OPTIMAL Theory-Based Interactive Image Making to Improve Gait and Quality of Life in Parkinson Disease
Purpose: Parkinson disease (PD) is characterized by aberrant control of movement resulting in impaired gait. Physical therapy plays a critical role in symptom management; however, sustained improvements require continued practice of gait. This pilot feasibility study aimed to evaluate the feasibility, safety, acceptability, and initial efficacy of gait training with interactive image making based on OPTIMAL theory in people with PD.
Methods: 11 participants were randomized into the experimental or control group and underwent 16, 50-minute sessions with a licensed physical therapist during the 8-week training period. The experimental group (n=6) engaged in gait training with interactive image making informed by the OPTIMAL theory, while the control group (n=5) engaged in gait training plus observation of landscape images not constructed using the OPTIMAL theory. Feasibility, acceptability, and appropriateness were assessed by recruitment, attendance, retention rates, and safety and by participant-reported outcome measures (Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). Secondary outcomes assessed gait speed, gait endurance, physical activity, motivation, and quality of life (QoL).
Results: Primary outcomes all exceeded the criterion levels (FIM, AIM, and IAM (criterion 75%; 76%, 89%, and 88% of agreement, respectively), attendance (criterion 70%; 98.86%), retention (criterion 90%; 100%). Secondary outcomes demonstrated improvement at the individual and group level.
Conclusion: These findings suggest that gait training through interactive image making is a safe, feasible, and acceptable intervention that may improve gait, mobility, and QoL in people with PD. Future research is needed to explore this effect and its mechanisms further within larger randomized controlled trials.
DOI: 10.29245/2767-5122/2025/2.1168 View / Download PdfAssessment of Autism Spectrum Disorders in Children with Visual Impairment and Blindness
Children with visual impairment and blindness (VIB) are consistently reported to show higher rates of autism spectrum disorder (ASD) or ASD-like features than sighted peers, yet the nature of this association remains unclear. A major source of ambiguity lies in the use of assessment tools developed for sighted populations, as these tools rely heavily on visual behaviours such as gaze following, joint attention, and eye contact. In children with VIB, these markers may reflect sensory differences rather than underlying neurodevelopmental disorders, increasing the risk of misdiagnosis. This commentary critically reviews recent adaptations of standard instruments, alongside the emergence of specialized measures. While adaptations and innovations show promise, their limited validation and integration into clinical practice hinder their impact. The present commentary builds on the findings of the scoping review by Stevenson & Tedone, 2024, which examined studies published between 1995 and 2020. The present work reflects on that body of evidence and notes that additional work since continues to shape understanding in this area. Taken together, these issues highlight the need for assessment frameworks that move beyond sighted developmental norms, prioritizing tools and training designed for non-sighted children. Only with rigorously validated instruments, longitudinal research and formalized guidelines can clinicians distinguish between neurodevelopmental disorders and expected development in children with VIB.
DOI: 10.29245/2767-5122/2025/2.1169 View / Download Pdf