Title : Improved Independent Walking in Blind Children after the Introduction of Pediatric Belt Cane

Cerebral visual impairment (CVI) is the leading cause of visual impairment in children in developed countries and is increasing in prevalence in developing nations. Congenital and early on-set mobility visual impairment and blindness prevent walking development in infants.  This study sought to measure and quantify the benefits of Belt Canes in patients with CVI foot motility/gait (see right for examples of Pediatric Belt Canes, are medically necessary devices for infants with a mobility visual impairment/blindness to walk).

Videos of 100 pediatric patients with CVI before (without protection from a safe mobility tool) and after (wearing the protective Pediatric Belt Cane) were analyzed using the MediaPipe platform to perform gait analysis. Subsequent analyses included linear regression analysis, data smoothing, peak-finding, and derivative analysis to calculate metrics for foot mobility, approximate speed, step frequency, and estimated step lengths. Paired-samples t tests were conducted to examine changes in foot mobility, step count, gait speed, and step length before and after use of the Pediatric Belt Cane. Foot mobility improved significantly following the intervention (mean Δ +0.021 meters/frame, +55.8%, p < .001) alongside increases in gait speed and step length. Step count also increased significantly following the intervention: children demonstrated a mean increase of 8.86 steps (95% CI −10.75 to −6.97, t(99) = −9.30, p < .001).

This work expands upon previous preliminary work to establish that Pediatric Belt Canes lead to marked, quantifiable improvements in walking for mobility visually impaired children, supporting the medical necessity Pediatric Belt Canes in the care and management of such patients. Further work in the exploration of the benefits of Pediatric Belt Canes is warranted, including larger sample sizes, the standardization of gait analysis, etc.

Dr. Robert Enzenauer is a pediatric ophthalmologist at Children's Hospital Colorado Anschutz Medical Campus. He holds an MD from the University of Missouri-Columbia School of Medicine in addition to an MPH from the University of Hawaii at Manoa and MBA from University of Massachusetts Amherst. Dr. Enzenauer’s research interests include caring for special-needs patients and assessing and treating the eye conditions of pediatric systemic disease. Dr. Enzenauer is also the director of the Pediatric Ophthalmology & Strabismus Fellowship at the Colorado University Anschutz School of Medicine.