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Considerations regarding the improvement of coordination capacity in blind children.

Introduction

"Vision impairment is a dysfunction in which the visual analyzer is unable to receive, transmit or interpret stimuli in a favorable way for educational and social integration" (Teodorescu, Bota, Stanescu, 2003, p. 88).

The Centers for Disease Control and Prevention (USA, 2015) states that visual impairment occurs when the loss of visual acuity reaches the value of 20/70, after the correction of vision by wearing glasses (http://www.cdc.gov/ncbddd/developmentaldisabiliti es/casedefinitions.html).

Visual acuity is influenced by various factors, such as: age, pupil diameter, eye accommodation etc. This is subjectively measured with an eye chart displaying successive rows of letters, numbers or figures of different heights. The examined person is positioned at a distance of 33 cm up to 5 m from the chart to be assessed their near or distance vision acuity.

Depending on the limitation of vision acuity, the following visual impairments are described:

--amblyopia--which represents a decrease in visual acuity, but allowing the person to carry out independently everyday activities;

--visual blindness (cecity)--which consists in the partial or total loss of visual acuity (blind people), an issue which requires the presence of a third person (human, animal etc.) to help them carry out daily activities; the lack of vision can be counteracted by the compensatory development of other analyzers, particularly the auditory and tactile ones.

The term amblyopia derives from the Greek word amblys, which means weak, dull, and ops, which means vision, and the term cecity from the Latin word caecitas, meaning blindness.

According to the reports of World Health Organization (2014), at a global level it would be 285 million people with visual impairments, of whom 246 million have been diagnosed with amblyopia and the remaining 39 million are suffering from visual blindness. The latter ones, in a percentage of 82%, are aged 50 years or more (http://www.who.int/mediacentre/factsheets/fs282/en/#).

Also, the World Health Organization states that amblyopia is currently the main impairment leading, in a 50% percentage, to the loss of vision. This is the consequence of degenerative physiological processes, coupled with the increasing number of ageing population at a global level (demographic ageing). Other conditions which lead to blindness are represented by: trachoma, glaucoma, diabetes etc.

(http://www.who.int/mediacentre/factsheets/fs213/en/)

To prevent the increasing number of blind people, regular ophthalmological examination is

Methods

* Bibliographical study method--aimed at examining some interdisciplinary informative materials in the fields of physical education and sports, medicine (ophthalmology) and psycho-pedagogy.

* Case study method--applied to a group made up of 5 children with visual blindness.

* Observation--focused on exploring the motor behavior of subjects included in the study and conducted during both the physical education classes and other curricular and extracurricular activities.

* Graphical method--materialized in drawing up some column charts, which have the advantage of quickly revealing the coordination capacity reaction (progression/regression) to the applied programme of physical exercises with hand apparatus.

All these methods fall into the quantitative and qualitative types.

Assessment tests required, and if some eye disorder is detected, the complex treatment should be applied as early as possible.

The study purpose is to assess the level of coordination capacity in children with visual blindness. For this, we shall apply a number of tests through which we aim to identify the response (progression/regression) to movement therapy under the form of physical exercises with hand apparatus.

The study objectives refer to the following aspects:

--improvement of coordination capacity in children with visual blindness;

--making up the group of subjects;

--selection and adjustment of the tests for assessing coordination capacity;

--establishing the hand apparatus specific to rhythmic gymnastics, used to compose programmes for the development of coordination capacity;

--collection, processing and interpretation of the data obtained from studying the group of children with visual blindness.

Assessing the level of coordination capacity was achieved based on some tests, as follows: eye-hand coordination test, spatial orientation test and Romberg test.

To establish the score for each test, we developed a number of assessment scales, taking as a landmark the results (trial/error) obtained in a test conducted prior to the application of the respective testing.

