The Effect of Basic Position Training on Walking Abilities of Visually Impaired Individuals

Objective of this study is to help the basic standing position training to take its part among basic exercises of the visually impaired individuals, and to observe the effects of this training on walking and balance skills. Method: 8 visually impaired sedentary individuals with impairment levels of B1 and B2 and ages of 18 to 24 voluntarily participated in the study. After acknowledging the visually impaired individuals with audial information regarding the study, they were told to brisk walk for 15 steps against the audio signal and then to heel-to-toe walk for 15 steps. Their corresponding walking distances, walking durations, directional impairments and losses of balance were recorded. During the 8 week period following this test, 45 minute training sessions accompanied by trainers that included 4 basic standing positions and their combinations were applied once a week, where the trainer corrected the individuals verbally and physically. Abovementioned tests were repeated after these 8 weeks. Gender categorization was not made since the participants were few in number. Non-parametric Wilcoxon Signed Rank Test was applied and a significant increase for the pretest was observed at a 0.05 significance level, where the distances walked increased and walking durations along with losses of balance decreased. Result: It was observed that walking skills of visually impaired individuals that received verbal and physical assistance, and that effectively performed basic positions and their combinations were smoother and more confident; that their walking distances were increased, their losses of balance were decreased and that they encountered less deviations from the direction of movement while walking, compared to their pretest conditions. Starting from this point of view, it might be concluded that the basic standing positions were highly beneficial and applicable activities for walking training of visually impaired individuals.


Introduction and Objectives
Directly proportional to the emergence of impairment, balance skills and perception of obstructions might develop late for visually impaired individuals.This results from the fact that, being able to see a point of reference supports awareness of bodily position and the capability of preserving stability, along with adaptation of the body to new positions (Casselbrand et al., 2007).
Identifying needs of visually disabled individuals and preparing exercise programs specifically designed for them improves these individuals' quality of life (Winnick, 2017;Gallahue, 1987).By arranging contents of these exercises so that they would contain kinesthetic and audial stimulants, development of motor skills can be contributed and losses of balance could be decreased to a lesser extent (Suveren, 2003;Deliceoğlu et al., 2017;Murphy, 1989;Pogrund et al., 1998).
Visual impairment is defined as, "a loss of sight that adversely affect a child's academic achievements" (Craft, 1995).
Problem of independent mobility that the visually impaired individuals encounter is reflected in a negative manner in terms of their social lives, which in turn leads to loss of motivation (Coughlan et al., 2012;Horak, 1987;Havik et al., 2010;Deliceoğlu et al., 2017;Arslantekin, 2014;Montarzino et al., 2007).Realization of spatial and bodily awareness increases disabled individuals' mobility (Kalia et al., 2010;Altunay, 2003

Discussion and Conclusions
The only way that the motor development process for visually impaired individuals can proceed like it does for normal individuals is through the application of a training system similar to that of visually healthy individuals (Pogrund and Fazzi, 2002) It was reported in the family guidance book prepared by Robinson and Lieberman (2007) that the verbal and physical support was vital in terms of exercise applications for visually impaired individuals.
Pogrund, R. L., Healy et al. (1998) mentioned in their book how important was the teaching method using audial stimulants and applications assisted by walls regarding development of attention and improvement of their posture and walking.
Teaching of independent mobility skills for the visually impaired aim to develop correct postures and to help them walk naturally (Altunay, 2003).Akı et al. (2007) applied a motor skills training program on partially-sighted children and investigated the efficiency of this training.Improvements were achieved in terms of all the activities along with an improvement in balance-keeping skills, which was in line with current study's findings.At the end of the rope jumping and strength exercises that Urhan (2018) applied on visually impaired children, he conducted a 1-mile run-walk-run test, -and besides other findings-he achieved an improvement in walking durations, which was in line with this study's findings.Chen et al. (2011) examined the impact of Tai Chi exercises on balance development in their study on visually impaired elderly and found improvement in the experiment group in comparison to the control group (P = 0.024).
Because the Tai Chi exercises were similar to the head position in the basic position combinations and weight transfer studies, the results of the studies are parallel to one another.
Suveren-Erdoğan and Suveren (2018) concluded that basic position exercises were highly effective in the development of such characteristics as the perception of obstructions, spatial orientation, postural control, and strength.Seemungal, Glasauer, Gresty, and Bronstein (2007) suggested that long-term training for blind people could affect navigation and orientation (a function of the vestibular system).Jazi et al. (2012) applied an 8-week equilibrium training on visually handicapped children and observed the development of dynamic equilibrium; they indicated that the preservation of balance depends partly on how the vestibular system works.As a result, they noted a significant improvement in both intra-group and inter-group equilibrium performances of the experiment group similar to this study (t (18) = 4.095, p <0.05).They argued that the vestibular system is another factor contributing to the stabilization of individuals with visual impairment, it affects, in general, the somatosensory system and in particular the equilibrium state of proprioceptive, and thus the kinaesthetic sensations in joints can develop after an eight-week equilibrium training (Jazi et al., 2012 ) While the basic position combinations, weight transmissions and a shift in the directions in the conducted study were considered to be effective on the vestibular system as well, when the data were evaluated, it was concluded that the basic standing positions were rather beneficial and applicable exercises in the walking training of visually impaired individuals.
Evaluating findings attained from the study, it was concluded that the basic standing positions were highly beneficial and applicable activities for walking training of visually impaired individuals.
In conclusion, it was observed that walking skills of visually impaired individuals who received verbal and physical assistance and successfully performed basic positions and their combinations were smoother and more confident, besides, their walking distances increased, their losses of balance decreased and they encountered fewer deviations from the direction of movement while walking, in comparison to their pre-test conditions.
Akyol et al. (2017) stated that visually impaired individuals might become more independent in their daily activities if they would be directed towards sports, by coming into a conclusion that sports had positive effects on balance and the walking distance.Research findings are compatible with this outcome in all aspects.Seok-Min et al. examined static and dynamic balance performances of Goalball and Track and Field Athletes, and they similarly used the brisk walk as the dynamic balance performance test.After the training program was applied, it has been observed that the step frequency post-test values of the sedentary individuals participating in the study were similar to those of the athletes participating in Seok-Min et al.'s study (Goalball 77.66 cm and Track and Field Athletes 69 cm). ).
A significant increase for the pretest was observed at a 0.05 significance level as a result of the study, where the distances walked increased and walking durations and loss of balance values decreased.