Measuring mobility performance: experience gained in designing a mobility course.

BACKGROUND: This paper reviews the most common methods of measuring and scoring orientation and mobility (O and M) and the effects of visual impairment on O and M. We discuss the difficulties inherent in designing a 'real-world' course to measure O and M and we describe the course that we finally used.

METHODS: Thirty-five participants in two age groups, with low vision due to a variety of disorders, took part in mobility trials on the final version of the course. Aspects of visual function were measured.

RESULTS: Factor analysis indicated that mobility errors, visual detection distance and visual identification distance were grouped with measures of visual acuity, contrast sensitivity and Humphrey visual field mean deviation, while preferred walking speed and walking speed were separately grouped. Humphrey pattern standard deviation did not group with any other measure and neither did percentage preferred walking speed. This study is in agreement with other studies that visual field and contrast sensitivity, sometimes with low contrast visual acuity, were the best clinical visual predictors of mobility performance. Based on our experiences we present a number of recommendations for designing courses for assessing mobility.

CONCLUSIONS: For future studies, it would behove researchers to include a range of mobility measures, until further understanding is gained about how they are interrelated and contribute information on the relationship among mobility, vision and other individual factors.