Impact of visual impairment on balance and visual processing functions in students with special educational needs

Balance Level and Fundamental Motor Skills of Youth with Visual Impairments: Pilot Study

Background: Visual impairment significantly affects balance and motor skills in children, often leading to postural instability and locomotor difficulties, thereby affecting lifestyle and general health. The aim of this study was to assess balance level and fundamental motor skills in the locomotion of youth with regard to their level of visual impairment. Methods: The pilot study included 25 physically active young people with visual impairments, divided into three groups (B1, B2, B3) based on the severity of impairment. Balance was assessed using the AMTI AccuSway platform, both with eyes open and eyes closed. Locomotor skills were evaluated using the TGMD-3. Statistical analysis involved Kruskal-Wallis, ANOVA, and correlation tests. Results: Significant differences in balance were found between the B1 and B2 groups, with poorer balance in individuals with more severe visual impairments, particularly in static conditions. No significant differences in locomotor skills were observed between groups. However, girls performed better in balance tests, particularly with eyes closed. A positive correlation was found between balance and locomotor skills in the B2 and B3 groups. Conclusions: Visual impairment negatively impacts balance, particularly in individuals with more severe impairments. However, no significant differences were found in locomotor skills between the groups. Regular physical activity supports motor development. Targeted interventions are necessary to improve balance and locomotor skills, especially in children with more severe visual impairments.

Fostering holistic eye care for children with special educational needs: an interprofessional education program bridging optometry and education

PURPOSE

This study outlines the initiation of an interprofessional education (IPE) program designed for optometry and education students. The program aimed to foster interdisciplinary collaboration and improve the management of eye health in children with special educational needs (SEN) - a vulnerable and underserved group.

METHODS

This program incorporated lectures and workshops to impart essential knowledge about SEN and to develop the necessary attitudes and skills for conducting eye examinations. A key component involved vision screenings at two special education schools, where optometry (n = 43) and education students (n = 39) collaborated to serve 170 children with mild to moderate intellectual disabilities. Quantitative data was gathered pre- and post-program using a single-stage, five-level Likert scale. Qualitative insights were drawn from students' reflective writings to evaluate their learning outcomes, understanding, and confidence in managing eye health for children with SEN.

RESULTS

Of the participants, 37 optometry and 21 education students completed the survey (70.7% response rate). The survey results indicated significant improvements in understanding SEN characteristics (p ≤ 0.013) and increased confidence when conducting eye examinations for children with SEN (p < 0.007) after the training program. The analysis of reflective writings highlighted the program's beneficial impacts on students. They recognized the value of interprofessional collaboration, reported enhanced professional competence, gained deeper insights into their own and their peers' roles within multidisciplinary teams, and developed a strengthened sense of social responsibility.

CONCLUSION

This IPE program proved to be an effective method for enhancing optometry and education students' knowledge and confidence in managing eye health needs of children with SEN. The findings support the advocacy for continued collaborative efforts between healthcare providers and educators to ensure comprehensive care for this population. Such disciplinary collaboration provides positive evidence in early stages of training in both disciplines.

CLINICAL TRIAL NUMBER

Not applicable.

Approaches for delivery of refractive and optical care services in community and primary care settings

BACKGROUND

Uncorrected refractive error is a leading cause of vision impairment which, in most cases, can be managed with the appropriate spectacle correction. In 2021, the World Health Assembly endorsed a global target of a 40-percentage-point increase in effective coverage of refractive error by 2030. To achieve this global target, equitable access to refractive and optical services within community and primary care settings needs to be strengthened. This review will inform the development of technical guidance to support improvements in the testing and correction of refractive error among World Health Organization (WHO) member states.

OBJECTIVES

To determine the range of approaches for delivery of refractive and optical care services in community and primary care settings, and the methods employed for their evaluation.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase and Global Health databases, grey literature, and annual reports and websites of relevant organizations involved in eye-care delivery from January 2002 to November 2022 to identify approaches for refractive and optical service delivery.

SELECTION CRITERIA

We included observational and interventional studies, reviews, and reports from relevant organizations related to delivering refractive services and optical services for preschool and school-aged children and adults in community and primary care settings published between January 2002 and November 2022. We searched for studies and reports published within the last 20 years because vision impairment due to uncorrected refractive error has only recently become a public health and eye health priority, therefore we did not expect to find much relevant literature until after 2002.

DATA COLLECTION AND ANALYSIS

Two review authors screened titles, abstracts and full texts, and extracted data. We resolved any discrepancies through discussion. We synthesized data, and presented results as tables, figures, and case studies. This project was led by the World Health Organization (WHO) Vision and Eye Care Programme.

MAIN RESULTS

We identified 175 studies from searches of databases and grey literature, 146 records from company reports, and 81 records from website searches of relevant organizations that matched our inclusion criteria. Delivery approaches for refractive and optical services in community care included school-based, pharmacy, and outreach models, whereas primary care approaches comprised vision centre, health centre, and a combination of vision or health centre and door-to-door delivery. In community care, school-based and outreach approaches were predominant, while in primary care, a vision-centre approach was mainly used. In the WHO African region, the school-based and outreach approaches were mainly reported while, in the Americas, the outreach approach was mostly used. Very few approaches for service delivery were reported in the WHO Eastern Mediterranean region. Prominent gaps exist in the evaluation of the approaches, and few studies attempted to evaluate the approaches for delivery of refractive and optical care services.

AUTHORS' CONCLUSIONS

We comprehensively describe a range of approaches for delivery of refractive and optical services in community and primary care. Further evaluation of their effectiveness will better inform the application of these service-delivery approaches. The study outcomes will help guide WHO member states in strengthening refractive and optical services at community and primary care levels.

FUNDING

This scoping review was supported by the Vision and Eye care Programme, World Health Organization and ATscale Global Partnership.

REGISTRATION

The protocol of this scoping review was published in the Open Source Framework.

Dynamic stability evaluation of trunk accelerations during walking in blind and sighted individuals

BACKGROUND

Dynamic stability is a fundamental goal in standing activities. In this regard, monitoring, analysis, and interventions made to improve stability is a research topic investigated in the biomechanics of human movements. Vision has a major role to play in controlling human movement. Nonetheless, little is known about the effects of visual deprivation, especially from birth on dynamic gait stability.

METHODS

The current study was conducted on 20 congenital blind and 10 sighted people (15-38 years). To evaluate the dynamic stability, descriptive data, harmonic ratio (HR), improved harmonic ratio (iHR), and root mean square (RMS), based on trunk acceleration data were measured in three axes: anteroposterior (AP), vertical (V), and mediolateral (ML) while participants walked an eight-meter straight path.

RESULTS

In the comparison of blind and sighted people (eyes open), standard deviation, HR, iHR, and RMS indices were found to be significantly different in both AP and V directions. All the mentioned parameters were significantly lower in blind than in sighted participants. In the comparison of blind people and sighted ones with closed eyes, changes were observed in the maximum, range, standard deviation, and RMS only in the AP axis. In the comparison between eyes open and closed in sighted people, a significant difference was found only in the harmonic ratio of the vertical axis.

CONCLUSION

Visual deprivation led to a decrease in dynamic stability parameters in the AP and V axes. Even the movement of sighted people in unchallenged conditions is dependent on visual information.

Correction: Impact of visual impairment on balance and visual processing functions in students with special educational needs

[This corrects the article DOI: 10.1371/journal.pone.0249052.].