Short- and Long-Term Effects of an Intensive Inpatient Vision Rehabilitation Program

Abstract

Stelmack JA, Moran D’A, Dean D, Massof RW. Short- and long-term effects of an intensive inpatient vision rehabilitation program. Objective To assess the effects of a visual rehabilitation program on visually impaired subjects’ visual ability and ability to perform activities. Design Prospective observational study. Setting Telephone interviews of respondents in their homes the week before admission to the rehabilitation center and 3 months and 1 year after discharge from the rehabilitation center. Participants A total of 178 consecutive patients from the Hines Blind Rehabilitation Center participated in development of the 48-item Veterans Affairs Low Vision Visual Functioning Questionnaire (VA LV VFQ-48). Data were analyzed for 95 who participated in all 3 administrations of the questionnaire. Intervention Comprehensive blind rehabilitation program (mean hospital admission, 40d). Main Outcome Measure The self-report ratings of patients’ difficulty performing 48 activities on the VA LV VFQ-48. Results The increase in visual ability ± standard deviation of .981±.482 logits (equivalent to an 8-line improvement in visual acuity on an Early Treatment of Diabetic Retinopathy Study chart) at 3 months postrehabilitation decreased to .682±.485 logits (equivalent to a loss of 2.5 lines of visual acuity on the same chart) 1 year postrehabilitation. The effect sizes measured at 3 months (2.035) and 1 year (1.495) indicate large treatment effects corresponding to statistically significant differences for the increase in visual ability at 3 months and 1 year postrehabilitation (paired 2-tailed t tests, P<.001) relative to pretreatment measures. The difference in visual abilities measured at 3 months and 1 year posttreatment also is statistically significant ( P<.001). Conclusions Treatment effects decreased over the 12-month follow-up period. However, the group of patients whose data were analyzed was still statistically and clinically significantly better at their 1-year follow-up than before beginning treatment.