Table 3.

Evidence Table for Daily Activity Performance for Older Adults With Low Vision

Author/Year	Level of Evidence/Study Design/Participants/Inclusion Criteria	Intervention and Control	Outcome Measures	Results
Low Vision Rehabilitation Services
Coulmont et al. (2013)	Level III 1-group, pretest–posttest N = 100 (M age = 81.8 ± 7.2; 76% female) Inclusion Criteria Age ≥65, enrolled in a rehabilitation program for visual impairment	Intervention Rehabilitation program for visual impairment delivered by orientation and mobility specialists, occupational therapists, low vision educators, social workers, and others Control No control	Functional Global Profile	Number of direct service hours was significantly and positively correlated with Functional Global Profile scores.
Goldstein et al. (2015)	Level III 1-group, pretest–posttest N = 441 (M age = 73.9 ± 14.0; 69.4% female) Inclusion Criteria Age ≥18, new patients at collaborating clinical centers	Intervention Low vision rehabilitation services including evaluation of visual function and evaluation and/or treatment by an occupational therapist, vision rehabilitation therapist, or other professional depending on the clinical site Control No control	Activity Inventory	Nearly half of participants showed clinically meaningful differences in overall visual ability after rehabilitation (Cohen’s d = 0.87).
Pearce et al. (2011)	Level I 2-group RCT N = 96 Intervention group, n = NR (M age = 73.3 ± 0.7; 61% female) Control group, n = NR (M age = 72.8 ± 0.6; 64% female) Inclusion Criteria Age ≥18 yr, first-time attendee at a clinic for low vision assessments	Intervention Low vision assessment plus 1-hr visit to an optician in the hospital to review low vision devices, discuss specific problems noted at home, and notify available services Control Low vision assessment plus a well-person check with a nurse who measured height, weight, vision, and blood pressure	Modified Massof Activity Inventory	Both groups showed significant improvement, with no difference between groups.
Renieri et al. (2013)	Level III 1-group, pretest–posttest N = 50 (M age = 75.0 ± 11.3; 46% female) Inclusion Criteria Consecutive patients scheduled for outpatient low vision services	Intervention Low vision rehabilitation services involving an ophthalmological evaluation, fitting for magnifying devices and vision aids, education, and suggestions for managing daily activities Control No control	Modified German NEI VFQ–25	Participants reported significant improvement in scores on the Near Tasks subscale of the NEI VFQ–25.
Ryan et al. (2013)	Level III 1-group, pretest–posttest N = 343 (Mdn age = 82, range = 75–86; 72% female) Inclusion Criteria Age >18, distance acuity of 6/12 or worse, near acuity of N6 or worse, requirement for low vision rehabilitation	Intervention Community-based low vision services including assessment of participants’ understanding of their ocular condition and prognosis, discussion of needs and initial goal setting, vision assessment, provision of low vision aids, suggestions for lighting and other methods of enhancing vision, provision of information on other rehabilitative services, and referral for additional services, reassessment, and follow-up Control No control	7-item NEI–VFQ	Participants showed a significant reduction in visual disability from baseline to 3 mo and from baseline to 18 mo.
Stelmack et al. (2012)	Level I 2-group RCT N = 100 Intervention group, n = 44 (M age = 78.9 ± 6.6; 0% female) Control group, n = 56 (M age = 79.9 ± 6.7; 3.6% female) Inclusion Criteria Age ≥65, macular disease, visual acuity in the better-seeing eye worse than 20/100 but better than 20/500	Intervention 5 weekly low vision rehabilitation therapy sessions and a home visit from a visual therapist who taught strategies for using remaining vision and low vision devices, plus 5 hr/wk of homework Control Wait list; offered standard therapy after 4 mo	48-item Veterans Affairs Low-Vision Visual Functioning Questionnaire	A significant group difference was found in overall visual ability at 4 mo and 12 mo favoring the intervention group.
Self-Management Approach
Alma et al. (2012)	Level III 1-group, pretest–posttest N = 26 (M age = 73.2 ± 8.0; 69% female) Inclusion Criteria Age ≥55, referred to a low vision rehabilitation center per Dutch guidelines	Intervention Multidisciplinary group rehabilitation program with 20 weekly group sessions focused on 4 components: (1) practical training (by occupational therapists); (2) education, social interaction, counseling, and training in problem-solving skills; (3) individual and group goal setting; and (4) a home-based exercise program Control No control	Utrecht Scale for Evaluation of Rehabilitation–Participation	No significant results were found at the scale level. At the item level, a significant increase was found in frequency of engaging in chores in and around the house between pretest and 6-mo follow-up, and a significant decrease was found in restrictions in housekeeping between posttest and 6-mo follow-up.
Rees et al. (2015)	Level I 2-group RCT N = 153 Intervention group, n = 93 (M age = 80.1 ± 8.1; 58.1% female) Control group, n = 60 (M age = 80.5 ± 8.1; 63.3% female) Inclusion Criteria Age ≥55, independent, visual acuity of <6/12 and >6/480 in the better-seeing eye	Intervention 8-wk group self-management program involving problem-solving skills training, goal planning, and usual low vision rehabilitation services Control Usual low vision rehabilitation services	Impact of Vision Impairment Questionnaire	No significant between-group differences were found at 1-mo and 6-mo follow-up.
