Visual Impairments
Conditions
Keywords
Pilates (Equipment-Based Pilates), Vestibular Exercise, Balance Performance, Gait Biomechanics, Muscle Strength, Children, Adolescents
Brief summary
This study looks at whether Reformer Pilates can help children and adolescents with visual impairment improve their balance, walking patterns, and muscle strength. Participants are between 10 and 17 years old. They are randomly placed into one of two groups: an exercise group or a control group. Those in the exercise group take part in 12 supervised Reformer Pilates sessions over 6 weeks, meeting twice a week. Those in the control group keep up with their usual daily activities and do not join the exercise program during this time. Before and after the 6-week period, researchers measure each participant's balance, walking patterns, and muscle strength. They then compare how much each group changed.
Interventions
BEHAVIORALEquipment-Based Pilates Exercise (Reformer)
Participants in this arm attended a supervised Reformer Pilates program, held twice a week for six weeks (12 sessions in total). Sessions were structured around the Reformer apparatus and followed a progressive format, with exercise difficulty gradually increasing as participants advanced through the program.
BEHAVIORALVestibular Exercise Program
Participants in this arm attended a supervised vestibular balance exercise program, held twice a week for six weeks (12 sessions in total). Exercises were performed under varying sensory conditions and progressed in difficulty as participants advanced through the program.
Sponsors
Marmara University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
The two research assistants performing outcome measurements were unaware of participants' intervention/control group allocation; however, the principal investigator's involvement, despite being aware of allocation, rendered the study effectively open-label.
Eligibility
Sex/Gender
ALL
Age
10 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
* Children and adolescents aged 10 to 17 years * Diagnosis of visual impairment, classified as degree 2 to 5 * informed consent provided by a parent or legal guardian
Exclusion criteria
* Presence of an orthopedic disorder affecting balance, gait, or participation in the exercise program * Presence of a neurological disorder affecting balance, gait, or participation in the exercise program * Use of medications known to affect balance or gait
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gait - Spatiotemporal: Gait Cadence | Baseline and post-intervention at Week 6 | Gait cadence is assessed using the iSen IMUs and it represents the average number of steps taken per minute during walking. |
| Gait - Spatiotemporal: Step Length and Stride Length During Gait | Baseline and post-intervention at Week 6 | Step length and stride length are assessed using the iSEN IMU system during walking, expressed in meters (m). Step length represents the average distance between consecutive foot contacts of opposite feet and stride length represents the average distance between successive contacts of the same foot. |
| Pelvic Symmetry | Baseline and post-intervention at Week 6 | Pelvic symmetry during gait is assessed using the iSEN IMUs and it is expressed as a percentage (%). |
| Gait: Stance and Swing Phase Duration | Baseline and post-intervention at Week 6 | During Gait Stance and swing phase durations are assessed bilaterally using the iSEN IMUs. Stance phase represents the portion of the gait cycle during which the foot is in contact with the ground, and swing phase represents the portion during which the foot is not in contact with the ground. Values are recorded separately for the right and left limbs, expressed in seconds and as a percentage of the gait cycle. |
| Gait: Double Support Duration During Gait | Baseline and post-intervention at Week 6 | Double support duration is assessed bilaterally using iSEN IMUs and represents the portion of the gait cycle during which both feet are concurrently in contact with the ground. Values are recorded separately for the right and left limbs, expressed as a percentage of the gait cycle. |
| Gait Kinematics: Hip Flexion-Extension Angle During Gait | Baseline and post-intervention at Week 6 | Hip flexion and extension angles during the gait cycle are assessed bilaterally using the iSEN IMUs and expressed in degrees (º). Maximum hip flexion angle and minimum hip extension angle are recorded separately for the right and left limbs. |
| Gait Kinematics: Hip Flexion-Extension Range of Motion During Gait | Baseline and post-intervention at Week 6 | Hip flexion-extension range of motion during the gait cycle is assessed bilaterally using the iSEN IMUs and expressed in degrees (º),it is recorded separately for the right and left limbs. |
| Gait Kinematics: Knee Flexion-Extension Angle During Gait | Baseline and post-intervention at Week 6 | Knee flexion and extension angles during the gait cycle are assessed bilaterally using the iSEN IMUs and expressed in degrees (º). Maximum knee flexion angle and minimum knee extension angle are recorded separately for the right and left limbs. |
| Gait Kinematics: Knee Flexion-Extension Range of Motion During Gait | Baseline and post-intervention at Week 6 | Knee flexion-extension range of motion during the gait cycle is assessed bilaterally using the iSEN IMUs and expressed in degrees (º), recorded separately for the right and left limbs. |
| Gait - Spatiotemporal:Walking Speed | Baseline and post-intervention at Week 6 | Walking speed is assessed using the iSen Inertial Motion Capture System by STT Systems (iSEN IMUs )during the walking test and it is expressed in meters per second (m/s). |
