Correlation analysis of balance and postural stability as a risk for falls in individuals with visual impairment

Abstract

Vision is critical for human balance. Visual impairment (VI) decreases the ability of individuals to maintain balance and greatly impacts the activities of daily living. Hence, the purpose of this study is to assess balance in individuals with VI using the Berg Balance Scale (BBS) and Activities-specific Balance Confidence (ABC) Scale regarding its correlation with fall risk. A total of 88 participants were eligible for this study. We administered pre-tested questionnaires for demographic conditions and history of falls after recruiting participants; following that, BBS and ABC Scale tests were conducted for the participants. A t-test was used to determine statistically significant differences between the means in the fall and non-fall groups. A Pearson bivariate correlation test and linear regression were used to determine the existence of relationships between BBS and ABC variables. In all, 51 participants in this study had experienced falls within 1 year (fall group), while 37 participants had falls over the past 1 year (non-fall group). The fall group had a lower mean of BBS (49) and ABC (69) scores than the non-fall group; also, there was a significant correlation between the BBS and ABC Scales (p < .05). The type of VI and sex also had significant differences in the risk of falls. These findings suggest that individuals with VIs should raise their awareness about improving aspects of balance in the body with specific exercise and training to minimize the risk of falls.

Keywords

Activities-specific Balance Confidence (ABC) Scale Balance Berg Balance Scale (BBS)fall risk postural stability visual impairment (VI)

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References

Adam

Patey

Fisher

Brian

(2021). The Activities-specific Balance Confidence (ABC) Scale in youth with visual impairment psychometrics and a population-specific short form. Measurement in Physical Education and Exercise Science, 26, 89–102. https://doi.org/10.1080/1091367X.2021.1949321

Alghadir

A. H.

Alotaibi

A. Z.

Iqbal

Z. A.

(2016). Postural stability in people with visual impairment. Brain and Behavior, 9, Article e01436. https://doi.org/10.1002/brb3.1436

American Academy of Ophthalmology. (n.d.). www.aao.org; https://www.aao.org/Assets/101a334c-a338-454f-9bcc-b6a23f08d4a5/636410015228330000/bc-1903-vision-rehabilitation-icd10-guide-d-pdf?inline=1

Ardakani

M. S.

(2020). Effect of core stability training on postural training on postural control, risk of falling, and function of the blind: A randomized controlled trial. Baltic Journal of Health and Physical Activity, 12, 11–22. https://doi.org/10.29359/BJHPA.12.3.02

Beninato

Portney

L. G.

Sullivan

P. E.

(2009. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Physical Therapy, 89, 816–825. https://doi.org/10.2522/ptj.20080160

Bouchard

(2000). The motor development of sighted children and children with moderate low vision aged 8–13. Journal of Visual Impairment & Blindness, 94, 564–573.

Choi

K. Y.

Wong

H. Y.

Cheung

H. N.

Tseng

J. K.

Chen

C. C.

C. L.

Eng

Woo

G. C.

Cheong

A. M. Y.

(2022). Impact of visual impairment on balance and visual processing functions in students with special educational needs. PLOS ONE, 17(4), Article e0249052. https://doi.org/10.1371/journal.pone.0249052

Cohen

(1988). Statistical power analysis for the behavioral science. Lawrence Erlbaum.

Daga

D.-F. A.

(2017). Fear of falling and postural reactivity in patients with glaucoma. PLOS ONE, 12, Article e0187220. https://doi.org/10.1371/journal.pone.0187220

10.

de Boer

M. R.

Pluijm

S. M. F.

Lips

Moll

A. C.

Völker-Dieben

H. J.

Deeg

D. J. H.

van Rens

G. H. M. B

. (2004). Different aspects of visual impairment as risk factors for falls and fractures in older men and women. Journal of Bone and Mineral Research, 19, 1539–1547. https://doi.org/10.1359/JBMR.040504

11.

Dijkhuizen

Krijnen

W. P.

van der Schans

C. P.

Waninge

(2017). Validity of the modified berg balance scale in adults with intellectual and visual disabilities. Research in Developmental Disabilities, 62, 58–68. https://doi.org/10.1016/j.ridd.2017.01.005

12.

