Evaluation of a Standardised Orientation and Mobility Training in Older Adults With Low Vision

• activities of daily life (subscale of the Groningen Activity Restriction Scale (GARS)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]
• distance activities and mobility (subscales of the Visual Functioning Questionnaire (VFQ)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]

• activities index (Frenchay Activities Index (FAI)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]
• social support interactions (Social Support List (SSL 12-I)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]
• health-related quality of life (EuroQol 5D (EQ5D)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]
• mental health and dependency (subscale of the Visual Functioning Questionnaire (VFQ)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]
• feelings of anxiety (anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]
• symptoms of depression (depression subscale of the Hospital Anxiety and Depression Scale (HADS-D)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]
• concerns about falling (falls efficacy scale international (FES-I)) [ Time Frame: 5 and 17 weeks ] [ Designated as safety issue: No ]

The purpose of this study is:

1. to develop a standardised orientation and mobility training (O&M-training) in the use of an identification/symbol cane by older adults with low vision, and;
2. to evaluate this newly developed standardised O&M-training with respect to effectiveness and feasibility in a randomised controlled trial.

• Low Vision
• Aged

• Active Comparator: regular O&M-training
  orientation and mobility training in use of the identification cane as provided by mobility trainers
  Intervention: Other: orientation and mobility training
• Experimental: standardised O&M-training
  standardised orientation and mobility training in use of the identification cane as provided by mobility trainers who received instruction in using the standardised protocol
  Intervention: Other: orientation and mobility training

• Ballemans J, Zijlstra GA, van Rens GH, Schouten JS, Kempen GI. Usefulness and acceptability of a standardised orientation and mobility training for partially-sighted older adults using an identification cane. BMC Health Serv Res. 2012 Jun 8;12:141. doi: 10.1186/1472-6963-12-141.
• Zijlstra GA, van Rens GH, Scherder EJ, Brouwer DM, van der Velde J, Verstraten PF, Kempen GI. Effects and feasibility of a standardised orientation and mobility training in using an identification cane for older adults with low vision: design of a randomised controlled trial. BMC Health Serv Res. 2009 Aug 27;9:153.

Inclusion Criteria:

• Aged 55 years or over
• Low vision
• Living independently in the community or in a home for older people
• Able to see large obstacles and to go outside for a short walk or doing groceries

• One of the following:

  1. experiencing difficulties with safely crossing a street
  2. experiencing difficulties with recognising acquaintances outdoors
  3. willing to become recognisable as being partially sighted by using the identification cane
• Written informed consent
• Orientation and Mobility training (O&M-training) in the use of an identification cane

Exclusion Criteria:

• Cognitive impairment (a score of less than 4 on the Abbreviated Mental Test 4)
• Language or hearing problems that impede completing an interview by telephone
• Confinement to bed or possible nursing home admission that impede completion of the O&M-training
• Permanent use of a walking aid incompatible with the use of an identification cane
• Having recently received an O&M-training in the use of an identification cane and permanent use of this cane