Effects of Mobility Training on Gait and Balance

Abstract

Approximately 3.8 million persons over age 65 are visually impaired (that is, are blind or have low vision), of whom about 173,000 are legally blind veterans (Department of Veterans Affairs, 2003). The population of legally blind veterans is projected to increase to nearly 1 million by 2010 (Veterans Benefits Administration, 2001). As these demographic changes occur, it is important to gain a better understanding of the effects of orientation and mobility (O&M) training on older people with visual impairments, including those served by the Georgia Veterans Affairs Blind Rehabilitation Center (BRC), on specific movement functions, especially gait and balance, and the potential for falls and injury. The lack of objective quantitative functional measures related to the outcomes of rehabilitation programs serving visually impaired persons limits the documentation and improvement of services to legally blind veterans. REVIEW OF THE LITERATUREThere are no protocols for determining changes in gait and balance in visually impaired persons who have completed O&M instruction at the BRC. Current assessments of patients' O&M skills are done through qualitative evaluations by mobility instructors in the form of "dropoff' lessons (Long, Rieser, & Hill, 2000 and/or "critical incident mobility assessment" (Geruschat, Turano, & Stahl, 1998). Yet, quanti-This project was funded by the Department of Veterans Affairs, Office of Rehabilitation Research and Development, Project C1861P.tative parameters for gait and balance are available and are predictive of a reduced ability to negotiate safely in one's environment and the risk of falls among older sighted people (Buchner et aI., 1996; Kressig et. aI., 2001;Watelain, Barbier, Allard, Thevenon, & Angue, 2000). Since there is a high correlation between physical function (i.e., gait, balance) and the ability to perform activities of daily living (ADLs), which include moving efficiently and safely in the environment as taught in O&M training, it is a logical step to measure functional parameters as a means of predicting an individual's ability to incorporate O&M skills into his or her daily routine. More quantitative measures of gait and balance may thus be useful outcome measures of O&M training. The use of such biomechanical measures may help BRC programs assess the effects of training on mobility problems and the risk of falls.Measures of gait and balance for sighted adults across the life span have been well documented in the literature and are predictive of function and the risk of falls in older individuals

A Proposal of a Motion Measurement System to Support Visually Impaired People in Rehabilitation Using Low-Cost Inertial Sensors

“…With the inertial sensors and the presented metrics, it will be possible to obtain outcome measures as stride rate, gate velocity (meters per minute), and grip characteristics. Additionally, the provided coverage and long mechanics will allow interpretations of the sweeping characteristics as amplitude, frequency and the ability to detect obstacles in the path, as it has been done previously either with more complex acquisition systems [ 15 , 50 , 51 ], simulated [ 52 ] or in some cases manually [ 53 ].…”

“…In several references [ 6 , 8 , 9 , 10 , 11 , 12 ] the emphasis and importance of the O&M service and training in order to improve the quality of life, is widely emphasized [ 5 , 13 ]. Therefore, there is a specific health discipline in charge of the study, development, and improvement of the O&M training in VIP [ 14 , 15 , 16 ]. The latest report of the international approaches to rehabilitation programs from the World Blind Union [ 7 ] presents two important challenges on which this project was motivated: (1) the limitation of resources to provide basic rehabilitation services and (2) transportation and geographic limitations, where many VIP must displace themselves to other cities in order to access the rehabilitation services which, in some cases, is impossible for some VIP.…”

Analysing the postural and gait behaviour of a person with retinitis pigmentosa travelling with a guide dog

“…Clinical observations and research data on RP report that subjects travel in familiar and less complex environments to reduce sustained effort, decrease walking speed and have difficulty executing a second task [2]. They manifest slower reaction time [3] and avoid night time travel [4]. They often travel without mobility aid, even when their vision is not functional enough to walk without a tool; this behaviour can modify posture [5].…”

Body Awareness and Dance-Based Training for Persons with Acquired Blindness—Effects on Balance and Gait Speed

“…9 Few studies have been published that assess the effects of training on balance skills in individuals with visual impairment. Using the Berg Balance Scale prior to and after orientation and mobility training, negligible effects have been shown 22 and gait speed remained unaffected. 22,23 A pilot study reported that the length of time of the one-leg stance increased after Tai Chi and orientation and mobility training, 24 but no recommendation could be proposed.…”