Risk of fall (RoF) intervention by affecting visual egocenter through gait analysis and yoked prisms.
BACKGROUND
Following a neurologic event such as traumatic brain injury (TBI), cerebrovascular accident (CVA), and chronic neurological conditions including Parkinson's disease, multiple sclerosis, and cerebral palsy a shift in the visual midline (egocenter) can directly affect posture, balance and spatial orientation. As a consequence, this increases the risk of fall (RoF) and injury that imposes a major financial burden on the public health system.


OBJECTIVE
To determine if there is a statistically significant change in balance with the intervention of yoked prisms to reduce the risk of fall in subjects with neurological impairments.


METHODS
Ambulation of thirty-six subjects was evaluated on a pressure sensitive mat before and after intervention with yoked prisms. Changes in gait and balance were analyzed in the anterior-posterior (AP) and medial-lateral (ML) axes during ambulation.


RESULTS
T-tests for each measure comparing the difference-of-differences to a zero change at baseline returned statistically significant reductions in both AP (p <  0.0001; 95% CI: 1.368- 2.976) and ML (p = 0.0002; 95% CI: 1.472- 4.173) imbalances using specifically directed yoked prisms to correct the visual midline deviation.


CONCLUSIONS
These findings demonstrate that yoked prisms have the potential to provide a cost-effective means to restore the visual midline thereby improving balance, reduce RoF and subsequent injury.
Padula Institute of Vision Rehabilitation, Guilford, CT, USA.|Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
William V
WV
Padula
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Prem
P
Subramanian
Padula Institute of Vision Rehabilitation, Guilford, CT, USA.
April
A
Spurling
Padula Institute of Vision Rehabilitation, Guilford, CT, USA.
Jonathan
J
Jenness
D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D002493:Central Nervous System Diseases / Q000534:rehabilitation*; D005260:Female; D005684:Gait; D006801:Humans; D007909:Lenses; D008297:Male; D004856:Postural Balance; D016138:Walking
Visual midline shift syndrome; balance; spatial visual process; visual egocenter; yoked prisms