An exploratory study on the predictive elements of passing on-the-road tests for disabled persons

Driving assessment and rehabilitation using a driving simulator in individuals with traumatic brain injury: A scoping review

BACKGROUND

Due to the heterogeneity of the lesion following a traumatic brain injury (TBI) and the complexity of the driving task, driving assessment and rehabilitation in TBI individuals is challenging. Conventional driving assessment (on-road and in-clinic evaluations) has failed demonstrating effectiveness to assess fitness to drive in TBI individuals.

OBJECTIVE

We aimed to determine if driving simulators represent an interesting opportunity in assessing and rehabilitating driving skills in TBI individuals.

METHODS

We searched PubMed, CINAHL and Cochrane library databases between 27-02-2014 and 08-04-2014 for articles published since 2000 with the contents of simulator driving assessment and rehabilitation.

RESULTS

Out of 488, eight articles with the subject of simulator driving assessment and two with the subject of simulator driving rehabilitation in individuals with TBI were reviewed.

CONCLUSIONS

Driving simulators represent a promising avenue for the assessment and rehabilitation of driving skills in TBI individuals as it allows control of stimuli in a safe, challenging and ecologically valid environment and offer the opportunity to measure and record driving performance. Additional studies, however, are needed to document strengths and limitations of this method.

Screening and assessment tools for determining fitness to drive: a review of the literature for the pathways project

With a brief introduction, 10 tables summarize the findings from the literature describing screening and assessment tools used with older adults to identify risk or determine fitness to drive. With a focus on occupational therapy's duty to address driving as a valued activity, this paper offers information about tools used by occupational therapy practitioners across practice settings and specialists in driver rehabilitation. The tables are organized into groups of key research studies of assessment tools, screening batteries, tools used in combination (i.e., as a battery), driving simulation as an assessment tool, and screening/assessment for individuals with stroke, vision impairment, Parkinson's disease, dementia, and aging. Each table has a summary of important concepts to consider as occupational therapists choose the methods and tools to evaluate fitness to drive.

Disability and rehabilitation in the dizzy patient

PURPOSE OF REVIEW

This review focuses on prospective studies of vertigo and balance therapy in the past 3 years, including advances in vertigo-habituation exercises for adults, pediatric intervention, and virtual reality techniques, and, in more depth, the literature pertinent to driving motor vehicles.

RECENT FINDINGS

Increased support has been generated for the efficacy of a minimal, home-based vertigo-habituation program for adults with peripheral vestibular disorders. Vestibular rehabilitation has been shown to be associated with improvements in independence and dynamic visual acuity. Community-based vestibular rehabilitation has been shown to be efficacious for selected patients, after careful screening, when trained personnel provide intervention. Vestibular rehabilitation has been incorporated into the rehabilitation program for head-injured military personnel who will be returned to duty, and multifactorial balance rehabilitation has been shown to be useful for children with hearing and balance impairments. Virtual reality techniques have made significant advances, so immersive environments have potential for rehabilitation for patients with vestibular disorders and for developing training regimens for astronauts to ameliorate some effects of exposure to microgravity. Driving skill, in general, is affected by use of benzodiazepines. For many patients with vestibular impairments driving is a particularly problematic activity of daily living.

SUMMARY

Progress has been made in studies of acute care, community-based, and pediatric vestibular rehabilitation. Work on simulator-based paradigms has moved toward readiness for implementation. Studies of driving have provided some insight into the problems of these patients. More work remains to be done on all of these problems.