Effect of Hearing Rehabilitation Therapy Program in Hearing Aid Users: A Prospective Randomized Controlled Study

Abstract

Objectives: Despite sufficient hearing gains, many patients with hearing loss have difficulty using hearing aids due to poor word recognition ability. This study was performed to introduce our hearing rehabilitation therapy (HRT) program for hearing aid users and to evaluate its effect on hearing improvement.

Methods: In this prospective randomized case-control study, 37 participants with moderate or moderate-severe sensorineural hearing loss who had used bilateral hearing aids for more than 3 months with sufficient functional hearing gain were enrolled in this study. Nineteen participants were randomly assigned to the control group (CG) and 18 patients were assigned to participate in our HRT program once a week for 8 consecutive weeks (hearing rehabilitation therapy group [HRTG]). Their hearing results and questionnaire scores for hearing handicap and hearing aid outcomes were prospectively collected and compared between the two groups.

Results: After completing 8 weeks of the HRT program, the HRTG showed a significantly greater improvement in scores for consonant-only and consonant-vowel sound perception than the CG (P<0.05). In addition, the HRTG showed a significant improvement in hearing ability as measured by two questionnaires (p<0.05), while no differences were observed in the CG. However, word and sentence recognition test results did not show significant differences between the two groups.

Conclusion: Even after short-term HRT, patients had subjectively better hearing outcomes and improved phoneme perception ability; this provides scientific evidence regarding a possible positive role for HRT programs in hearing aid users. Further validation in a larger population through a long-term follow-up study is needed.

Keywords: Hearing Aids; Hearing Loss; Rehabilitation.

Fig. 1.

Flow diagram for the hearing rehabilitation therapy clinical trial.

Fig. 2.

A schematic presentation of the hearing rehabilitation training (HRT) protocol. The HRT program consisted of face-to-face training and self-home training with three interviews with an ENT doctor. A 30-minute face-to-face training was conducted once a week for 8 weeks, with the first 4-week period involving constant discrimination retraining and weeks 5–8 focusing on identification and understanding training. At the same time, patients were taught to perform self-home training every day at home. In the training process, the 10 most commonly used Korean consonants were used for training, starting with low-frequency consonants and gradually progressing to high-frequency consonants. The doctor’s role during our HRT program was to interview the patient three times (HRT prescription, reinforcement, and final motivation for self-HRT). AV, auditory-visua; AO, auditory-only.

Fig. 3.

Baseline results of pure tone audiometry (PTA; A) and word recognition score (B) show no significant differences between the auditory training group and the control group (P>0.05, Mann-Whitney test or t-test). Error bars indicate standard deviation. HRTG, hearing rehabilitation therapy group; CG, control group.

Fig. 4.

Changes in scores of the Korean consonant perception tests. Significantly higher mean changes in scores were observed in the HRTG under both consonant-only and consonant+vowel conditions (^*P<0.05, Mann-Whitney test). A box and whisker plot shows summary of a set of data: maximum, 75th percentile; median, 25th percentile; and minimum. HRTG, hearing rehabilitation therapy group; CG, control group.

Fig. 5.

Changes in hearing questionnaire scores. (A) The Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) score gradually increased in the hearing rehabilitation therapy group (HRTG), but no significant change was observed in the control group (CG), indicating that the HRTG had higher satisfaction than the CG with hearing aid use. Total (B), situational (C), and emotional (D) scores on the Korean version of the Hearing Handicap Inventory (K-HHIE) questionnaire significantly decreased in the HRTG, while no changes were observed in the CG, indicating that the level of discomfort regarding hearing loss significantly decreased after HRT. ^***P<0.001, linear mixedeffects model.