* The eye-hand coordination test consists in throwing rhythmic gymnastics balls (3) into a space delimited by means of a hoop. The hoop is positioned on the ground, at a 3-meter distance from the launching area. The time for achieving the three throws is 1 minute. Score scale:

0 points = subject does not reach the target in the three attempts and fails to fall within the time frame;

1 point = subject does not reach the target in the three attempts, but falls within the time frame;

2 points = subject reaches the target once in the three attempts and fails to fall within the time frame;

3 points = subject reaches the target once in the three attempts, but falls within the time frame;

4 points = subject reaches the target twice in the three attempts and fails to fall within the time frame;

5 points = subject reaches the target twice in the three attempts, but falls within the time frame;

6 points = subject reaches the target three times in the three attempts and fails to fall within the time frame;

7 points = subject reaches the target three times in the three attempts, but falls within the time frame.

* The spatial orientation test involves marking on a line two points, A and B, found at a 2-meter distance. Starting from point A, the subject with visual blindness must cover the 2 meters so as to stop in point B. Scores are awarded as follows: exceeding point B is marked with +, and not reaching it is marked with cu -. Measurements were performed in centimeters.

Score scale:

0 points = exceeding/not reaching point B by +/-100 cm;

1 point = exceeding/not reaching point B by +/-75 cm;

2 points = exceeding/not reaching point B by +/-50 cm;

3 points = exceeding/not reaching point B by +/-25 cm;

4 points = reaching point B (0 cm).

* The Romberg test assesses static balance; the position that the subject must hold for 1 minute is represented by standing, with the upper limbs flexed at 90[degrees] in the scapular-humeral joint. It was assessed the total number of deviations and steps during the trial.

Score scale:

1 point = [greater than or equal to] 20 deviations;

2 points = [greater than or equal to] 10 deviations;

3 points = [greater than or equal to] 5 deviations;

4 points = < 5 deviations;

1 point is added for each stepping.

The overall score represents the sum of points obtained for deviations and stepping.

The three tests were applied to children with visual blindness, in dynamics. The initial assessment was carried out before applying the gymnastics programme and was aimed at determining the coordination level, which has become a landmark for the final assessment applied 6 months later, a time frame during which the subjects have learnt to perform various actions with the selected hand apparatus (rope, hoop, ball).

Research subjects and location: The subjects, 5 in number, were selected among pupils from Special Middle School for Visually Impaired, Bucharest, being enrolled in the 3rd grade.

In order to make up the group of subjects, we applied the following criteria:

* Inclusion criteria:

--diagnosis: visual blindness;

--age: 9-11 years;

--good physical condition.

* Exclusion criteria:

--diagnosis: bilateral amblyopia;

--age: under 9 years;

--age: over 11 years;

--poor physical condition;

--participation in previous studies.

To conduct the study, we developed the research ethics rules. The subjects were included in the research based on the consent of the school leadership and parents (a written consent given after being informed).

Data regarding the investigated subjects are presented in table no. 1.

The programme applied: During the study, there were conducted 10 lessons which included various exercises with the following hand apparatus: rope, hoop and ball. Table no. 2 shows how the means used were staggered throughout the 11 weeks of work.

Results

In tables no. 3, 4 and 5, we present the data obtained from the assessments in dynamics, performed on the basis of tests described in the general part.

In table no. 3, it is noticed that the data obtained for the eye-hand coordination test have improved from one assessment to the other in the case of three subjects (2, 3 and 5). The other two subjects (1 and 4) have not shown progress at the assessments in dynamics following the application of rehabilitation programme.

Table no. 4 shows the data obtained by assessing the spatial orientation of subjects with visual blindness. Three of the 5 subjects (2, 3 and 4) have progressed after learning to handle the apparatus specific to rhythmic gymnastics. The increased scores highlight an improvement in the tests performed, as a response to the application of the rehabilitation programme.

As regards the assessment of static balance (table no. 5), the obtained results prove that three of the 5 subjects (1, 3 and 4) have recorded progress from the initial assessment to the final one after participating in the study and performing various actions with hand apparatus specific to rhythmic gymnastics. The decreased scores emphasize an improvement in the tests performed, as a response to the application of the rehabilitation programme.

