Table 2

Characteristics and findings of the eligible studies that performed non-vestibular specific balance assessments

First author, year, countryStudy designNN with hearing loss (HL)Age (mean)Mode of balance assessmentSTROBE qualityVision assessmentFindings
Alarcon, 2013, Spain26 M cohort26 ScCMV17 (severity not specified)
CI use not reported
8.7 yearsMovement
ModerateNot specified
  • 27% (3 out of the 11 children without cerebral palsy) had borderline balance skills.

  • 8% (2) had severe visual deficit – no further details available.

De Kegel, 2015, Belgium28 Case–control26 ScCMV
38 AcCMV
107 cCMV negative controls
19 (ScCMV 83.2 dB; AcCMV 94.0 dB)*
9 using CI
24 monthsGhent Developmental Balance TestModerate–lowNot reported
  • Children with ScCMV and hearing impairment had significantly worse balance than controls and children with AcCMV.

Harris, 1984, USA25 P cohort50 cCMV5 (1 MI, 4 total)
CI use not reported
3 monthsTraction response testModerate–lowOphthalmological examination
  • 9% (4 out of 43) had transient head lag.

  • No ophthalmological abnormalities found.

Korndewal, 2017,
R cohort26 ScCMV
107 AcCMV
3 AcCMV (2 ears MO, 1 ear SE, 4 ears PR)
CI use not reported
5 years, 6 monthsMovement ABC
Physical therapist report
ModerateOphthalmological examination.
Optometrist examination.
  • 6% (8) had balance impairment.

  • 2.8% (3) AcCMV had visual impairment (1 unilateral optic nerve atrophy impairment, 2 cortical visual impairment).

  • Study design: R=retrospective, P=prospective, M=mixed (retrospective and prospective)

  • Hearing loss=severity reported where available.

  • Mode of balance assessment please see appendix A for glossary of vestibular and balance investigations.

  • Findings: (n)=number of cCMV cases out of N; where number of children tested is different to N, (n out of….) is reported.

  • *Where only mean decibel (dB) hearing threshold was reported, this can be interpreted as: <20 dB=normal; 21–40 dB=mild; 41–70 dB=moderate; 71–90 dB=severe; 91–119 dB=profound (Bernard, 2015).

  • ABC, assessment battery for children; AcCMV, asymptomatic cCMV; CI, cochlear implant; M, mixed (retrospective and prospective); MI, mild; MO, moderate; N, number of cCMV cases; P, prospective; PR, profound; r, Retrospective; ScCMV, symptomatic CMV; SE, severe; STROBE, Strengthening the Reporting of Observational Studies in Epidemiology.