A high-fidelity simulator that
allows people to practice driving on a computer-generated course can
help stroke patients learn to drive again, researchers have found.
Patients who received simulator
training were also almost twice as likely as stroke patients without
the training to pass an official driving test at the end of a
five-week training period, according to Dr. Abiodun Akinwuntan, a
Medical College of Georgia physical therapy instructor and the lead
researcher on the study published in the Sept. 27 issue of
Neurology.
“Traditionally, to help patients
learn to drive again, therapists have relied on conventional methods
like paper-and-pencil-based training and sometimes an on-road
training method,” Dr. Akinwuntan says. “I have never been a
proponent of the on-road method because it can be unsafe. Healthy
drivers find the roads dangerous enough.”
In 2003, Dr. Akinwuntan and his
colleagues at the Katholieke Universiteit in Leuven, Belgium, the
Belgian Road Safety Institute in Brussels and University Hospital in
Pellenberg, Belgium, studied 83 stroke patients in the
rehabilitation unit of the hospital. Using a 20-mile
computer-simulated course that Dr. Akinwuntan developed, patients
practiced driving in a variety of traffic situations. Virtual rural
and open roads, urban settings and highways each tested a different
skill level.
“Rural, small roads have less
traffic and test basic skills,” he says. “The urban setting has more
traffic and can test how well patients perform when their attention
is divided among many distractions, and the highway setting gives an
idea whether they understand what it means to overtake another car –
can they effectively react to other drivers and their maneuvers.”
For training, patients drive in a
specially equipped car on a course projected on a large screen in
front of them. Mistakes are monitored both by computer and an
observing evaluator. Patients using simulator training were more
likely both to pass the driver’s test and to retain the skill level
achieved in training.
The possibilities to apply
simulator training to other areas are endless, Dr. Akinwuntan says.
For example, the simulator could be used to help determine the types
of driving skills affected at different stages of Parkinson’s
disease and how interventions like deep brain stimulation help
people overcome some of the problems.
Dr. Akinwuntan also plans to help
develop a unit at MCG that would use simulators and virtual reality
systems to assist doctors and therapists in determining the
challenges patients face after leaving the hospital.
“Such information could be used to
modify interventions or influence the rehabilitation programs of
patients,” Dr. Akinwuntan says.