Based on the graphical method (charts no. 1, 2 and 3), we present the progress recorded by the subjects throughout the study.

Chart no. 1 shows the scores obtained by the participants in the study following the asessments in dynamics of their eye-hand ability. If, in the initial assessment, it has been noticed that all three attempts were unsuccessful, in the final assessment, it has been found that only one of the 5 subjects managed once to reach the target positioned on the ground. As regards the execution time, most children with visual blindness succeeded in achieving the three throws within the time frame alloted for the test, even if, in the initial assessment, two pupils had exceeded the 60 seconds. However, three subjects made progress (subjects 2, 3 and 5), recording a higher score in the second assessment.

In chart no. 2, we can notice the scores obtained by the subjects in the assessment of spatial and temporal orientation ability. The columns indicate that three children with visual blindness have managed to progress following the application of the movement therapy programme. We mention that two subjects (2 and 4) have stopped just at the point marked on the ground, within the final assessment.

In chart no. 3, we notice the progress made by the subjects in Romberg test, which assesses static balance. Following the assessments in dynamics, we observe that three pupils (subjects 1, 3 and 4) have recorded progress highlighted by a higher score in the initial assessment compared to the final one. This progress proves the efficiency of the rehabilitation programme for the static balance of the investigated subjects.

Conclusions

1. Of the total number of subjects included in the study, 60% have progressed after the treatment, an assertion supported by the results obtained at the assessments in dynamics. This demonstates that the means specific to rhythmic gymnastics can contribute significantly to the improvement of coordination capacity.

2. The process of learning the required actions was difficult, because the subjects included in the research were suffering from visual blindness.

3. Children with suppressed visual function cannot perceive through the analyzer the demostrations performed by the physical education teacher, therefore his/her presence is compulsory to explain them the test requirements and to compensate for their visual impairment through a tactile-kinesthesic intervention.

4. Exercises with hand apparatus can develop the motor background of children with visual impairments, especially those with visual blindness, can increase the coordination capacity and therefore the quality of life for these categories of people with special educational needs.

Aknowledgements

For all of our participants from my study I want to say thank you.

References

Cordun M, 2009, Kinantropometrie, Editura CD Press, Bucuresti

Dumitrache M, 2015, Compendiu de patologie oftalmologica, Editura Medicala, Bucuresti

Grigore V, 2003, Gimnastica: manual pentru cursul de baza, Editura Bren, Bucuresti

Macovei S, 2007, Exercitii cu obiecte portative pentru educatia fizica adaptata si incluziva, Editura Didactica si Pedagogica R. A., Bucuresti

Teodorescu S, Bota A, Stanescu M, 2003, Educatie fizica si sport adaptat pentru persoane cu deficiente senzoriale, mintale si defavorizate social, Editura Semne, Bucuresti

http://www.cdc.gov/ncbddd/developmentaldisabilitie s/casedefinitions.html

http://www.who.int/mediacentre/factsheets/fs282/en/ #

http://www.who.int/mediacentre/factsheets/fs213/en/\ Blindness: Vision 2020--The Global Initiative for the Elimination of Avoidable Blindness

IONESCU Oana-Cristiana (1), CORDUN Mariana (2)

(1) Doctoral School, National University of Physical Education and Sports, Bucharest, ROMANIA

(2) Department of Special Motricity and Medical Recovery, Faculty of Kinetotherapy, National University of Physical Education and Sports, Bucharest, ROMANIA

E-mail address: oanac.ionescu@yahoo.com 468

* the abstract was published in the 16th I.S.C. "Perspectives in Physical Education and Sport"--Ovidius University of Constanta, May 20-21, 2016, Romania

Received 17.03.2016/Accepted 04.04.2016

Caption: Chart no. 1--Scores recorded by the subjects (Eye-hand coordination test)

Caption: Chart no. 2--Scores recorded by the subjects (Spatial orientation test)

Caption: Chart no. 3--Scores recorded by the subjects (Romberg test)
Table no. 1--Data on the research subjects

