Effects of multimodal and unimodal physical training interventions on visual function in glaucoma and elderly controls: A pilot study

ObjectiveTo investigate the effect of a 12-week multimodal motor-cognitive and resistance training (MMI) compared to a unimodal resistance training intervention (UMI) on static and dynamic visual function in glaucoma patients (GLA) and healthy controls (HC). MethodsFifteen GLA and 24 age-matched HC participated in this randomized, controlled longitudinal pilot study. Visual function was assessed using clinical parameters and, on a treadmill, (TM) while standing (static, S0) as well as during walking at 3.5 km/h (S3.5) and a self-preferred speed (SSelf). The following outcomes were measured pre and post 12-weeks of intervention (MMI or UMI): (a) standard clinical measures and (b) TM-related measures, i.e. (i) best-corrected visual acuity without (VAS) and with crowding (VAC), (ii) visual field sensitivity (VF), and (iii) contrast sensitivity (CS). A 4-factorial repeated-measures ANOVA (SPEED [S0; S3.5; SSelf] x TIME [pre; post] x INTERVENTION [UMI; MMI] x GROUP [GLA; HC]) was applied to determine significant interaction effects (p [≤] 0.05) and the effect size partial-eta-squared was calculated. ResultsPost-interventional improvement of visual function was absent or minor. Only for standard clinical measures a main effect of TIME (visual acuity; p=0.024) and a TIME x INTERVENTION interaction (foveal sensitivity; p=0.039) were found. For S0 vs S3.5 small effects appeared in post-hoc comparisons, but TIME and TIME x SPEED just failed to reach significance for CS (p=0.059) and VAs (p=0.052), respectively. ConclusionWhile trends were evident, the effect of the 12-week interventions on visual function were small and, especially for TM-walking, largely independent of group and intervention type. In future studies a greater sample of more advanced glaucoma cases should be included to probe for significant visual function differences between groups and intervention types.