聋或听力困难儿童姿势控制的差异：姿势摇摆结局的系统综述与荟萃分析

文献信息

中文摘要

背景： 聋或听力困难（DHH）儿童可能因参与平衡调节的感觉输入差异而表现出姿势控制改变。对姿势描记结局的定量合成可以阐明这些差异的幅度和一致性，同时识别限制研究间可比性的方法学因素。本综述评估了DHH儿童相对于典型听力同龄人的姿势摇摆结局。方法：遵循PRISMA指南，检索五个数据库，纳入在儿童DHH人群中采用静态姿势描记的研究。25项研究符合系统综述的纳入标准，12项研究纳入荟萃分析。计算前后（AP）和内外侧（ML）摇摆指标的标准均数差。关注任务条件和测量方法检查研究间异质性。结果：合并估计表明DHH儿童存在摇摆改变，AP和ML变异性一致地区分各组。然而，各任务间异质性高，且方案特征报告有限，限制了对姿势难度、感觉条件和分析选择如何影响结局的评估。结论：姿势描记证据支持DHH儿童与典型听力儿童之间姿势控制存在有意义的差异，但研究结果的显著异质性限制了可解释性和跨研究比较。鉴于需要在任务设计、结局选择和报告方面提高标准化以推进儿童平衡评估的机制理解，我们为未来研究提供方法学建议，以指导标准化评估方案的制定。

英文摘要

Children who are deaf and hard of hearing (DHH) may exhibit altered postural control due to differences in sensory inputs contributing to balance regulation. Quantitative synthesis of posturographic outcomes can clarify the magnitude and consistency of these differences while identifying methodological factors that limit comparability across studies. This review evaluated postural sway outcomes in DHH children relative to typically hearing peers. Following PRISMA guidelines, five databases were searched for studies employing static posturography in pediatric DHH populations. Twenty-five studies satisfied inclusion criteria for the systematic review and 12 studies were included in the meta-analysis. Standardized mean differences were calculated for anterior-posterior (AP) and medial-lateral (ML) sway metrics. Between-study heterogeneity was examined with attention to task conditions and measurement approaches. Pooled estimates indicated altered sway in DHH children, with AP and ML variability consistently differentiating groups. However, heterogeneity was high across tasks, and limited reporting of protocol features constrained evaluation of how postural difficulty, sensory conditions, and analysis choices influenced outcomes. Posturographic evidence supports meaningful differences in postural control between DHH and typically hearing children, but substantial heterogeneity of findings limits interpretability and cross-study comparison. Given the need for greater standardization in task design, outcome selection, and reporting to advance mechanistic understanding for pediatric balance assessment, we provide methodological recommendations for future investigations to inform the development of standardized assessment protocols.