Low vision rehabilitation in improving the quality of life for patients with impaired vision A systematic review and meta-analysis of 52 randomized clinical trials
机构:[1]Department of Physical Therapy, Beijing Bo’ai Hospital, Chinese Rehabilitation Research Centre,[2]Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine,[3]Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University,临床科室康复医学科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[4]Department of Rehabilitation Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University,[5]Department of Rehabilitation Medicine, Beijing Haidian Hospital, Beijing.
Background & aim: Low vision rehabilitation optimizes the use of residual vision after severe vision loss, but also teaches skills to improve visual functioning in daily life. These skills promote independence and active participation in society. This meta-analysis was designed to evaluate the efficacy of low vision rehabilitation in improving the quality of life (QoL) in visually impaired adults. Methods: We searched the Cochrane Library, PubMed, EMBASE, and Web of Science up to January 1, 2020. Randomized controlled trials (RCTs) that compared rehabilitation interventions with active or inactive controls were included. The standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated to compare outcomes. Two reviewers extracted data and assessed trial quality independently. All statistical analyses were performed using the standard statistical procedures of RevMan 5.2. Results: A total of 52 RCTs with 6,239 participants were included in this meta-analysis. Compared to inactive comparators including waiting list or no care, low vision rehabilitation improved vision-related QoL, visual functioning (QoL: psychological aspect), and self-efficacy or self-esteem (QoL: psychological aspect), with pooled SMDs of -0.61 (95% CI -0.95 to -0.26; P = .0006), -1.14 (95% CI -1.69 to -0.59; P < .0001), and -0.84 (95% CI -1.47 to -0.22; P < .0001), respectively. Compared to active comparators, low vision rehabilitation improved vision-related QoL (SMD -0.26; 95% CI -0.46 to -0.06; P = .01) and activities of daily living (QoL: physical aspect) (SMD -0.39; 95% CI -0.67 to -0.12 P < .0001). However, no significant difference in health-related QoL and adaptation to vision loss (QoL: psychological aspect) was found between low vision rehabilitation and inactive comparators. Conclusions: This meta-analysis indicated that low vision rehabilitation interventions, particularly psychological therapies and methods of enhancing vision, may improve vision-related QoL and visual functioning in people with sight loss compared to usual care. Further studies should explore longer maintenance effects and the costs of several types of low vision rehabilitation. Studies characterizing the mechanisms of rehabilitation interventions in different settings, including low-income countries, are also required.
第一作者机构:[1]Department of Physical Therapy, Beijing Bo’ai Hospital, Chinese Rehabilitation Research Centre,
通讯作者:
通讯机构:[2]Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine,[*1]Rehabilitation and Treatment Centre, Wangjing Hospital of CACMS, Chaoyang District, Beijing 100102, China
推荐引用方式(GB/T 7714):
Liu Jianhua,Dong Jige,Chen Yaping,et al.Low vision rehabilitation in improving the quality of life for patients with impaired vision A systematic review and meta-analysis of 52 randomized clinical trials[J].MEDICINE.2021,100(19):doi:10.1097/MD.0000000000025736.
APA:
Liu, Jianhua,Dong, Jige,Chen, Yaping,Zhang, Weidong,Tong, Shuai&Guo, Jiangzhou.(2021).Low vision rehabilitation in improving the quality of life for patients with impaired vision A systematic review and meta-analysis of 52 randomized clinical trials.MEDICINE,100,(19)
MLA:
Liu, Jianhua,et al."Low vision rehabilitation in improving the quality of life for patients with impaired vision A systematic review and meta-analysis of 52 randomized clinical trials".MEDICINE 100..19(2021)