Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 6, 2016
   Pages 933 — 944

Abstract — Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation

Erik Renz, BS;1 Madeleine E. Hackney, PhD;2* Courtney D. Hall, PT, PhD3

1Georgia Institute of Technology, Atlanta, GA; 2Atlanta Department of Veterans Affairs (VA) Medical Center, Rehabilitation Research and Development Center, Decatur, GA; Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Decatur, GA; and Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, GA; 3Auditory and Vestibular Dysfunction Research Enhancement Award Program, James H. Quillen VA Medical Center, Mountain Home, TN; and Department of Physical Therapy, East Tennessee State University, Johnson City, TN

Abstract — Intraocular lenses (IOLs) provide distance and near refraction and are becoming the standard for cataract surgery. Multifocal glasses increase the variability of toe clearance in older adults navigating stairs and increase fall risk; however, little is known about the biomechanics of stair navigation in individuals with multifocal IOLs. This study compared clearance while ascending and descending stairs in individuals with monofocal versus multifocal IOLs. Eight participants with multifocal IOLs (4 men, 4 women; mean age = 66.5 yr, standard deviation [SD] = 6.26) and fifteen male participants with monofocal IOLs (mean age = 69.9 yr, SD = 6.9) underwent vision and mobility testing. Motion analysis recorded kinematic and custom software-calculated clearances in three-dimensional space. No significant differences were found between groups on minimum clearance or variability. Clearance differed for ascending versus descending stairs: the first step onto the stair had the greatest toe clearance during ascent, whereas the final step to the floor had the greatest heel clearance during descent. This preliminary study indicates that multifocal IOLs have similar biomechanic characteristics to monofocal IOLs. Given that step characteristics are related to fall risk, we can speculate that multifocal IOLs carry no additional fall risk.

Key words: balance, biomechanics, fall risk, foot clearance, intraocular lenses, monofocal, motion analysis, multifocal, older adults, stair negotiation, vision, visual impairment.


View HTML ?? View PDF ?? Contents Vol. 53, No. 6
This article and any supplementary material should be cited as follows:
Renz E, Hackney ME, Hall CD. Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation. J Rehabil Res Dev. 2016;53(6): 933–44.
http://dx.doi.org/10.1682/JRRD.2015.02.0030
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