Effects of Multimodal and Unimodal Physical Training Interventions on Visual Function in Glaucoma and Elderly Controls – A Pilot Study

Cynthia Moffack Djuloun,1 Khaldoon O Al-Nosairy,1 Rosalie Beyer,1 Constantin W Freitag,2 Francie H Stolle,1 Martin Behrens,3,4 Tom Behrendt,2 Gokulraj T Prabhakaran,1 Hagen Thieme,1 Lutz Schega,2,* Michael B Hoffmann1,5,* 1Ophthalmic Department, University Hospital, Magdeburg, Germany; 2Department of Sport Science, Institute III, Otto von Guericke University, Magdeburg, Germany; 3University of Applied Sciences for Sport and Management, Potsdam, Germany; 4Department of Orthopedics, Rostock University Medical Center, Rostock, Germany; 5Center for Behavioral Brain Research, Magdeburg, Germany*These authors contributed equally to this workCorrespondence: Michael B Hoffmann, Ophthalmic Department, University Hospital, Magdeburg, Germany, Tel +49 391 67 13585, Fax +49 391 67 13570, Email [email protected]: This study aimed to investigate the effects of a 12-week multimodal motor-cognitive and resistance training (MMI) compared to a unimodal resistance training intervention (UMI) on static and dynamic visual function in glaucoma (GLA) patients and healthy controls (HC).Methods: Fifteen GLA and 24 age-matched HC participated in this randomized, controlled longitudinal pilot study. Visual function was assessed using clinical parameters and on a treadmill (TM) while standing (static, S0) as well as during walking at 3.5 km/h (S3.5) and a self-preferred speed (SSelf). The following outcomes were measured pre and post 12-weeks of intervention (MMI or UMI): (a) standard clinical measures and (b) TM-related measures, i.e.: 1) best-corrected visual acuity without (VAS) and with crowding (VAC); 2) visual field sensitivity (VF); and 3) contrast sensitivity (CS). A 4-factorial repeated-measures ANOVA (SPEED [S0; S3.5; SSelf] × TIME [pre; post] × INTERVENTION [UMI; MMI] × GROUP [GLA; HC]) was applied to determine significant interaction effects (p ≤ 0.05) and the effect size partial-eta-squared was calculated.Results: Post-interventional improvement of visual function was absent or minor. Only the main effect of TIME (visual acuity; p = 0.024) and a TIME × INTERVENTION interaction (foveal sensitivity; p = 0.039) were found for standard clinical measures. For S0 vs. S3.5 small effects appeared in post-hoc comparisons, but TIME and TIME × SPEED just failed to reach significance for CS (p = 0.059) and VAs (p = 0.052), respectively. No GROUP interactions were observed.Conclusion: While trends were evident in this pilot study, the effect of the 12-week interventions on visual function was non-significant and, especially for TM-walking, largely independent of group and intervention type. In future studies, a greater sample size, with more advanced GLA cases, should be included to probe for significant visual function differences between groups and intervention types.Keywords: dynamic visual function, glaucoma, multimodal training, cognitive training, mobility