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Balance Control in Individuals With Visual Impairment: A Systematic Review and Meta-Analysis

Hamed Zarei, Ali Asghar Norasteh, Lauren J. Lieberman, Michael W. Ertel, and Ali Brian

Background: Individuals with visual impairment have balance deficits; therefore, this systematic review aimed to provide comprehensive insights into the balance control of individuals with visual impairments when compared with individuals with full vision. Methods: Primary sources were obtained from eight databases including PubMed, LILACS, Science Direct, SCOPUS, CINAHL, PEDro, CENTRAL, and Web of Science. The search period covered years from inception to January 10, 2022. Results: A total of 20 studies with 29 trials with 1,280 participants were included in the systematic review. The results showed that individuals with sight had better static and dynamic balance than individuals with visual impairment (p = .001). However, individuals with visual impairment had significantly better static balance with visual perturbation and stronger static balance with visual and proprioception perturbation (p = .001). Furthermore, individuals with sight had better balance control than individuals with visual impairment who participated in sports (p = .001). Finally, individuals with visual impairment who participated in sports had better balance control than sedentary people with visual impairment (p = .001). Conclusion: Individuals with visual impairment have defects in both dynamic and static balance when compared to individuals with sight. In addition, balance improved with increasing age in individuals with visual impairment while balance control was dependent on the proprioception and vestibular systems. Also, individuals with sight had better balance than individuals with visual impairment who participated in sports and individuals with visual impairment who participated in sports compared with sedentary people with visual impairment.

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Balance Recovery Strategy in Children With and Without Hearing or Visual Impairments

Hamed Zarei, Ali Asghar Norasteh, Lauren J. Lieberman, and Ali Brian

Purpose: The purpose of this study was to examine the balance recovery strategy in children with hearing (HI) and visual impairments (VI) compared with those without these disorders. Materials and Methods: This study featured a cross-sectional design with subjects (N = 45) placed within one of three equally stratified purposive groups (HI, VI, and comparison) within the age range of 9–13 years (mean = 11.43, SD = 1.5). Balance recovery strategy was measured in static and after-perturbation conditions by a four-camera Vicon system used to record three-dimensional lower body kinematic data. A repeated-measures analysis of variance (3 × 2, Group × Condition) was utilized to analyze data. Significance was set at p ≤ .05. Results: In the static condition, the results of the study showed that there was no significant difference between the groups in the ankle joint sway (p > .05). In hip joint sway, VI children had greater sway compared with comparison (p = .001) and HI children (p = .02). Also, HI children had greater sways than comparison (p = .02). In the after-perturbation condition, the results showed that VI children had greater sway in the hip and ankle joints than HI children (p = .001) and comparison (p = .001) to restore and maintain balance. Conclusion: It seems that comparison as well as higher proportion VI children use a hip strategy to maintain and restore balance. Also, it seems that HI children use a different strategy (ankle strategy) to maintain and restore balance compared with comparison and VI children.

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The Effects of an Integrative, Universally Designed Motor Skill Intervention for Young Children With and Without Disabilities

Sally Taunton Miedema, Ali Brian, Adam Pennell, Lauren Lieberman, Larissa True, Collin Webster, and David Stodden

Many interventions feature a singular component approach to targeting children’s motor competency and proficiency. Yet, little is known about the use of integrative interventions to meet the complex developmental needs of children aged 3–6 years. The purpose of this study was to examine the effects of an integrative universally designed intervention on children with and without disabilities’ motor competency and proficiency. We selected children (N = 111; disability = 24; no disability = 87) to participate in either a school-based integrative motor intervention (n = 53) or a control condition (n = 58). Children in the integrative motor intervention both with and without disabilities showed significant improvement in motor competency and proficiency (p < .001) as compared with peers with and without disabilities in a control condition. Early childhood center directors (e.g., preschool and kindergarten) should consider implementing integrative universally designed interventions targeting multiple aspects of motor development to remediate delays in children with and without disabilities.

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Adapted Physical Education Collaborative Consulting: A Systematic Literature Review

Patricia Santos de Oliveira, Mey de Abreu van Munster, Joslei Viana de Souza, and Lauren J. Lieberman

The purpose of this review was to analyze English language articles that addressed collaborative consulting in adapted physical education (APE). A systematic process was used to search the literature in six different databases. First, article quality was analyzed. Subsequently, thematic categorization of data was performed. Eleven articles published between 1995 and 2015 that satisfied the criteria for inclusion in the study were selected. The results were organized into seven thematic categories: the concept and definition of consultation, the role of the APE consultant, the planning and documentation of APE consulting, the stages of APE consulting, general physical education and APE teachers’ perceptions regarding consulting, major challenges of APE consulting, and collaborative work training for physical education teachers. In conclusion, although research remains scarce, all of the selected articles reinforce the relevance of collaborative consulting for including students with disabilities in general physical education settings. Further investigation, particularly through empirical studies, must be encouraged.

