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

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.