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Balance, gait, and navigation performance are related to physical exercise in blind and visually impaired children and adolescents.

ABSTRACT: Self-motion perception used for locomotion and navigation requires the integration of visual, vestibular, and proprioceptive input. In the absence of vision, postural stability and locomotor tasks become more difficult. Previous research has suggested that in visually deprived children, postural stability and levels of physical activity are overall lower than in sighted controls. Here we hypothesized that visually impaired and blind children and adolescents differ from sighted controls in postural stability and gait parameters, and that physically active individuals outperform sedentary peers in postural stability and gait parameters as well as in navigation performance. Fourteen blind and visually impaired children and adolescents (8-18 years of age) and 14 matched sighted individuals took part. Assessments included postural sway, single-leg stance time, parameters of gait variability and stability, self-reported physical activity, and navigation performance. Postural sway was larger and single-leg stance time was lower in blind and visually impaired participants than in blindfolded sighted individuals. Physical activity was higher in the sighted group. No differences between the group of blind and visually impaired and blindfolded sighted participants were observed for gait parameters and navigation performance. Higher levels of physical activity were related to lower postural sway, longer single-leg stance time, higher gait stability, and superior navigation performance in blind and visually impaired participants. The present data suggest that physical activity may enhance postural stability and gait parameters, and thereby promote navigation performance in blind and visually impaired children and adolescents.

SUBMITTER: Rogge AK

PROVIDER: S-EPMC8068618 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundVisually impaired and blind adolescents fare poorly in educational attainment compared to adolescents without vision impairment. Rehabilitation holds the potential to compensate for the hindrances that the impairment causes. Many rehabilitation initiatives exist. However, the efficacy of these initiatives remains uncertain. This systematic review assessed which rehabilitation initiatives improve participation in an educational setting for visually impaired and blind adolescents.MethodsPubMed, Embase, Scopus, Cinahl, and Cochrane library databases were searched. Only primary studies as randomized controlled trial (parallel group or crossover), cohort studies, case-control studies, qualitative studies, and case-studies were included. Data on the study characteristics, visual impairment, type of intervention, research question, main findings, and implications for practice were extracted from the papers. Critical appraisal was performed using the Critical Appraisal Checklist for Qualitative Research and the Checklist for Quasi-Experimental Studies both from the Joanna Briggs Institute. The data extraction and the critical appraisal were performed independently by two reviewers.ResultsA total of 10 studies with visually impaired and blind adolescents were considered eligible, from an original search result of 3210 studies. In the thematic analysis we identified a heightened focus on different means for studying by making the curriculum content more accessible by applying different audio, tactile, or electronic devices (n = 8). A minor focus in the identified studies (n = 2) was placed on the impact of support from the environment on the development of literacy, for example the support from teachers or parents. Outcome parameters representing more diverse rehabilitation initiatives have not been adequately investigated in the literature. The scientific evidence that we identified was based on few publications with contradictory results and some studies were of questionable quality, limiting the applicability of their findings.ConclusionsOverall, the review identified a gap in the evidence regarding rehabilitation initiatives for visually impaired and blind adolescents that enables participation in an educational setting. The overall quality assessment of the 10 studies identified several risks of bias, for which reason the current scientific evidence does not qualify as a basis for decision making, leaving the adolescents in a heightened risk to fall even further behind in the educational system. Further high quality randomized controlled trials are required to establish high-quality evidence.

Project description:OBJECTIVES:Compared with sighted individuals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness. DESIGN:A systematic review of articles reporting physical activity interventions in visually impaired individuals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure. SETTING:Most interventions were conducted in a group setting, with some including an at-home, self-directed component. PARTICIPANTS:Following identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment. PRIMARY AND SECONDARY OUTCOME MEASURES:Outcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait. RESULTS:Eighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and diverse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale. CONCLUSIONS:Physical activity interventions in individuals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger sample sizes, stronger designs and longer follow-up periods are needed. PROSPERO REGISTRATION NUMBER:CRD42018103638.

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Balance, gait, and navigation performance are related to physical exercise in blind and visually impaired children and adolescents.

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