Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 7
June 2024
Volume 65, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2024
Eccentric-viewing training for reading enhances balance in the visually impaired.
Author Affiliations & Notes
  • Aaron Johnson
    Psychology, Concordia University, Montreal, Quebec, Canada
    Vision Health Research Network, Montreal, Quebec, Canada
  • Hana Boxerman
    Centre de réadaptation Lethbridge-Layton-Mackay, installation Constance-Lethbridge, Montreal, Quebec, Canada
  • Caitlin Murphy
    Psychology, Concordia University, Montreal, Quebec, Canada
    Charles River Laboratories International Inc, Montreal, Quebec, Canada
  • Footnotes
    Commercial Relationships   Aaron Johnson None; Hana Boxerman None; Caitlin Murphy None
  • Footnotes
    Support  Infrastructure funding from the Réseau de recherche santé de la vision, and the Centre de recherche interdisciplinaire en réadaptation.
Investigative Ophthalmology & Visual Science June 2024, Vol.65, 2573. doi:
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      Aaron Johnson, Hana Boxerman, Caitlin Murphy; Eccentric-viewing training for reading enhances balance in the visually impaired.. Invest. Ophthalmol. Vis. Sci. 2024;65(7):2573.

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

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Abstract

Purpose : Fixation stability is frequently targeted and trained in low-vision rehabilitation practices to improve accuracy and speed in reading. But does this training lead to improvements in other tasks that use vision? About 1 in 4 older adults report having a major fall, with this increasing to 1 in 2 for visually impaired older adults. Previously, researchers have shown that fixation stability is a visual parameter that can contribute to the control of balance. However, these studies were correlational in nature, and did not include a direct intervention to improve fixation stability. Here, we quantified fixation stability before and after a 6-week eccentric viewing rehabilitation training program, to determine if this could lead to improved reading and balance.

Methods : 16 rehabilitation clients have successfully completed the program to date. Tests included reading ability using the Pepper Visual Skills Reading Test (PVSRT) and fixation stability using the Optos Scanning Laser Ophthalmoscope. Balance was assessed using a subjective measure (Activities-specific balance confidence, ABC) and objective measures including the Timed Up-and-Go (TUG), Dynamic Gait Index (DGI), and postural control were measured using the Nintendo Wii Balance Board.

Results : Fixation stability improved in all clients to below 2 degrees, except for one client that showed no improvement. Reading speed did not statistically improve (g=-.1), but reading accuracy did show improvement (g = 0.657, p<.001). Subjective balance confidence assessed by the ABC showed improvement (g=.841, p=.002). TUG performance improved post-training (g = 0.428, p=.013). Improvement post-training was also observed for the DGI (g = 0.489, p=.003). However, postural control showed a minimal effect of training, g = 0.035, p=.849.

Conclusions : These results show that improvements in fixation stability through eccentric viewing training can lead to expected improvements in reading accuracy. However, cross-modal improvements are also observed in subjective and objective measures of balance performance, though training has little impact on postural control.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Left: Subjective balance scores (measures by the ABC) pre- and post-eccentric viewing fixation stability training. Right: Effect size (Hedges g) for the difference in ABC scores, with lines reflecting 95% confidence intervals around the effect size.

Left: Subjective balance scores (measures by the ABC) pre- and post-eccentric viewing fixation stability training. Right: Effect size (Hedges g) for the difference in ABC scores, with lines reflecting 95% confidence intervals around the effect size.

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