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Donald Calvin Fletcher, Laura Renninger, Ken Downes; Performance Measures in Low Vision Patients Before and After Occupational Therapy (OT) Training. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4156.
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© ARVO (1962-2015); The Authors (2016-present)
To examine activities of daily living (ADL) performance metrics before and after occupational therapy in low vision patients in order to determine if OT improves ADL performance.
28 patients at their first low vision referral were evaluated in the study. 26 patients received OT training; 2 patients declined OT and acted as controls. A battery of performance measures was performed pre and post training or 1 year after the initial evaluation. These measures included SK Read, utility bill and bank statement reading, currency identification, hand writing performance, and subjective frustration level estimation.
Patient age median/range was 83/70 - 94 years with 79% female. Vision loss was due to AMD in 93% of patients. Visual acuity median/range was 20/160 and 20/20 to 20/730. 26 out of 28 patients received occupational therapy training, median total therapy time was 3.5 hours (Range: 1 - 6.5). SK Read mean error rate improved from 4.1 to 2.4 errors per block after OT training, while the control group had no improvement in error rate after 1 year. Only 31% of patients at the initial consultation could accurately read a utility bill. After OT training, 96% of patients gained this ability. The control patients were not able to do this task at initial consultation or at 1 year follow up. All subjects could identify currency and both the OT trained and control groups improved in the mean time to identify (OT trained 23 to 16 seconds vs control group 24 to 11 seconds at 1 year follow up). Hand writing performance was unchanged in both trained and control groups. Subjective frustration estimates (scale from 1-10) improved substantially in the OT trained group (6.7 to 3.8), while the control group had minimal improvement (9.0 to 8.5).
After OT training most of the ADL performance metrics showed an improvement and a profound decrease in subjective frustration score was also noted. The small control group without training did not demonstrate these improvements. The value of low vision rehabilitation programs including a training component is supported by this evidence.
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