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A Self-Assessment Instrument Designed for Measuring Independent Mobility in RP Patients: Generalizability to Glaucoma Patients

From the Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

PURPOSE. To determine whether the patient-based assessment of difficulty in mobility, developed and validated in a group of patients with retinitis pigmentosa (RP), is valid for measuring perceived visual ability for independent mobility in patients with glaucoma.

METHODS. A mobility questionnaire that had previously been developed was administered to 83 patient-volunteers who had various amounts of visual impairment caused by glaucoma. Each volunteer rated the perceived difficulty of walking independently in each of 35 mobility situations. A Rasch analysis of the ordinal difficulty ratings was used to estimate interval measures of perceived visual ability for independent mobility.

RESULTS. The instrument showed good construct and content validity and high reliability scores. Criterion validity of the instrument was demonstrated by its ability to discriminate mobility-related behaviors such as fear of falling, asking for accompaniment, and believing their ability to travel independently is less than that of persons with normal vision. To make the perceived mobility scale comparable for the two diagnostic groups the questionnaire was restricted to those items whose difference in item-logit distributions was within ±3 (18 items). Using the same instrument calibration, we compared the person measures between the patients with glaucoma and those with RP. Patients with glaucoma had, on average, higher perceived visual ability for independent mobility than those with RP.

CONCLUSIONS. The instrument developed for patients with RP, to determine difficulty across a range of mobility situations, is a valid measure of perceived ability for independent mobility in patients with glaucoma.

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