The challenge of reading music notation for pianists with low vision: An exploratory qualitative study using a head-mounted display.

Reading musical notation while interpreting it on a musical instrument poses problems for musicians with a visual impairment (VI). This study sought to describe the visual aids, adaptations and compensatory strategies used by five amateur pianists with low vision when reading music, to identify the problems they face when using these aids, and to verify whether a head-mounted display (HMD) such as eSight Eyewear can be used to overcome some of them. In this exploratory study, the participants read and interpreted two excerpts of musical notation using eSight Eyewear. The data, collected through interviews, were coded using a qualitative method and a phenomenological approach. The results suggest that musicians with a VI use various visual aids, adaptations and compensatory strategies. However, these approaches are not without significant problems, particularly when they involve magnification. On the other hand, eSight Eyewear allows users to adjust magnification, have their hands free and use adapted musical notation. Many magnification-related problems are overcome with this HMD, which can be used to simultaneously read and interpret standard musical notation. However, reading sheet music with such a device remains a complex task, given the need to control head movements accordingly.

Comparison of Two Lighting Assessment Methods when Reading with Low Vision.

SIGNIFICANCE: Lighting assessments are an important component of low-vision rehabilitation but are rarely studied systematically. Our study indicates that preferred lighting levels support improvements in reading ease and enjoyment, independently of the evaluation technique. To determine preferred illumination level and color temperature, the LuxIQ is quicker to administer and covers broad options of settings. PURPOSE: The purpose of this study was to determine if preferred lighting, as assessed by the LuxIQ versus a standard lighting assessment, leads to better reading outcomes in individuals with low vision. METHODS: Preferred lighting was assessed at home with visually impaired persons (mean age, 75.3 years), using the LuxIQ (n = 18) or a standard technique based on trying out light bulbs of various intensity and color temperature (n = 16). Maximum reading speed and reading acuity were measured before the lighting intervention and then under the preferred lighting conditions. A 1-month telephone follow-up evaluated the (1) compliance with the lighting recommendations and, for those who modified their lighting, (2) their level of satisfaction with the length of reading time and eye strain felt during reading. RESULTS: Compared with usual lighting conditions, most participants preferred a cooler temperature at a higher illuminance level. Neither lighting assessment type appeared to lead to substantially improved objectively measurable reading outcomes. At the 1-month follow-up, 56% of the participants had modified their lighting, having a significant effect on satisfaction (P < .01), independent of assessment method. Of 18 respondents, 16 (87.5%) mentioned that reading was more enjoyable or easier with the lighting modifications. CONCLUSIONS: Both lighting assessment methods lead to comparable results, but the LuxIQ is easier and faster to use. More research is needed to determine whether the LuxIQ is suitable to be incorporated into clinical practice.

Reliability and validity of the Canadian-French ecological adaptation of the weighted version of the Melbourne low-vision ADL Index.

Background: The Mesure de l'impact de la déficience visuelle dans les activités quotidiennes (MIDVAQ) is the Canadian-French adaptation of the Melbourne Low-Vision ADL Index. It measures performance, personal importance and handicap situation in 16 instrumental activities requiring near vision (standardized material, part A) and in 9 self-care and domestic activities (self-report questionnaire, part B). This study aimed at measuring the MIDVAQ reliability and its relationship with measures of visual functions and functional vision.Methods: The MIDVAQ was administered twice to 100 visually impaired participants, at home, with their personal visual and non-visual aid. A second rater was present at T1. Two different versions of part A were used alternately at T1 and T2.Results: The total Handicap scale demonstrates good internal reliability (Cronbach's alpha coefficient = 0.82) and very high inter-rater and test-retest reliability (ICCs = 1.00 and 0.86). Part A alternative versions are highly comparable. Vision function measures are significantly correlated with total Handicap score, for which 48% of the variance is explained by functional vision estimates, age, and education.Conclusions: The MIDVAQ is highly valid and reliable. It can be useful to measure the functional impact of the visual impairment, its progression, and the outcomes of low vision rehabilitation services.Implications for rehabilitationEven if administered at home in an ecological way, this measure of the impact of the visual impairment in daily activities is very reliable.Given its good metric properties, this tool can be confidently used to assess the functional impact of visual impairment, outcomes of the low vision rehabilitation services, etc.This measurement tool provides complementary information to those obtained from clinical measures of visual functions, by reflecting the interaction between the functional abilities with the requirements of the environment.