| Static Balance Performance: Center of Pressure Sway Area | Baseline and post-intervention at Week 6 | Center of Pressure Sway Area: Static balance performance is assessed using the TekScan pressure platform. Center of pressure (COP) sway area is measured during standardized quiet standing and expressed in square centimeters (cm²) and Higher values indicate greater postural sway. |
| Static Balance Performance: Center of Pressure Path Length | Baseline and post-intervention at Week 6 | Center of pressure path length is measured using the TekScan pressure platform during quiet standing, representing the total displacement distance of the center of pressure, expressed in centimeters (cm). |
| Static Balance Performance: Antero-posterior Center of Pressure Excursion | Baseline and post-intervention at Week 6 | Anteroposterior center of pressure excursion is measured using the TekScan pressure platform during quiet standing, representing postural sway in the forward-backward direction, expressed in centimeters (cm). |
| Static Balance Performance: Mediolateral Center of Pressure Excursion | Baseline and post-intervention at Week 6 | Medio-lateral center of pressure excursion is measured using the TekScan pressure platform during quiet standing, representing postural sway in the side-to-side direction, expressed in centimeters (cm). |
| Gait Kinematics: Ankle Dorsiflexion-Plantarflexion Angle During Gait | Baseline and post-intervention at Week 6 | Ankle dorsiflexion and plantarflexion angles during the gait cycle are assessed bilaterally using the iSEN IMUs and expressed in degrees (º). Maximum dorsiflexion angle and minimum plantarflexion angle are recorded separately for the right and left limbs. |
| Gait Kinematics: Ankle Dorsiflexion-Plantarflexion Range of Motion During Gait | Baseline and post-intervention at Week 6 | Ankle dorsiflexion-plantarflexion range of motion during the gait cycle is assessed bilaterally using the iSEN IMUs system and expressed in degrees (º), it is recorded separately for the right and left limbs. |
| Gait Kinematics: Pelvic Tilt Angle During Gait | Baseline and post-intervention at Week 6 | Maximum posterior and anterior pelvic tilt angles during the gait cycle are assessed using the iSEN IMUs inertial measurement unit system and expressed in degrees (º), recorded separately as posterior tilt and anterior tilt values. |
| Gait Kinematics: Pelvic Tilt Range of Motion | Baseline and post-intervention at Week 6 | Pelvic tilt range of motion during the gait cycle is assessed using the iSEN IMUs , representing the combined anterior (posterior tilt) and interior (anterior tilt) excursion, expressed in degrees (º). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Strength: Isometric Knee Extensor Muscle Strength | Baseline and post-intervention at Week 6 | Knee Extension Isometric Strength Assessment: Participants will sit with knees at \~90° flexion, feet unsupported, distal posterior thigh positioned \~10 cm from the chair's front edge, arms on the armrests with hands gripping the handles, and thighs/pelvis stabilized with a strap. A dynamometer will be fixed to an apparatus mounted behind the chair using a rigid, non-stretch strap positioned \~2 cm proximal to the lateral malleolus and secured across the anterior tibial surface; participants will perform knee extension, applying maximal isometric force against the dynamometer through the strap. Three 5-second maximal contractions will be performed, with 1-minute rest between trials and verbal encouragement to ensure maximal effort; peak force will be recorded for each trial. |
| Muscle Strength: Isometric Knee Flexor Muscle Strength | Baseline and post-intervention at Week 6 | Knee Flexion Isometric Strength Assessment: Participants will sit with feet unsupported, arms on the armrests with hands gripping the handles, and popliteal fossa positioned \~10 cm anterior to the chair's front edge, with thighs/pelvis stabilized using a strap. A dynamometer will be fixed to an apparatus mounted in front of the chair using a rigid, non-stretch strap positioned \~2 cm proximal to the lateral malleolus and secured across the posterior tibial surface; participants will flex the knee to 90° and apply maximal isometric force against the dynamometer through the strap. Three 5-second maximal contractions will be performed, with 1-minute rest between trials and verbal encouragement to ensure maximal effort; peak force will be recorded for each trial. |
| Trunk Muscle Endurance: Trunk Flexor Endurance | Baseline and post-intervention at Week 6 | Trunk flexor endurance is assessed using a 1-minute curl-up test. Participants perform repeated curl-ups from a supine position with knees flexed at 90°, sliding their hands forward toward the knees and returning to the starting position with proper form. The number of correctly completed repetitions within 1 minute is recorded. |
| Trunk Extensor Endurance | Baseline and post-intervention at Week 6 | Description: Trunk extensor endurance is assessed using a modified Sørensen test performed on a Roman chair, with the pelvis and lower extremities secured. Participants cross their arms over the chest and maintain the trunk horizontally aligned with the lower extremities, knees extended, for as long as possible. The test is terminated when the participant can no longer sustain the position, and the duration is recorded in seconds. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORSelda Uzun, PhD
Marmara University
Outcome results
None listed