Gleeson Michael, Sherrington Catherine, Lo Serigne, Auld Robin, Keay Lisa
Injury Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Clin Exp Optom. 2017 Nov;100(6):633-641. doi: 10.1111/cxo.12517. Epub 2017 Feb 1.
Older adults with visual loss have high rates of depression, restricted participation and reduced quality of life. We sought to measure the impact of lessons in the Alexander technique on vision-related emotional and social well-being, as secondary outcomes to a study on improving physical functioning in this population.
This is a single-blind randomised controlled trial. One hundred and twenty community-dwelling adults aged 50 to 90 years with visual impairments were randomised to either 12 Alexander lessons over 12 weeks and usual care or usual care. The Perceived Visual Ability Scale, the Keele Assessment of Participation, the emotional subscale of the Impact of Vision Impairment Profile, the Positive and Negative Affect Scale and the five-item Geriatric Depression Scale were administered at baseline and three and 12 months. Participants were receiving services from Guide Dogs NSW/ACT.
None of the validated questionnaires found statistically significant improvements after adjustment for baseline at three or 12 months, although the emotional subscale of the Impact of Vision Impairment approached significance in favour of the intervention group (4.54 points, 95 per cent CI: -0.14 to 9.21, p = 0.06). Depressive symptoms were prevalent and associated with greater impact of visual impairment on emotional well-being (odds ratio: 1.12, 95 per cent CI: 1.07 to 1.17, p < 0.0001). Faster gait, an indicator of general mobility, was associated with less depressive symptoms (odds ratio: 1.27, 95 per cent CI: 1.06 to 1.54, p = 0.01).
On average, there was no significant impact of weekly lessons in the Alexander technique on social and emotional well-being, although the emotional impact of visual impairment showed a trend toward less distress in the intervention group. Our data found that emotional distress associated with visual impairment influences depressive symptoms but contrary to expectations, the level of social support received was not significant. Additionally, gait speed is a significant predictor of depressive symptoms, suggesting that general mobility is of importance to the well-being of older adults with visual impairments.
视力受损的老年人患抑郁症的比例很高，参与度受限，生活质量下降。作为一项改善该人群身体功能研究的次要结果，我们试图衡量亚历山大技术课程对与视力相关的情绪和社会幸福感的影响。
这是一项单盲随机对照试验。120名年龄在50至90岁之间、居住在社区且有视力障碍的成年人被随机分为两组，一组在12周内接受12节亚历山大技术课程并接受常规护理，另一组只接受常规护理。在基线、3个月和12个月时，分别使用视觉能力感知量表、基尔参与度评估量表、视力障碍影响量表的情绪子量表、正负性情绪量表和五项老年抑郁量表进行评估。参与者接受新南威尔士州/澳大利亚首都直辖区导盲犬协会的服务。
在对3个月和12个月时的基线进行调整后，没有一个经过验证的问卷发现有统计学上的显著改善，尽管视力障碍影响量表的情绪子量表接近显著有利于干预组（4.54分，95%可信区间：-0.14至9.21，p = 0.06）。抑郁症状普遍存在，且与视力障碍对情绪幸福感的更大影响相关（比值比：1.12，95%可信区间：1.07至1.17，p < 0.0001）。更快的步速是一般活动能力的一个指标，与较少的抑郁症状相关（比值比：1.27，95%可信区间：1.06至1.54，p = 0.01）。
平均而言，每周的亚历山大技术课程对社会和情绪幸福感没有显著影响，尽管在干预组中，视力障碍的情绪影响显示出痛苦减轻的趋势。我们的数据发现，与视力障碍相关的情绪困扰会影响抑郁症状，但与预期相反，所接受的社会支持水平并不显著。此外，步速是抑郁症状的一个重要预测指标，这表明一般活动能力对视力受损的老年人的幸福感很重要。