Subjects    Gender   Age        Diagnosis
                     (years)

Subject 1   F        9 years    BE--Proliferative retinopathy;
                                BE--Surgical aphakia;
                                RE--Vitrectomy;
                                LE--Corneal transplant, vitrectomy.
Subject 2   M        10 years   Leber congenital amaurosis
Subject 3   M        10 years   NLP, total retinal detachment;
                                LE--Uveitis sequelae, surgical
                                  aphakia;
                                Mental retardation
Subject 4   M        9 years    Congenital nystagmus, optic nerve
                                  hypoplasia;
                                Neuro-psychomotor retardation;
                                Autistic spectrum disorders;
                                Post hypoxic brain injuries.
Subject 5   M        9 years    LE--NLP;
                                BE--Optic nerve atrophy.

Legend:

LE--left eye;

RE--right eye;

BE--both eyes;

NLP--no light perception.

Table no. 2--Work programme

Week                 Means                         Dosage
no.

Week 1   Exercises for getting
         familiar with the selected
         hand apparatus:

         --Learning the apparatus        5 minutes
         grip--rope;

         --Learning the apparatus        5 minutes
         grip--hoop;

         --Learning the apparatus        5 minutes
         grip--ball.

Week 2   Exercises performed with hand
         apparatus--rope:

         --Standing, rope grip with      3x8, 1-minute break between
         one end in each hand, the       series
         apparatus is carried to the
         frontal plane;

         --Standing, rope grip with      3x8, 1-minute break between
         one end in each hand, the       series
         apparatus is carried to the
         sagittal plane;

         --Backward movement,            5 minutes
         executing snake- shaped
         drawings on the ground.

Week 3   Exercises performed with hand
         apparatus--hoop:

         --Standing, swing on the        3x8, 1-minute break between
         frontal plane, hoop grip with   series
         the right hand;

         --Standing, swing on the        3x8, 1-minute break between
         frontal plane, hoop grip with   series
         the left hand;

         --Standing, hoop is passed      3x8, 1-minute break between
         from one hand to the other;     series

         --Standing, hoop is rolled on   5 minutes
         the ground with the skillful
         hand.

Week 4   Exercises performed with hand
         apparatus--ball:

         --Standing, swing on the        3x8, 1-minute break between
         sagittal plane, ball is held    series
         with the right hand;

         --Standing, swing on the        3x8, 1-minute break between
         sagittal plane, ball is held    series
         with the left hand;

         --Standing, bounces are         3x8, 1-minute break between
         performed with the right        series
         hand;

         --Standing, bounces are         3x8, 1-minute break between
         performed with the left hand.   series

Week 5   Exercises performed with hand
         apparatus--rope:

         --Standing, rope grip with      5 minutes
         one end in each hand, the
         apparatus is wrapped around
         the body;

         --Standing, circular            3x8, 1-minute break between
         horizontal swing overhead,      series
         performed to the right, rope
         grip with one end in each
         hand;

         --Standing, circular            3x8, 1-minute break between
         horizontal swing overhead,      series
         performed to the left, rope
         grip with one end in each
         hand.

Week 6   Exercises performed with hand
         apparatus--hoop:

         --Standing, hoop rotation       3 minutes
         around the vertical axis from
         support to the ground,
         performed with the right
         hand;

         --Standing, hoop rotation       3 minutes
         around the vertical axis from
         support to the ground,
         performed with the left hand;

         --Standing, hoop is held with   3 minutes
         double grip overhead, passing
         through the hoop;

         --Standing, hoop rotation on    3x8, 1-minute break between
         the frontal plane, around       series
         both hands, to the right;

         --Standing, hoop rotation on    3x8, 1-minute break between
         the frontal plane, around       series
         both hands, to the left.

Week 7   Exercises performed with hand
         apparatus--ball:

         --Standing, bounces are         4x8, 1-minute break between
         performed with alternating      series
         hands;

         --Travelling with bounces       3 minutes
         performed alternately;

         --Travelling with bounces       3 minutes
         performed with the right
         hand;

         --Travelling with bounces       3 minutes
         performed with the left hand.

