It may seem like we are stating the obvious, but visual contrast seems to matter more than visual acuity. When we look at light contrast in lower frequencies (red ranges), we start to see some decomposition of gait with regards to step length, but not necessarily cadence or speed in this study of over 4,000 folks over 50 (hey, that’s us!). What are your patients wearing on their feet? What color is your floor? How about the walls?
Do your gait retraining in a well lit area with lots of contrast between the floor and your patients shoes, as well as the surroundings.
Duggan E, Donoghue O, Kenny RA, Cronin H, Loughman J, Finucane C. Time to Refocus Assessment of Vision in Older Adults? Contrast Sensitivity but Not Visual Acuity Is Associated With Gait in Older Adults. J Gerontol A Biol Sci Med Sci. 2017 Feb 28. doi: 10.1093/gerona/glx021. [Epub ahead of print]