Audio-motor and related audio-spatial interventions for spatial function in people with visual impairment: a systematic review

Background Auditory feedback linked to movement or active spatial exploration may support non-visual spatial learning, but the evidence spans conceptually distinct training, assistive-technology, and sensory-substitution approaches. Objective To systematically review audio-motor and related audio-spatial interventions for auditory localization, proprioception, spatial perception, spatial cognition, mobility, and navigation in people with visual impairment. Methods Web of Science, Scopus, and EBSCOhost were searched from database inception to December 2024. A targeted supplementary search through 15 July 2026 was used to identify recent contextual studies and emerging technologies, but was not treated as a complete de novo update of the principal systematic search. Peer-reviewed intervention studies involving participants with visual impairment were eligible; sighted participants were permitted only as comparator groups. Risk of bias was assessed with RoB 2 for studies reported as randomized and ROBINS-I for non-randomized studies. Because populations, intervention mechanisms, study designs, outcomes, measurement instruments, and reporting formats were heterogeneous, findings were synthesized narratively following the Synthesis Without Meta-analysis (SWiM) framework. Results Ten studies involving 151 participants were included in the principal synthesis. Interventions comprised movement-contingent auditory devices, spatial-audio or game-based navigation training, audiovisual motor training, and camera-based auditory feedback. Findings suggested possible improvements in selected task-specific outcomes, particularly auditory localization, reaching or proprioceptive matching, and virtual or real-world navigation. Standardized effect sizes were presented when reported, but effects were inconsistent and several studies relied on small samples, within-group comparisons, or non-randomized designs. Conclusions The certainty of evidence was low or very low across outcome domains. Preliminary evidence suggests that selected audio-motor and related audio-spatial interventions may improve specific spatial tasks in some visually impaired populations, but heterogeneity, imprecision, and risk of bias preclude firm conclusions regarding clinical effectiveness, optimal dose, long-term benefit, or prevention of developmental delay.