Effect of Brailletonik Cognitive-Motor Exercises on Postural Control in Blind Women

Visual impairment is blindness and low vision. Besides, it is among the most common disabilities and causes of functional disability among individuals with profound effects on functioning. Visual impairments cause some problems in visual receptors that include disorders in spatial orientation, balance, performing motor skills, cognitive skills, and learning. Balance control and injuries/falling are in diverse relations. Simultaneously, the issue of balance in the blinds' lives occurs in a more complicated manner, e.g., when cognitive attention is focused on something else. Considering the importance of balance for the blind to reduce falls and injuries and the effect of dual concentration and activity on balance and reduce the executive performance of the blind, compared with others. This study aimed to investigate the impact of Brailletonik cognitive–motor exercises on postural control and cognitive abilities in blind women. 

The was a quasi–experimental study with pretest–posttest and a control group design. The sample consisted of 21 blind women (age: 20–35 years) that lived in Isfahan Province, Iran, in 2018 and selected by convenience sampling technique. The study participants were randomly assigned into the experimental (n=12) and control (n=9) groups. The inclusion criteria of the study were absolute or very severe blindness; awareness in Braille for the blind; being in the age range of 20 to 35 years; no history of lower limb fractures or sprains in the past 6 months; no substance dependence and use of sedatives, alcohol, etc.; having certain diseases, such as inflammation, osteoporosis, diabetes, cardiovascular, specific orthopedic problems; presenting dizziness, hearing problems, and any factors that interfere with exercise or affect balance, and no regular sports activity during the last 3 months. The exclusion criteria were lower extremity problems, dizziness, physical weakness, and absence from>4 consecutive sessions or 3 non–consecutive sessions during the course. The experimental group participated in Brailletonik exercise sessions for 2 months 3 times a week; however, the control group participated in usual aerobic exercises. The study subjects were instructed quiet upright standing on a Kistler force platform under the following conditions: quiet upright standing (single task) and quiet upright standing while performing a cognitive activity (dual–task). Postural control was evaluated before and after Brailletonik exercises.</span> Each test was repeated 3 times for 60 seconds. The rest between the two trials was considered 60 seconds, and the test sequences were random. The parameters of mean velocity, the standard deviation of velocity in both anterior–posterior and medio–lateral plans, and standard deviation of amplitude in both anterior–posterior and medio–lateral plans from the center of foot pressure have recorded the device (for both pretest and posttest). Analysis of Covariance (ANCOVA) analyzed the obtained data in SPSS at a significance level of α=0.05.

The ANCOVA results for both single tasks suggested that the mean value of the mean velocity (p</em>=0.002), the standard deviation of the velocity in the lateral view (p</em>=0.004), and the standard deviation of the velocity in the anterior–posterior view (p</em>=0.05) in the experimental group was significantly less than the control group; however, the standard deviation of displacement in two lateral (p</em>=0.416) and anterior–posterior (p</em>=0.539) views was not significantly different between the two groups. Moreover, the ANCOVA results for dual–task indicated that the mean value of the mean velocity (p</em><0.001), the standard deviation of the velocity in the lateral view (p</em><0.001), and standard deviation of the velocity in the anterior–posterior view (p</em><0.001) in the experimental group was significantly smaller than the control group; however, the standard deviation of displacement in two lateral (p</em>=0.165) and anterior–posterior (p</em>=0.469) views did not significantly differ between the research groups.

The present study data revealed that the cognitive–motor exercises of brailletonik in dual tasks and single tasks effectively improve postural control of the blinds. Related centers, such as the State Welfare Organization, Exceptional Education, Rehabilitation Centers, and Families of the Blinds, are encouraged to include Brighton exercises in the weekly blinds Schedule.