The effect of cane length and paving design on walking performance in individuals with congenital blindness

Disturbance in the visual system is directly related to dysfunction in walking. This study investigated the independent and interactive effects of two paving designs (common vs standard (ISO 23599)) and two white cane lengths (standard vs extended) on walking performance. Twenty individuals with congenital blindness performed four walking experiments in a 2 × 2 within-subjects factorial design. Key gait and balence parameters were measured using Kinovea software and a trunk accelerometer. A two-way repeated measures multivariate analysis of variance (RM-MANOVA) was applied to the data. While the overall multivariate test for an interaction effect was not statistically significant (<i>p</i> = 0.146), the univariate tests revealed a strong synergistic effect for key gait parameter. Specifically, a significant interaction was found for speed (<i>p</i> = 0.009), stride length (<i>p</i> = 0.008), and step length (<i>p</i> = 0.032). The benefit of standard paving on these variables was substantially greater when participants used an extended cane. A significant multivariate main effect was also found for paving type (<i>p</i> = 0.002). Optimal walking performance for visually impaired individuals is best achieved through a synergistic combination of assistive tools and environmental design. Our findings indicate that the simultaneous use of an extended white cane and standardized tactile paving yields the greatest improvements in key gait patterns like speed and stride length. This highlights that mobility strategies should focus on integrating the tool and the environment to maximize safety and efficiency.