Use and underuse of mobility aids in individuals with visual impairment: a cross-sectional study of a Norwegian sample

Purpose To examine the use and underuse of mobility aids in individuals with visual impairment. Methods A telephone survey including a probability sample of 736 adults who were members of the Norwegian Association of the Blind and Sighted (response rate: 61%). The interviews took place between January and May 2017, collecting information about access, use, underuse and training in five types of mobility aids (white cane, guide dog, GPS, door-to-door transport and sighted guide). For each mobility aid, we obtained data for underuse defined as non-use despite expecting benefits of use in terms of increased mobility or safety. Participants also answered questions about loneliness (Three-Item Loneliness Scale) and life satisfaction (Cantril's Ladder of Life Satisfaction). Results Of the participants, 69% reported using at least one type of mobility aid. Use of specific aids ranged from 12% for the GPS to 52% for door-to-door transport. Estimates of underuse ranged between 14% for door-to-door transport and 28% for GPS. Underuse was not related to lack of resources, as many non-users expecting benefits had access to mobility aids and had undergone training in its use. For example, 81% of non-users of the white cane had access to a cane. In post hoc analyses, non-users who expected benefits from use had lower life satisfaction compared with users. Conclusions Many individuals with visual impairment do not use mobility aids. Strategies that help visually impaired individuals overcome barriers to the use of mobility aids may improve their sense of safety, mobility and quality of life.Implications of rehabilitation The best mobility aids are those being used. Rehabilitation professionals involved in the provision of mobility aids should be sensitive to the user's lived experiences, and be alert of the cultural meanings of mobility aids and on disability in general. Rehabilitation professionals, social service workers and others need more knowledge of the psychosocial and cultural aspects related to why people do not use their mobility aids. A successful integration of mobility aids in people's daily life cannot be achieved by sufficient accessibility alone. Structured routines for follow-up of those who receive aids should be implemented, so that the aids are actually used. Due to the high rates of underuse and its possible relation to quality of life, promoting regular use of mobility aids should be prioritized.