Franjoine

M. R.

Gunther

J. S.

Taylor

M. J.

(2003). Pediatric balance scale: A modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatric Physical Therapy, 35, 114–128. https://doi.org/10.1097/01.PEP.0000068117.48023.18

13.

Gashaw

Admass

B. A

. (2021). Injury related to fall and its predictors among medically diagnosed adults with visual impairment in Ethiopia: An observational cross-sectional study. Hindawi Advances in Orthopedics, 2021, Article 6686068. https://doi.org/10.1155/2021/6686068

14.

Gashaw

Janakiraman

Minyihun

Jember

Sany

(2020). Self-reported fall and associated factors among adult people with visual impairment in Gondar Ethiopia: A cross-sectional study. BMC Public Health, 20, Article 498.

15.

Giagazoglou

P. A.

Amiridis

I. G.

Zafeiridis

Thimara

Kouvelioti

Kellis

(2009). Static balance control and lower limb strength in blind and sighted women. European Journal of Applied Physiology, 107, 571–579. https://doi.org/10.1007/s00421-009-1163-x

16.

Haibach

P. S.

Lieberman

L. J.

(2013). Balance and self-efficacy of balance children with CHARGE syndrome. Journal of Visual Impairment & Blindness, 1074(4), 297–309. https://doi.org/10.1177/0145482x1310700406

17.

Haibach-Beach

P. M.

McNamera

Liberman

(2020). Home-based balance pilot intervention for adults with visual impairments. British Journal of Visual Impairment, 40, 145–159. https://doi.org/10.1177/0264619620935937

18.

Häkkinen

A. H.

Holopainen

Kautiainen

Sillanpää

Häkkinen

(2006). Neuromuscular function and balance of prepubertal and pubertal blind and sighted boys. Europe PMC, 95(10), 1277–1283. https://doi.org/10.1080/08035250600573144

19.

Harry

K. M. L. R.

Harwood

(2001). Visual problems and falls. Age and Ageing, 30, 13–18. https://doi.org/10.1093/ageing/30.suppl_4.13

20.

Harry

K. M. L. R.

Scudds

R. J.

(2003). Comparison of balance in older people with and without visual impairment. Age and Ageing, 32, 643–649.

21.

Houwen

Visscher

Lemmink

K. A. P. M.

Hartman

(2008). Motor skill performance of school-age children with visual impairments. Developmental Medicine & Child Neurology, 50, 139–145. https://doi.org/10.1111/j.1469-8749.2007.02016.x

22.

Ministry of Health Indonesia. (n.d.). Dewasa (kemkes.go.id). https://ayosehat.kemkes.go.id/kategori-usia/dewasa

23.

Miyata

Tamura

Kobayashi

Takeda

Iwamoto

(2022). Berg Balance Scale is a valid measure for plan interventions and for assessing changes in postural balance in patients with stroke. Journal of Rehabilitation Medicine, 54, Article jrm00359. https://doi.org/10.2340/jrm.v54.4443

24.

Myers

A. M.

Fletcher

P. C.

Myers

A. H.

Sherk

(1998). Discriminative and evaluative properties of the Activities-specific Balance Confidence (ABC) Scale. The Journals of Gerontology: Series A, 53(4), M287–M294. https://doi.org/10.1093/gerona/53a.4.m287

25.

Napier-Dovorany

Graham

(n.d.). Evaluating fall risk in people with low vision: A case series. Optometry & Visual Performance. https://www.ovpjournal.org/uploads/2/3/8/9/23898265/ovp1-3_article_napier_web.pdf

26.

Newton

Sanderson

. (2013). The effect of visual impairment on patients’ falls risk. Nursing Older People, 258(8), 16–21. https://doi.org/10.7748/nop2013.10.25.8.16.e489

27.

Ouyang

Zheng

Lin

Fang

(2022). Risk factors of falls in elderly patients with visual impairment. Frontiers in Public Health, 10, Article 984199. https://doi.org/10.3389/fpubh.2022.984199

28.

