Acceptability of Telerehabilitation for Magnification Devices for the Visually Impaired Using Various Approaches to Facilitate Accessibility

Abstract

Purpose We examined different methods to reduce the burden of accessing technology for videoconferencing during telerehabilitation for magnification devices for the visually impaired. Methods During telerehabilitation studies over the past 5 years, vision rehabilitation providers assessed and gave training to visually impaired participants with newly dispensed magnification devices at home who connected to Zoom videoconferencing via loaner tablets or smartphones with assistance from (phase 1; n = 10) investigators by phone, (phase 2; n = 11) local Lions Club volunteers in participants’ homes, or (phase 3; n = 24) remote access control software in a randomized controlled trial with 13 usual care controls who received in-office training. All participants completed the same post-telerehabilitation phone survey. Results A significantly greater proportion of phase 3 subjects indicated they strongly or mostly agreed that the technology did not interfere with the session (96%) compared to phase 1 (60%; 95% confidence interval [CI], 1.2–12.5; P = 0.03) or phase 2 (55%; 95% CI, 1.8–188; P = 0.01). The majority indicated telerehabilitation was as accurate as in person (68%), they were comfortable with telerehabilitation (91%) and interested in a future session (83%), and their magnifier use improved (79%), with no significant differences in these responses between phases (all P > 0.10), including comparisons of participants randomized to telerehabilitation or in-office training in phase 3 who reported similar overall satisfaction levels ( P = 0.84). Conclusions Participants across all phases reported high levels of acceptance for telerehabilitation, with least interference from technology using remote access control in phase 3. Translational Relevance With accommodations for accessibility to videoconferencing technology, telerehabilitation for magnification devices can be a feasible, acceptable, and valuable option in countries with resources to support the technology.

Value of Handheld Optical Illuminated Magnifiers for Sustained Silent Reading by Visually Impaired Adults

“…The power of their new optical magnifiers ranged from 5 to 28 D (mean, 11 [SD, 5] D). Their TICS scores for cognitive status ranged from 24 to 48 (mean, 35.6 [SD, 5.8]), and SF-36 (Short-form Health Survey) scores for general health ranged from 20 to 95 (mean, 56 [SD,19]).…”

“…A potential way to offer assessment and additional training is via telerehabilitation using a video visit encounter, but there is limited evidence available to support the efficacy of a remote training modality 18 . Preliminary data support that additional training via telerehabilitation can improve self-reported magnifier use, 19 near reading acuity with magnifiers, and near reading speed at the reading acuity level 20 . It is important for future research to gain a better understanding of real-world reading challenges in the home environment that can be observed during telerehabilitation, which affect extended reading.…”

New insights into visually impaired patients' preferred reading illumination and home‐based reading speed with new task‐lighting

“…Recent studies have demonstrated the feasibility of using tele-rehabilitation with participants who have low vision to conduct follow-up evaluations Kaminski et al (in press). [18][19][20] In a previous study that evaluated various modalities to assess optimal lighting conditions and print size, the LuxIQ was most effective at improving reading speeds for normal-sized text (1.0 M) and smaller print in visually impaired older adults compared with an Apple iPad (apple. com) with display modifications for intensity, hue or colour filter (as part of its standard accessibility features), or a mobile application (app) for the Playbulb LED smart bulb (playb ulb.com).…”

“…That includes evaluating the positioning of the lamp relative to the reading material and whether the correct settings for brightness and colour temperature are being used. Recent studies have demonstrated the feasibility of using tele‐rehabilitation with participants who have low vision to conduct follow‐up evaluations Kaminski et al (in press) 18–20 …”

Outcomes of Telerehabilitation Versus In-Office Training With Magnification Devices for Low Vision: A Randomized Controlled Trial

“…Telerehabilitation using videoconferencing to remotely evaluate and provide visual aid training to patients with low vision at home is feasible 1 , 2 and can overcome several barriers to care 3 – 6 ; however, it is not yet widely implemented in clinical practice. There is a lack of a rigorous evidence basis for telerehabilitation involving magnification device training for low vision; randomized controlled trials have not yet been conducted.…”