Development and Evaluation of the Walk for Health Program: A Physical Activity Intervention for Adults with Visual Impairments

Abstract

Background Although the pervasive comorbidity documented in adults with visual impairments may be linked to physical inactivity, little is known regarding the extent to which mobility and health status can be improved in this population. The aim of this preliminary study was to develop and implement an adaptive, community-based walking program for adults with visual impairments and to evaluate its impact on daily step activity, cardiovascular health, body composition, and lipid function. Methods During an 8-week period, 17 adults (age = 47.3 ± 12.3 years) with visual impairments were prompted at biweekly intervals (weeks 1, 3, 5) to increase their daily step activity by 1,000 steps per day and maintain these gains during weeks 2, 4, and 6. Participants were asked to sustain walking levels achieved by week 6 during the final 2 weeks of the program. Results Following the walking intervention, participants displayed a 78% increase in daily step activity (p < .01), but no improvements in cardiovascular health, body composition, or lipid function were observed. Conclusion Daily step activity was improved after completion of the walking program, but markers of health-related fitness remained unchanged. Future studies should be conducted to quantify the volume of physical activity required to improve the health status of persons with visual impairments.

Physical activity interventions for adults who are visually impaired: a systematic review and meta-analysis

“…Visual impairment was defined in several ways with varying levels of detail. Most studies provided cut-points of visual acuity (eg, 6/24 or worse), while some linked these cut points to those designated by the WHO International Classification of Diseases Codes 31 32. Visual conditions identified included age-related conditions such as macular degeneration and cataracts, diabetic retinopathy, glaucoma, corneal scars and congenital blindness.…”

“…Of these, three used the Otago exercise programme,30 33 34 three used general physical activity training programme aiming to improve balance29 35 36 and one used the Matter of Balance programme 37 38. The remaining interventions were based on other forms of physical activity including walking (n=1),31 tai chi (n=2),39 40 Alexander technique (n=1),25 26 Yoga (n=2),41 42 dance (n=1),43 aerobics (n=1)27 and core stability training (n=1) 28. One study used a falls prevention programme (FallProof) as a control, comparing to a dance-based intervention programme 32.…”

“…One study used a falls prevention programme (FallProof) as a control, comparing to a dance-based intervention programme 32. The interventions were predominately delivered in a group based, face-to-face format with only three being chiefly self-directed with periodic contact from investigators 31 33 34. The interventions ran for an average of 13 weeks (range of 4 weeks to 1 year) with three-quarters (n=13/17, 76%) having a duration of 4–12 weeks.…”

“…Although on the surface visual impairment may appear to be a barrier to undertaking moderate or vigorous physical activity, the existence of numerous sports for visually impaired athletes at Paralympic level would suggest otherwise 50. Even though few individuals reach this height of athletic ability, it is evident that visually impaired individuals can perform higher intensity activities, evidenced by the feasibility of physical activity trials with walking and aerobics as the intervention 27 31. Therefore, development of interventions for moderate and/or vigorous physical activity could form a focus in future work.…”

“…In terms of delivery mode, studies were predominately group-based, with 9 of 16 (delivery mode unknown in one study) purely delivered in a face-to-face manner, and a further four involving group classes with additional self-directed practice at home. The remaining three studies were of a more self-directed nature with varying levels of investigator involvement including five home visits throughout the yearlong study,33 five home visits (from occupational therapist or peer mentor) and two phone calls over the 6-month duration,34 and a single orientation session followed by self-directed activity 31. Further intervention studies could compare the effectiveness of group-based and self-directed trials to determine the possibility of reducing investigator burden in delivery by increasing self-directed options where possible.…”