/journal.pone.0018082. |
| 21747773 | Background | Patel AD. Why would Musical Training Benefit the Neural Encoding of Speech? The OPERA Hypothesis. Front Psychol. 2011 Jun 29;2:142. doi: 10.3389/fpsyg.2011.00142. eCollection 2011. |
| 19673820 | Background | Petersen B, Mortensen MV, Gjedde A, Vuust P. Reestablishing speech understanding through musical ear training after cochlear implantation: a study of the potential cortical plasticity in the brain. Ann N Y Acad Sci. 2009 Jul;1169:437-40. doi: 10.1111/j.1749-6632.2009.04796.x. |
| 18792140 | Background | Mirza S, Douglas SA, Lindsey P, Hildreth T, Hawthorne M. Appreciation of music in adult patients with cochlear implants: a patient questionnaire. Cochlear Implants Int. 2003 Jun;4(2):85-95. doi: 10.1179/cim.2003.4.2.85. |
| 15497033 | Background | McDermott HJ. Music perception with cochlear implants: a review. Trends Amplif. 2004;8(2):49-82. doi: 10.1177/108471380400800203. |
| 23459244 | Background | Looi V, Gfeller K, Driscoll V. MUSIC APPRECIATION AND TRAINING FOR COCHLEAR IMPLANT RECIPIENTS: A REVIEW. Semin Hear. 2012 Nov 1;33(4):307-334. doi: 10.1055/s-0032-1329222. Epub 2012 Nov 19. |
| 30462748 | Background | Lima JP, Iervolino SMS, Schochat E. Musical and temporal auditory skills in cochlear implant users after music therapy. Codas. 2018 Nov 12;30(6):e20180006. doi: 10.1590/2317-1782/20182018006. English, Portuguese. |
| 27837214 | Background | Hutter E, Grapp M, Argstatter H. [Music therapy in adults with cochlear implants : Effects on music perception and subjective sound quality]. HNO. 2016 Dec;64(12):880-890. doi: 10.1007/s00106-016-0279-7. German. |
| 34401506 | Background | Hey M, Bohnke B, Mewes A, Munder P, Mauger SJ, Hocke T. Speech comprehension across multiple CI processor generations: Scene dependent signal processing. Laryngoscope Investig Otolaryngol. 2021 Jun 15;6(4):807-815. doi: 10.1002/lio2.564. eCollection 2021 Aug. |
| 17136415 | Background | Haumann S, Muhler R, Ziese M, von Specht H. [Discrimination of musical pitch with cochlear implants]. HNO. 2007 Aug;55(8):613-9. doi: 10.1007/s00106-006-1485-5. German. |
| 9201460 | Background | Gfeller K, Woodworth G, Robin DA, Witt S, Knutson JF. Perception of rhythmic and sequential pitch patterns by normally hearing adults and adult cochlear implant users. Ear Hear. 1997 Jun;18(3):252-60. doi: 10.1097/00003446-199706000-00008. |
| 34596714 | Background | Dincer D'Alessandro H, Boyle PJ, Portanova G, Mancini P. Music perception and speech intelligibility in noise performance by Italian-speaking cochlear implant users. Eur Arch Otorhinolaryngol. 2022 Aug;279(8):3821-3829. doi: 10.1007/s00405-021-07103-x. Epub 2021 Oct 1. |
| 24975453 | Background | Amann E, Anderson I. Development and validation of a questionnaire for hearing implant users to self-assess their auditory abilities in everyday communication situations: the Hearing Implant Sound Quality Index (HISQUI19). Acta Otolaryngol. 2014 Sep;134(9):915-23. doi: 10.3109/00016489.2014.909604. Epub 2014 Jun 30. |
| PMID: 34596714 | View source |
| PMID: 9201460 | View source |
| DOI:10.1007/s00106-006-1485-5 | View source |
| PMID: 34401506 | View source |
| PMID: 27837214 | View source |
| PMID: 30462748 | View source |
| PMID: 23459244 | View source |
| PMID: 15497033 | View source |
| PMID: 18792140 | View source |
| PMID: 19673820 | View source |
| PMID: 21747773 | View source |
| PMID: 21589653 | View source |
| PMID: 38353294 | View source |
| PMID: 10686177 | View source |
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