Reduced health-related quality of life among Japanese college students with visual impairment

Physical Activity and Quality of Life in People With Visual Impairments: A Systematic Review

Objective

This systematic review aimed to investigate the relationship between physical activity and quality of life (QOL) in people with visual impairments. Methods: Electronic searches were performed in PubMed, SPORTdiscus, CINAHL, Embase, and Web of Science. Observational studies describing the relationship between physical activity and QOL in adults with visual impairments were included. The Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies was used to assess the quality of the studies. Results: Overall, 327 studies were identified, and eight met the inclusion criteria. All studies had cross-sectional designs and seven were performed in developed countries. Physical activity was assessed objectively by one study, and five studies used the International Physical Activity Questionnaire. The World Health Organization Quality of Life Questionnaire was the most used instrument to measure QOL. Six studies reported a positive relationship between physical activity and QOL domains, as follows: life satisfaction, activity limitation, fair or poor health, physically and mentally unhealthy days, psychological health, and overall QOL. Conclusion: People with visual impairments who are engaged in physical activity are more likely to have better QOL outcomes.

The association between visual impairment and fatigue: a systematic review and meta-analysis of observational studies

PURPOSE

The aim was to compare fatigue levels between patients with visual impairment and controls with normal sight and to examine the association between fatigue and vision loss severity.

METHODS

A systematic literature search was performed using databases of PubMed, Embase, PsycINFO and Cochrane to identify observational studies with outcomes related to fatigue (e.g. vitality subscale of the Short-Form 36, Fatigue Assessment Scale). A meta-analysis was performed using standardised mean differences (SMDs) and odds ratios (OR) to quantitatively summarise the association between visual impairment and fatigue. Sources of heterogeneity were explored by subgroup and sensitivity analyses. Study quality was assessed with the Newcastle-Ottawa scale.

RESULTS

After reviewing 4477 studies, 22 studies with a total of 40 004 participants were included, of which 18 contributed to meta-analysis. Among these, eight were assessed as moderate quality studies and 10 as high quality studies. Pooled analysis involving 2500 patients and 8395 controls showed higher fatigue severity levels (S.M.D. = -0.36, 95% CI -0.50 to -0.22, 14 studies) among visually impaired patients compared to normally sighted controls. This effect size was small and persisted in sensitivity analyses that involved study quality, fatigue assessment tools and visual acuity data. Furthermore, pooled analysis of four studies including 2615 patients and 5438 controls showed a significant association between visual impairment and fatigue (OR = 2.61, 95% CI 1.69 to 4.04). Secondary meta-analysis of four studies showed no significant difference in fatigue severity (S.M.D. = 0.01, 95% CI -0.37 to 0.39) between patients with moderate visual impairment and patients with severe visual impairment or blindness.

CONCLUSIONS

Current moderate to high quality evidence suggest that patients with visual impairment experience more severe fatigue symptoms than persons with normal sight. However, a limited number of available studies indicates that fatigue is not associated with severity of vision loss. Future studies are required to determine which factors and underlying mechanisms may explain the association between visual impairment and fatigue. Discussing fatigue at an early stage and developing intervention options for vision-related fatigue should be considered within the field of low vision rehabilitation.