Rovner et al. (2013)	Level I 2-group RCT N = 141 Intervention group, n = 121 (M age = 82.7 ± 6.6; 67.8% female) Control group, n = 120 (M age = 82.8 ± 7.3; 59.2% female) Inclusion Criteria Age ≥65, bilateral AMD, moderate difficulty in ≥1 valued vision-function goal	Intervention Problem-solving therapy teaching problem-solving skills in a structured way to enable participants to systematically identify problems, generate alternative solutions, select the best solution, develop and conduct a plan, and evaluate whether the problem is solved Control Supportive therapy, a structured, standardized psychological treatment	• Targeted Vision Function • NEI VFQ–25	No significant between-group differences were found at 3 mo or 6 mo on either outcome measure.
Rovner et al. (2014)	Level I 2-group RCT N = 188 Intervention group, n = 96 (M age = 85.2 ± 6.6; 72.9% female) Control group, n = 92 (M age = 82.7 ± 6.9; 67.4% female) Inclusion Criteria Age ≥65, bilateral AMD, visual acuity <20/70, moderate difficulty performing a valued vision-dependent activity, subthreshold depressive symptoms	Intervention Low vision rehabilitation services plus in-home behavior activation therapy, emphasizing the links among action, mood, and mastery and promoting self-efficacy and social connection as ways to improve mood and function and counter self-defeating behaviors, delivered by occupational therapists in 6 1-hr sessions over 8 wk, in addition to environmental modifications to improve function and action plans Control Low vision rehabilitation services plus in-home supportive therapy emphasizing discussion of illness, disability, and vision loss, 6 1-hr sessions over 8 wk	• Activities Inventory • NEI VFQ–25	Activities Inventory scores improved in both groups at 4 mo, with no between-group difference. The intervention group improved significantly in NEI VFQ–25 Near Activities scores at 4 mo, with no between-group difference.
Tay et al. (2014)	Level III 1-group, pretest–posttest N = 9 (M age = 63 ± 9.2; 44.4% female) Inclusion Criteria Age ≥50, visual acuity worse than 6/24 with correction in the better-seeing eye	Intervention Singapore Low Vision Self-Management Program consisting of 6 weekly half-day group sessions led by an occupational therapist and focused on understanding vision loss; maximizing remaining vision and using other senses; staying in touch and communication; managing personal care, medications, and money; household management; participation in daily activities and hobbies; and safety and mobility Control No control	Low Vision Quality of Life Questionnaire	No significant difference was found between baseline and posttest.
Whitson et al. (2013)	Level III 1-group, pretest–posttest N = 12 (M age = 84.5 ± 4.7; 75% female) Inclusion Criteria Age ≥65, macular disease, cognitive deficits	Intervention Memory or Reasoning Enhanced Low Vision Rehabilitation program, consisting of twice-weekly face-to-face sessions over 6 wk with an occupational therapist in a quiet environment with a focused education agenda and the involvement of a cognitively and visually intact friend or family member to help participants achieve functional goals Control No control	• NEI VFQ–25 • Satisfaction with IADLs • Timed activity performance measures	Significant improvements were found in NEI VFQ–25 Composite and Near Activities scores. Participants showed improvements in IADL satisfaction scores and significantly reduced time in activities including filling in a crossword puzzle answer and making a 4-item grocery list.
Tango
Hackney et al. (2013)	Level III 1-group, repeated-measure N = 13 (M age = 86.9 ± 5.9; 53.8% female) Inclusion Criteria Age ≥75, diagnosed with visual impairment, able to walk 10 ft with assistance	Intervention Adapted tango dance program in which participants were paired with partners without vision loss, 20 1.5-hr lessons over 12 wk Control No control	NEI VFQ–25	Significant improvements were found at program completion and 1-mo follow-up.
Hackney et al. (2015)	Level I 2-group, repeated-measure RCT N = 32 Intervention group, n = 14 (M age = 84.9 ± 9.0; 50% female) Control group, n = 18 (M age = 74.8 ± 11.2; 56% female) Inclusion Criteria Age ≥50, diagnosed with eye pathology and/or visual acuity with presenting correction less than 20/60 in the better-seeing eye, able to walk 10 ft or more independently	Intervention Adapted tango program identical to the intervention in Hackney et al. (2013) Control FallProofTM, a standard fall prevention protocol with lesson plans for specific exercises and progressions	NEI VFQ–25	Both groups showed significant improvement. However, no evidence was provided that tango was significantly more effective than FallProof.

Note. AMD = age-related macular degeneration; IADLs = instrumental activities of daily living; M = mean; Mdn = median; NEI VFQ–25 = National Eye Institute Visual Function Questionnaire–25; NR = not reported; RCT = randomized controlled trial.

Suggested citation: Liu, C.-j., & Chang, M. C. (2020). Interventions within the scope of occupational therapy to improve performance of daily activities for older adults with low vision: A systematic review (Table 3). American Journal of Occupational Therapy, 74, 7401185010. https://doi.org/10.5014/ajot.2019.038372