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Physical activity interventions for adults who are visually impaired: a systematic review and meta-analysis
  1. Joanna Sweeting1,2,
  2. Dafna Merom3,
  3. Putu Ayu Swandewi Astuti2,4,
  4. Michael Antoun5,
  5. Kate Edwards1,6,
  6. Ding Ding1,2
  1. 1 Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
  2. 2 Prevention Research Collaboration, The University of Sydney School of Public Health, Camperdown, New South Wales, Australia
  3. 3 Physical Activity and Health, Western Sydney University School of Science and Health, Campbelltown, New South Wales, Australia
  4. 4 Department of Public Health and Faculty of Medicine, Universitas Udayana, Bukit Jimbaran, Bali, Indonesia
  5. 5 Sydney Dental School, The University of Sydney, Camperdown, New South Wales, Australia
  6. 6 Faculty of Health Sciences, The University of Sydney, Cumberland, New South Wales, Australia
  1. Correspondence to Dr Joanna Sweeting; joanna.sweeting{at}sydney.edu.au

Abstract

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.

  • public health
  • sports medicine
  • preventive medicine
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors JS, DM, MA, KE and DD were involved in study design. JS and MA performed the systematic search. JS, DM, PASA, KE and DD made significant contributions to the analysis and/or interpretation of the data. JS, DM, PASA, MA, KE and DD all contributed to drafting and revising the work.

  • Funding The work was supported by a Sydney Research Accelerator (SOAR) prize awarded to Ding. Ding is funded by a National Heart Foundation Future Leader Fellowship.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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