Orientation and mobility training for adults with low vision

The review found two small quasi-randomised trials with similar methods, comparing training to physical exercise and assessing O&M physical performance by means of a volunteer or a professional, which were unable to demonstrate a difference. Therefore, there is little evidence on which type of O&M training is better for people with low vision who have specific characteristics and needs. Orientation and mobility instructors and scientists should plan randomised controlled trials (RCTs) to compare the effectiveness of different types of O&M training. A consensus is needed on the adoption of standard measurement instruments of mobility performance which are proven to be reliable and sensitive to the diverse mobility needs of people with low vision. For this purpose, questionnaires and performance-based tests may represent different tools that explore people with low vision's subjective experience or their objective functioning, respectively. In fact, it has to be observed that low vision rehabilitation research is increasingly shifting towards the use of quality of life questionnaires as an outcome measure, sometimes with the aim to study complex and multidisciplinary interventions including different types of education and support, of which O&M can be a component. An example of this is an ongoing cluster RCT conducted by Zijlstra et al. in The Netherlands. This trial is designed to compare standardised O&M training with usual O&M care not only for its effectiveness, but also its applicability and acceptability. This study adopts validated questionnaires for patients' subjective assessment of performance during activities of daily living. As performance assessment does not need to be made by an O&M trainer, this allows for masking of assessors and a patient-centred outcome measure.