SPATIAL ORIENTATION DEVELOPMENT IN PERSONS WITH SEVERE VISUAL IMPAIRMENTS AND BLINDNESS BY MEANS OF PHYSICAL THERAPY IN A SANATORIUM STAGE

Abstract

Purpose – to develop and learn the spatial orientation skills in people with severe visual impairments and blindness by means of physical therapy at the sanatorium. Materials and methods. The study was hold at the Western Rehabilitation and Sports Center of the National Committee of Disabled Sports of Ukraine (Yavoriv village, Turkiv district, Lviv region). The study involved 245 people of 18–35 years old with severe visual impairments or blindness. The test for proprioreceptive sensitivity was applied to evaluate the accuracy of the spatial parameter of movements. Results. Patients took a physical therapy course at the sanatorium. The author’s physical therapy program was based on the integration of various types of physical activity in combination with spatial orientation training. This physical therapy course included special classes in spatial orientation for the persons with severe visual impairment and blindness. The purpose of spatial orientation training for visually impaired and blind people was to develop skills that allowed them to navigate freely and move independently under any circumstances. The initial test for proprioreceptive sensitivity showed difficulties in fixing the limb in the desired angle of the elbow joint flexion in accordance with the test program. It indicated the complexity in the spatial orientation of persons with special needs who had pathology of vision. In the beginning of the study, the satisfactory results in flexion of the right elbow to the acute (small) angle were marked in 78 persons (32%), to the right (average) angle – in 101 persons (41%), and to the obtuse (large) angle – in 59 people (24.1%). The satisfactory results in flexion of the left elbow to the same angles was marked in 93 (38%), 108 (44%) and 37 persons (15%), respectively. The initial deviation from the needed small angle of flexion of the right elbow joint was 11.33±15.32°, the left elbow – 8.61±10.14° (p=0.39). The test in flexion to the average angle showed the following error indices: the right elbow – 6.43±11.24°, the left elbow – 8.55±11.59° (p=0.45). Flexion to the large angle showed such deviation from the needed degrees: on the right elbow – 9.69±12.12°, on the left elbow – 10.85±12.03° (p=0.69). Repeated tests in flexion of elbow joints were hold after physical therapy program. Flection of the right elbow to the acute angle were performed satisfactorily by 101 persons (41%), to the right angle – 150 persons (61%), to the obtuse angle – 81 persons (33%). As for the left elbow, repeated testing was successful in 115 (47%), 123 (51%) and 108 (44%) persons, respectively with the specified angles of flection. A comparative analysis of the error indicators of the flexion amplitude made possible to state an improvement in the proprioceptive sensitivity of people with severe visual impairment and blindness. So, the amplitude error in the series of the right limb flexion to the small angle decreased by 8.3%, of the left limb – increased by 19.5%. In the series of flexion to the average angle, the amplitude error on the right limb increased by 17.7%, on the left limb – by 6.7%. When flexing the right limb to the large angle, the amplitude error decreased by 25.8%, the left limb – by 21.4%. Conclusions. The systematic and targeted use of physical therapy allowed the formation of proprioreceptive sensitivity and the creation of a basis for improving the spatial orientation of people with special needs who had pathologies of vision. A sufficient level of spatial orientation will increase social and physical activity, expand people's capabilities and improve quality of life indicators.