Week 8   Exercises performed with hand
         apparatus--rope:

         --Standing, circular swing on   3x8, 1-minute break between
         the frontal plane, performed    series
         to the right, rope grip with
         one end in each hand;

         --Standing, circular swing on   3x8, 1-minute break between
         the frontal plane, performed    series
         to the left, rope grip with
         one end in each hand;

         --Standing, stepping forward    3x8, 1-minute break between
         over the rope with the right    series
         foot;

Week 9   --Standing, stepping forward    3x8, 1-minute break between
         over the rope with the left     series
         foot.

         Exercises performed with hand
         apparatus--hoop:

         --Standing, hoop rotation       3x8, 1-minute break between
         forward on the sagittal         series
         plane, around the right hand;

         --Standing, hoop rotation       3x8, 1-minute break between
         forward on the sagittal         series
         plane, around the left hand;

         --Standing, hoop rotation on    3x8, 1-minute break between
         the transverse plane            series
         (overhead), around both
         hands, towards the skillful
         side;

         --Standing, hoop rotation on    3x8, 1-minute break between
         the frontal plane, around       series
         both hands, towards the
         skillful side.

Week 10  Exercises performed with hand
         apparatus--ball:

         --Standing, ball rolling on     3 minutes
         the right arm;

         --Standing, ball rolling on     3 minutes
         the left arm;

         --Standing, ball rolling        5 minutes
         forward on both arms;

         --Travelling with ball          4 minutes
         passing from one hand to the
         other, around the body.

Table no. 3--Eye-hand coordination test

                         Initial assessment

Subjects    Number of   Number of    Time (in
             failed     successful   seconds)   Score
            attempts     attempts

Subject 1       3           0           30        1
Subject 2       3           0           70        0
subject 3       3           0           86        0
Subject 4       3           0           58        1
Subject 5       3           0           51        1

                             Final assessment

Subjects    Number of   Number of    Time (in
             failed     successful   seconds)   Score
            attempts     attempts

Subject 1       3           0           26        1
Subject 2       3           0           54        1
subject 3       3           0           72        1
Subject 4       3           0           40        1
Subject 5       2           1           52        3

Table no. 4--Spatial orientation test

Subjects       Initial assessment       Final assessment

               Distance                 Distance
              travelled      Score     travelled      Score
            to point B (in           to point B (in
             centimeters)             centimeters)

Subject 1        -48           2          -27           2
Subject 2        -10           3           0            4
Subject 3        +100          0          -53           1
Subject 4        +26           2           0            4
Subject 5        +44           2          +31           2

Table no. 5--Romberg test

                          Initial assessment

Subjects     Deviation       Total      Deviation   Stepping
            distribution   number of      score
                           deviations

Subject 1        4r            4            4          1
Subject 2     9r + 121         21           1          4
Subject 3    11r + 131         24           1          6
Subject 4     4r + 111         15           2          3
Subject 5     4r + 31          7            3          2

             Initial assessment      Final assessment

Subjects    Stepping   Overall    Deviation       Total
             score      score    distribution   number of
                                                deviations

Subject 1      1          5           1r            1
Subject 2      4          5        7r + 81          15
Subject 3      6          7        6r + 111         17
Subject 4      3          5        4r + 111         15
Subject 5      2          5           41            4

                           Final assessment

Subjects    Deviation   Stepping   Stepping   Overall
              score                 score      score

Subject 1       4          0          0          4
Subject 2       2          3          3          5
Subject 3       2          4          4          6
Subject 4       2          2          2          4
Subject 5       4          1          1          5

Legend:

r--right;

l--left.
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Title Annotation:Original article
Author:Ionescu, Oana-Cristiana; Cordun, Mariana
Publication:Ovidius University Annals, Series Physical Education and Sport/Science, Movement and Health
Article Type:Report
Date:Jun 15, 2016
Words:3230
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