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B. Christy, J. E. Keeffe, P. K. Nirmalan; Measuring Outcomes of Low Vision Rehabilitation Using the Elvrt. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6012.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effectiveness of activity based training on changes in the quality of life after vision rehabilitation for persons with low vision
First time referrals to the low vision clinic of L V Prasad Eye Institue in south India were recruited for the study. A previously validated WHOQOL instrument and a newly developed 10-item Effectiveness of Low Vision Rehabilitation Training (ELVRT) instrument were administered at baseline and 9 months after initiation of vision rehabilitation to measure changes in quality of life and the effectiveness of the independent living skills training such as safe navigation, activities of daily living, home mangement, money management and personal grooming. Rasch analysis (Winsteps Software) was used to develop calibrated scores and effect sizes to compare the pre-and post Rasch calibrated scores. The psychometric properties of the ELVRT were evaluated using Rasch analysis.
436 subjects aged 8 to 86 years (37.82 ± 21.85) were enrolled in the study. The ELVRT had a good fit to the Rasch model (Χ2 p=1.000), person and item separation reliability of 0.79 and 0.99 and a cronbach alpha of 0.83. Pre-rehabilitation ELVRT and QOL scores were not significantly associated with sociodemographic factors, comorbidity or duration of vision loss. Persons with poorer best corrected visual acuity had greater difficulty with activities (F=65.80, p=<0.001) and worse QOL (F=4.386, P=0.013). Effect sizes (ES) showed clinically significant improvement for all measured items (ES 0.75 to 1.35) except for bathing unaided (ES=0.15). The overall ES for WHOQOL pre-post measures showed a small but clinically significant improvement (ES=0.27).WHOQOL measures focused on independent living skills training showed a significant improvement (ES 0.17 to 1.27), however, WHOQOL measures focused on psychosocial aspects did not show a significant improvement (ES -0.12 to 0.15).
An activity based measure like the ELVRT should be used in conjunction with quality of life measures to evaluate changes after low vision rehabilitation for persons with low vision.
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