title: The effectiveness of low-vision rehabilitation on participation in daily living and quality of life.
abstract: OBJECTIVE
  To evaluate the effectiveness of a multidisciplinary low-vision rehabilitation program on quality of life evaluated by the Impact of Vision Impairment (IVI) instrument.
  
  
  METHODS
  First-time referrals to low-vision clinics were assessed before and after rehabilitation (3-6 months). Rasch analysis was used to estimate the three IVI subscale and overall values on an interval scale. A mixed between-within subjects ANOVA was used to identify whether presenting visual acuity had an interaction effect with rehabilitation change. Cohen d values were used to estimate the magnitude of the change and the standardized response mean (SRM) procedure was selected to determine the clinical significance of the rehabilitation-induced changes.
  
  
  RESULTS
  One hundred twenty-four women and 68 men (mean age, 80.3 years) completed the rehabilitation. Most had age-related macular degeneration (62%, 119) and were moderately to severely vision impaired (<6/18; 78%, 149). After rehabilitation, significant improvements were recorded for the overall IVI score (P = 0.006) and two subscales: reading and accessing information and emotional well-being (P = 0.007 and 0.009, respectively). No significant improvement was found on the mobility and independence subscale (P = 0.07). The magnitude of the post-intervention improvement was found to be relatively moderate (Cohen d = 0.17-0.30) and clinically modest (SRM = 0.22-0.42).
  
  
  CONCLUSIONS
  Significant improvements in overall quality of life and two specific areas of daily living in people with low vision were found, although the magnitude and clinical significance of the rehabilitation-induced gains were modest. Further investigation in other models of low-vision rehabilitation is needed to optimize quality of life gains in people with low vision.
authors: Department of Ophthalmology, Centre for Eye Research Australia, The University of Melbourne, East Melbourne, Victoria 8002, Australia. ecosse@unimelb.edu.au
authors: Ecosse L
authors: EL
authors: Lamoureux
authors: Julie F
authors: JF
authors: Pallant
authors: Konrad
authors: K
authors: Pesudovs
authors: Gwyn
authors: G
authors: Rees
authors: Jennifer B
authors: JB
authors: Hassell
authors: Jill E
authors: JE
authors: Keeffe
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D011788:Quality of Life; D016896:Treatment Outcome; D015354:Vision, Low / Q000534:rehabilitation*; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data