April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Long-Term Effects of Vision Rehabilitation on Self-Reported Mobility Performance
Author Affiliations & Notes
  • Thomas Kuyk
    TASC, Brooks City-Base, Texas
  • Patti S. Fuhr
    Blind Rehab-VAMC, Birmingham VAMC, Birmingham, Alabama
  • Lei Liu
    School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama
  • Footnotes
    Commercial Relationships  Thomas Kuyk, None; Patti S. Fuhr, None; Lei Liu, None
  • Footnotes
    Support  Department of Veterans Affairs Rehabilitation Research and Development Service (C2240R).
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5561. doi:
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      Thomas Kuyk, Patti S. Fuhr, Lei Liu; Long-Term Effects of Vision Rehabilitation on Self-Reported Mobility Performance. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5561.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To investigate the effect of vision rehabilitation on patients’ self-reported mobility over a period of several years.

Methods: : In a telephone interview prior to entering an in-patient rehabilitation program, 211 legally blind veterans were administered a mobility questionnaire that assessed, on a scale of 1-5, level of difficulty performing in 35 mobility situations, along with questions on falls and confidence in 4 common travel situations. The questionnaire was part of an assessment of health-related quality of life (HRQOL; Fuhr, ARVO 2009) and was administered again at 2, 6, 18 and 30 months after completion of the rehab program. Data from 88 subjects who completed all 5 interviews are reported.

Results: : At 2 and 6 months post-rehab, difficulty ratings for 31/35 and 29/35 test items were lower than pre-rehab levels (p’s < 0.0001). The most difficult pre-rehab tasks were traveling in unfamiliar (3.2) and in high glare (3.3) areas. The largest decreases in post-rehab difficulty ratings were for traveling outdoors (-0.47) and on uneven surfaces (-0.54). At 18 months the downward trend in difficulty ratings had reversed with 25/35 ratings (p = 0.017) higher than those at 6 months. All 30 month difficulty ratings were higher than 6-month ratings and 25/35 were higher than pre-rehab ratings. Physical, but not mental, health (SF-12) declined significantly over time but did not follow the same pattern as difficulty ratings. Pre-rehab falls were reported by 49% of subjects, declined to 40% at 6 months, and then returned to pre-rehab levels at 30 months. Confidence ratings for travel in unfamiliar areas, stores and outdoors followed the same pattern of gains and losses as difficulty ratings.

Conclusions: : Vision rehabilitation had positive, short-term effects on mobility performance, confidence and falls despite declines in subject physical health. However, by 18 months post-rehab the positive effects were eroding and by 30 months difficulty ratings in most categories were at or above pre-rehab levels. The pattern of near-term gain and long-term losses paralleled that of HRQOL and suggests a need for post-rehab booster programs to counteract the declines.

Keywords: low vision • clinical (human) or epidemiologic studies: outcomes/complications • visual impairment: neuro-ophthalmological disease 

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