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