Charles Bonnet syndrome: development and validation of a screening and multidimensional descriptive questionnaire.

OBJECTIVE: The purpose of this study was to develop a French Canadian questionnaire for the detection of Charles Bonnet syndrome that allows for (i) valid screening and (ii) the examination of different dimensions of the client's visual hallucinations in order to better assess the resulting needs. METHOD: Questionnaire development was guided by interviews with visually impaired individuals experiencing visual hallucinations, as well as supported by scientific literature and expert experience. A clinical study involving 76 individuals with low vision was conducted to determine the sensitivity and specificity of the instrument according to criterion validation. RESULTS: Of the 54 closed-ended questions, a subset of 11 revealed a sensitivity of 1.00 and a specificity of 0.77. Two additional questions showed high discriminating potential. Improvements to the wording and structure of some questions aiming at needs assessment were identified and applied. The improved version consists of 55 questions grouped in 8 dimensions: (1) Screening; (2) Characteristics of hallucinations; (3) Psychological impact; (4) Psychopathological origin; (5) Coping strategies; (6) Context of appearance of hallucinations; (7) Time-related matters; (8) Psychosocial support. The screening is operationalized through an algorithm applied to the set of 13 questions. CONCLUSION: The questionnaire will be a valuable aid in screening for Charles Bonnet syndrome among the low vision clientele. However, the screening will need to be supplemented by a focused low vision interdisciplinary assessment including a visual examination and a clinical interview with a psychologist.

Impact of partial administration of the Cognitive Behavioral Driver's Inventory on concurrent validity for people with brain injury.

OBJECTIVES: We sought to determine whether the partial administration of the Cognitive Behavioral Driver's Inventory (CBDI) has a significant effect on its concurrent validity. METHOD: Data were extracted from charts of clients with cerebrovascular accident or traumatic brain injury from three centers. The CBDI was administered either completely or partially (right and left perimetry or Wechsler Adult Intelligence Scale-Revised (WAIS-R; Wechsler, 1982; Picture Completion and Digit Symbol tests were not completed). Concurrent validity indicators were calculated for the CBDI and three different scenarios of partial administration of the CBDI. RESULTS: Only 52% of the road test failures were predicted correctly by the completely administered CBDI. Nonadministration of the WAIS-R rarely modified the CBDI results. Omission of perimetry scores tended to increase the sensitivity and decrease the specificity (not significantly). CONCLUSION: The CBDI should be used as a complement, not a substitution, for a road test. Partially administrating the CBDI, specifically excluding perimetry measures, can affect its concurrent validity.

Test-retest reliability and internal consistency of the Quebec-French version of the Survey of Pain Attitudes.

OBJECTIVE: To determine the test-retest reliability and internal consistency of the Quebec-French version of the Survey of Pain Attitudes (QAD/F-SOPA). DESIGN: Measurement of test-retest reliability (2-wk interval) and internal consistency. SETTING: Five rehabilitation settings that offer services to chronic pain patients. PARTICIPANTS: Convenience sample of 69 Francophone adults (having either French as the mother tongue or a good mastery of French) with musculoskeletal pain for a minimum of 6 months and stable pain condition during the test-retest interval. INTERVENTIONS: Completion of the QAD/F-SOPA twice within a 2-week interval. MAIN OUTCOME MEASURES: Test-retest reliability (Pearson r , 2-tail paired t test, P <.001) and internal consistency (Cronbach alpha at time 1). RESULTS: Fifty-six subjects completed the QAD/F-SOPA on both occasions. Except for the disability subscale, the r values fell between 0.7 and 0.9 (high correlation). For the paired t test, all subscales (except for control and medication) had a P value greater than .05, confirming their test-retest stability. All subscales showed satisfactory internal consistency estimates (0.7-0.9) except for the harm (.67) and disability (.64) subscales. CONCLUSIONS: Globally, the QAD/F-SOPA has good reliability and validity properties and meets the prerequisites for use for clinical and research purposes. The disability subscale shows weaker properties; further studies would help determine how it could be improved.