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Exploring Children/Adolescents With Visual Impairments’ Physical Literacy: A Preliminary Investigation of Autonomous Motivation

Ali Brian, An De Meester, Aija Klavina, J. Megan Irwin, Sally Taunton, Adam Pennell, and Lauren J. Lieberman

Physical literacy refers to the confidence, competence, motivation, knowledge, and understanding to value and take responsibility for engagement in physical activities throughout the lifespan. Little is known regarding the physical literacy of children/adolescents with visual impairments (VIs). Purpose: The purpose of this study was to examine predictors of autonomous motivation in children/adolescents with VI (N = 41) from Latvia and the United States. A secondary aim was to explore differential effects of the country regarding all variables of interest. Methods: Within this preliminary investigation, levels of perceived motor competence, competence satisfaction, and autonomous motivation were captured in children/adolescents with VI located in Latvia and the United States. Results: Competence satisfaction and perceived motor competence significantly predicted autonomous motivation regardless of location. Significant differences regarding country occurred for competence satisfaction and autonomous motivation. Discussion/Conclusion: Implications for cultivating physical literacy for children/adolescents with VI involve strategies for physical educators focusing on fostering motivation.

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Longitudinal Locomotor Competence and Body Mass Index Across Self-Reported Gender and Vision Level for Youth With Visual Impairments: A 3-Year Investigation

Ali Brian, Angela Starrett, Adam Pennell, Pamela Haibach-Beach, Emily Gilbert, Alexandra Stribing, Sally Taunton Miedema, and Lauren Lieberman

Youth with visual impairments are more likely to be overweight than peers without visual impairments and often struggle with their locomotor skills. Locomotor development can combat unhealthy body weight statuses by supporting physical activity behaviors. There are no longitudinal investigations concerning the locomotor skill and body mass index (BMI) developmental trajectories of youth with visual impairments. The purpose of this study was to examine the 3-year developmental trajectory of the locomotor skills and BMI of youth with visual impairments including differential effects of self-reported gender and degree of vision. Participants (N = 34, M age = 11.75 years, 47% female) showed severely delayed and arrested locomotor development with increases in BMI across 3 years regardless of self-reported gender or degree of vision. Participants failed to breech a proficiency barrier of motor competence to combat against increases in BMI across time. Additional longitudinal inquiries are needed.

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Factor Structure of the Barriers to Physical Activity Scale for Youth With Visual Impairments

Jeffrey J. Martin, Erin E. Snapp, E. Whitney G. Moore, Lauren J. Lieberman, Ellen Armstrong, and Staci Mannella

Youth with visual impairments (VIs) often experience unique barriers to physical activity compared with their sighted peers. A psychometrically sound scale for assessing barriers to physical activity for youth with VI is needed to facilitate research. The purpose of this study was to confirm the ability of the previously identified three-factor structure of the Physical Activity Barriers Questionnaire for youth with Visual Impairments (PABQ-VI) to produce scores considered to be valid and reliable that perform equally well across age, VI severity, and gender. Our results supported the three-factor structure and that the PABQ-VI produces scores considered valid and reliable. Mean, variance, and correlation differences were found in personal, social, and environmental barriers for age and VI severity, but not gender. Researchers can use the PABQ-VI to test and evaluate ways to reduce barriers for this population.

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The Effects of Ecologically Valid Intervention Strategies on the Locomotor Skills of Children With Visual Impairments

Ali Brian, Laura Bostick, Angela Starrett, Aija Klavina, Sally Taunton Miedema, Adam Pennell, Alex Stribing, Emily Gilbert, and Lauren J. Lieberman

Children with visual impairments often exhibit difficulties with locomotor skills (e.g., the ability to move one’s body from one place to another), warranting the need for ecologically valid interventions with conditions that attempt to match the real world in a variety of settings. Parents and physical education teachers are the ones choosing to provide movement opportunities for children with visual impairments and must be included in any ecologically valid intervention strategy. This was a descriptive-analytic study. To support the greatest diversity in settings, the authors recruited 94 participants (blind = 44 and low vision = 50; M age = 13.01 years, SD = 3.26) from schools for the deaf and blind in the United States (teacher led, n = 17) or Latvia (teacher led, n = 57), through an online LISTSERV throughout the United States (parent led, n = 10), and a control subgroup (n = 10). At the pretest, no participant’s motor development met age expectations. Children with visual impairments from multiple locations and cultures significantly improved compared with controls who did not. Results were most favorable when the physical educator was the interventionist. However, further research is needed to replicate these findings.