Patino

M.-C.

McKean-Cowdin

Azen

S. P.

Allison

J. C.

Choudhury

Varma

, & the Los Angeles Latino Eye Study Group (2010). Central and peripheral visual impairment and the risk of falls and falls with injury. Ophthalmology, 117(2), 199–206.

29.

Portfors-Yeomans

C. V.

Riach

C. L.

(2008). Frequency characteristics of postural control of children with and without visual impairment. Developmental Medicine & Child Neurology, 37, 456–463.

30.

Powell

L. E.

Myers

A. M.

(1995). The Activities-specific Balance Confidence (ABC) Scale. The Journals of Gerontology: Series A, 50A, M28–M34. https://doi.org/10.1093/gerona/50A.1.M28

31.

Rashidipour

Meshkati

Badami

Fallah

M. H.

(2021). Balance of children with visual impairment: Effectiveness of game-like exercises at home protocol. Health Education and Health Promotion, 9, 147–152.

32.

Rif’Ati

Halim

Lestari

Y. D.

Moeloek

N. F.

Limburg

(2021). Blindness and visual impairment situation in Indonesia based on rapid assessment of avoidable blindness surveys in 15 provinces. Ophthalmic Epidemiology, 28, 408–419. https://doi.org/10.1080/09286586.2020.185317

33.

Rutkowska

Bednarczuk

Molik

Morgulec-Adamowicz

Marszałek

Kaźmierska-Kowalewska

Koc

(2015). Balance functional assessment in people with visual impairment. Journal of Human Kinetics, 15, 99–109.

34.

Salar

Ardakani

M. K.

Lieberman

L. J.

Beach

P. S.

Perreault

(2022). The effects of balance and core stability training on postural control in people with visual impairment: A systematic review. British Journal of Visual Impairment, 41, 528–541.

35.

Singh

R. R.

Maurya

(2022). Visual impairment and falls among older adults and elderly: Evidence from longitudinal study of ageing in India. BMC Public Health, 22, 2324. https://doi.org/10.1186/s12889-022-14697-2

36.

Sleeuwenhoek

H. C.

Boter

R. D.

Vermeer

(1995). Perceptual motor performance and the social development of visually impaired children. Journal of Visual Impairment & Blindness, 89, 359–367.

37.

Sweeting

Merom

Astuti

P. A. S.

Antoun

Edwards

Ding

(2020). Physical activity interventions for adults who are visually impaired: A systematic review and meta-analysis. BMJ, 10, Article e034036. https://doi.org/10.1136/bmjopen-2019-034036

38.

Talbot

L. A.

Musiol

R. J.

Witham

E. K.

Metter

E. J.

(2005). Falls in young, middle-aged and older community dwelling adults: Perceived cause. environmental factors and injury. BMC Public Health, 51(1), Article 86.

39.

Wang

Qian

M.-L.

Shan

Liu

X.-Q.

(2022). Risk factors for falls among children aged 0–18 years: A systematic review. World Journal of Pediatrics, 18, 647–653. https://doi.org/10.1007/s12519-022-00556-y

40.

Waninge

van Wijck

Steenbergen

van der Schans

C. P.

(2011). Feasibility and reliability of the modified berg balance scale in persons with severe intellectual and visual disabilities. Journal of Applied Research in Intellectual Disabilities, 55(3), 292–301.

41.

Wiszomirska

Kaczmarczyk

Błażkiewicz

Wit

(2015). The impact of a vestibular-stimulating exercise regime on postural stability in people with visual impairment. Biomed Research International, 2015, Article 136969. https://doi.org/10.1155/2015/136969

42.

Wood

J. M.

Lacherez

Black

A. A.

Cole

M. H.

Boon

M. Y.

Kerr

G. K.

(2011). Risk of falls, injurious falls, and other injuries resulting from visual impairment among older adults with age-related macular degeneration. Investigate Ophthalmology & Visual Science, 52, 5088–5092.