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Ava K Bittner, Katherine Green, Rakin Khan, Anushka Mitesh Mistry, Maryn JaNet Barnes, Nicole C. Ross; Changes in Reported Difficulty with Near Reading following Telerehabilitation for Low Vision. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4030.
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© ARVO (1962-2015); The Authors (2016-present)
Following our pilot study of telerehabilitation for low vision (LV), we enlisted local Lions Club volunteers to help set-up loaner equipment for the videoconferencing portal in patients’ homes, intending to reduce the burden of technology for older adults with LV and improve their overall satisfaction with the encounter. We also aimed to determine if a visual function questionnaire could document meaningful changes in reading ability following telerehabilitation training.
During telerehabilitation, LV providers evaluated patients’ use of newly prescribed magnification devices for near reading, and gave training to improve their proficiency. Local Lions Club volunteers set-up loaner videoconference equipment in the homes of nine LV patients. Items pertaining to near reading from the Activity Inventory (AI) questionnaire were administered by phone within a week prior to telerehabilitation (usually the day before or day of the session), and re-administered 1-3 months post-telerehabilitation to eight patients who were still using the same magnification devices. AI data were Rasch analyzed and filtered for items that were not important or not difficult at baseline.
Lions volunteers successfully connected the audio and video for all sessions. All nine of the patients who received this help from the Lions reported by phone to our research assistants immediately after telerehabilitation that they were overall very satisfied with the session, whereas only four of ten patients were very satisfied in the previous pilot study without Lions (p=0.005). Post-telerehabilitation, the majority of patients indicated less difficulty on the AI item related to reading handwritten notes, and half reported less difficulty reading bills and product labels with their magnification device. The mean AI change score was 2.07 (range 0.33-6.08), indicating less difficulty with near reading for all patients, with a Cohen’s d coefficient of 0.996, and 37.5% of patients achieved an minimum clinically important difference (MCID) criterion of ≥1.
Lions volunteers who set-up the videoconference portal in patients’ homes were a valuable solution to overcome technical issues and significantly improve patients’ overall satisfaction level. The magnitude of improvement in near reading tasks measured with the AI was similar to previous clinical trials of mobile-clinic or in-office, outpatient LV rehabilitation.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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