# Changes of Gait Patterns after Correction of Refractive Error in the Elderly with Cataracts
## 4 Discussion
Despite the improvement of the average of visual acuity in the binocular from the scenarios without glasses (0.64 \(\pm\) 0.23) to the average of visual acuity in the scenarios with glasses (0.82 \(\pm\) 0.19), no clear correlation was observed between visual improvement and gait patterns. Thus, we were able to confirm the effectiveness of wearing correction glasses for the maintenance of gait stability in our elderly subjects regardless of the level of corrected visual acuity and the degree of refractive error. However, in this study, there were limitations in the ranges of visual improvement due to age-related cataracts in one or both eyes in the patients, and the range of refractive errors was also limited. Therefore, the conduction of additional studies is required in order to perform a more accurate analysis. Visual information is essential in the process of adapting to various surroundings and modifying gait patterns. As a proactive strategy during adaptation for walking, by utilizing one's sense of vision, potential obstacles in the surroundings can be predicted and thereby avoided during forward movement [38]. The proactive control of vision during movement is classified according to strategies for avoidance and accommodation. Strategies for avoidance involve shifting foot placement in an effort to adapt to the surroundings, increasing foot lift from the ground in order to avoid obstacles, and changing the direction of movement or stopping in order to avoid obstacles. Therefore, the accurate correction of refractive errors in the elderly can facilitate the initiation of visual scans of the surroundings, which could result in the development of more efficient proactive strategies for adaptation to walking with minimal consumption of energy. For humans, the optimal walking speed minimizes the consumption of energy per unit of distance. Walking at a slower or faster speed can cause a disruption of the optimal walking model, thus requiring much higher consumption of energy [39]. Based on the findings of this study, the authors would like to emphasize that improving the visual correction status in elderly patients can result in more efficient processing of visual information through the initiation of scans of the surroundings, leading ultimately to the stabilization of gait patterns. Globally, 30% of the elderly population aged 65 years or older have experienced falls, and recurrent falls have been reported in half of them [40]. [PERSON] et al. [41] reported that visual problems were present in 76% of elderly patients hospitalized for fall incidents, and in 79% of them, was able to recover their vision via either the correction of refractive error (40%) or cataract surgery (37%). Hospitalization for fall treatment increases the medical costs and socioeconomic burden associated with poor quality of life for the elderly [42]. Therefore, through the results of this study, gait rehabilitation experts should also recognize that appropriate optical correction for refractive error is an important factor leading to the prevention of frequent falls in the elderly by improving gait stability. This study has the following limitations. First, because the measurements used in the analysis of the results were taken immediately after the participants wore correction glasses, there was no consideration of adaptation effects that might occur after the participants wore correction glasses. Second, no analysis of the effects of major visual functions, such as contrast sensitivity and stereopsis, on gait patterns in the elderly subjects was performed. Finally, the establishment of correlations between each participant's body balance and factors affecting gait patterns will be required in order to determine the specific causesof changes in gait patterns after the correction of refractive errors. The conduction of follow-up studies to address these limitations is currently underway.