Static and dynamic balance performance and associated factors among children with and without hearing impairment in Addis Ababa, Ethiopia: a comparative cross-sectional study

BACKGROUND: Balance is essential for daily activities, motor development, and overall well-being. The vestibular system plays a key role in balance control, and impairments associated with hearing loss may negatively affect balance in children. However, balance assessment is not routinely performed in children with hearing impairment. OBJECTIVES: This study assessed static and dynamic balance performance and associated factors among children with and without hearing impairment in selected public schools in Addis Ababa, Ethiopia. METHODS: A comparative cross-sectional study was conducted from September 2023 to June 2024 among 148 schoolchildren aged 7-18 years (74 with hearing impairment and 74 sex-matched peers with normal hearing). Balance performance was evaluated using the single-leg stance test (eyes open and closed), functional reach test, and Pediatric Balance Scale. Data were analyzed using independent t-tests, Pearson's correlation, and regression analyses in SPSS version 27. Statistical significance was set at p < 0.05. RESULTS: Children with hearing impairment scored significantly lower than their normal-hearing peers in the single-leg stance (eyes open and closed), functional reach test, and pediatric balance scale (all p < 0.001). When analyzed by sex, males with hearing impairments had significantly lower scores in single-leg stance (eyes open and closed, p < 0.001), functional reach test (p < 0.002), and pediatric balance scale (p < 0.001) compared to males with normal hearing. Similarly, females with hearing impairments demonstrated significantly lower scores in single-leg stance (eyes open and closed, p < 0.001), functional reach test (p < 0.003), and pediatric balance scale (p < 0.001) compared to females with normal hearing. CONCLUSION: Children with hearing impairment demonstrated significantly lower static and dynamic balance performance than age- and sex-matched peers with normal hearing. These findings highlight the importance of incorporating routine balance assessment in this population.