The Effect of Hearing Aid Amplification on Gait Parameters: A Pilot Study Using Ear-Worn Motion Sensors.

Background/Objectives: Hearing loss, particularly in older adults, is associated with reduced physical functioning; increased fall risk; and altered gait patterns, including slower walking speed and shorter step length. While the underlying mechanisms are not fully understood, one possibility is that these gait changes result from an additional cognitive load due to hearing difficulties. Prior research suggests that hearing aids may improve balance; however, their impact on gait remains less well explored. Methods: This study investigated gait parameters in individuals with hearing loss as they walked with and without hearing aid amplification under different dual-task conditions. Additionally, we showed the potential of ear-worn sensors for detecting relevant gait changes. To achieve this, we used a hearing-aid-integrated accelerometer and our open-source EarGait framework comprising gait-related algorithms specifically developed for ear-worn sensors. Results: Our findings revealed no significant differences in gait velocity or step length between the unaided and aided conditions. For stride time, we observed a significant interaction effect; however, the effect size was negligible. The dual-task costs were lower than in previous reports, indicating that the applied dual-task paradigm did not induce the expected cognitive demand. The ear-worn gait analysis system showed strong performance compared to foot-worn sensors. Conclusions: Our findings indicate that in controlled, low-cognitive-demand settings, hearing aid amplification does not affect gait performance and, therefore, neither hinders nor improves walking performance. Additionally, the high accuracy of the ear-worn gait analysis system highlights the strong potential of ear-mounted wearable devices ("earables") for real-world mobility assessments. Future research should explore more complex real-world conditions to better understand the impact of hearing aids on walking behavior. Our proposed earable-based system offers a promising tool for continuous, unobtrusive gait monitoring in everyday environments.