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Multidisciplinary visual rehabilitation in low- and middle-income countries: a systematic review
- Publication Year :
- 2020
- Publisher :
- Taylor & Francis, 2020.
-
Abstract
- To systematically review the evidence for effectiveness of rehabilitation interventions in people who are visually impaired, living in low- and middle-income countries. Fifteen databases and the grey literature were searched up until February 2020; papers were identified according to eligibility criteria, and assessed for risk of bias. Eligible studies were controlled trials (randomised or non-randomised) of rehabilitation interventions for blind or visually impaired adults or children from low- and middle-income countries. Possible outcomes included visual acuity, activities of daily living, safety, quality of life and psychological status. Fifteen eligible studies were identified from India, Turkey, Nigeria, Croatia and Iran. Six studies were randomised, seven were non-randomised trials, and in two the method of allocation was not clear. Participants were adults, children and both adults and children. Seven studies were small (n ≤ 65) and examined the effect of training programmes. Remaining studies compared the effect of low vision aids, economic rehabilitation, goalball, rehabilitation compliance and service delivery methods, including one large four-arm randomised trial (n = 436). Studies measured a variety of outcomes, and mostly showed a positive effect of interventions for pre- and post-intervention assessment, although between intervention group comparisons were often inconclusive. Overall, only four studies had a low risk of bias. A lack of high-quality evidence for rehabilitation interventions is a barrier to provision of low vision services in low- and middle-income countries. Future research should focus on establishing effectiveness and cost-effectiveness of devices and models of vision rehabilitation appropriate for low-resource settings.IMPLICATIONS FOR REHABILITATIONThe systematic review found a lack of high-quality evidence for rehabilitation interventions is a barrier to provision of low vision services in low- and middle-income countries.Consider how visual rehabilitation interventions which have been shown to be effective can be delivered by non-specialists.Ensure that service providers for people who are visually impaired are trained in recognising depression and anxiety and have pathways for referral to mental health services, as appropriate. The systematic review found a lack of high-quality evidence for rehabilitation interventions is a barrier to provision of low vision services in low- and middle-income countries. Consider how visual rehabilitation interventions which have been shown to be effective can be delivered by non-specialists. Ensure that service providers for people who are visually impaired are trained in recognising depression and anxiety and have pathways for referral to mental health services, as appropriate.
- Subjects :
- Adult
030506 rehabilitation
medicine.medical_specialty
Visually impaired
medicine.medical_treatment
Visual rehabilitation
Visual impairment
Vision, Low
Blindness
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Multidisciplinary approach
Activities of Daily Living
Medicine
Humans
Child
Developing Countries
Rehabilitation
business.industry
Low vision
Low and middle income countries
Quality of Life
medicine.symptom
0305 other medical science
business
Rehabilitation interventions
030217 neurology & neurosurgery
Visually Impaired Persons
Subjects
Details
- ISSN :
- 09638288
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....0971b2ac832f5c1c253bd52cd0bed7e2
- Full Text :
- https://doi.org/10.6084/m9.figshare.12850184.v1