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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.