The development of a simulator-based intervention to rehabilitate driving skills in people with acquired brain injury

ADRIS: The new open-source accessible driving simulator for training and evaluation of driving abilities

BACKGROUND AND OBJECTIVE

Independent living and transportation are crucial aspects for people living with a disability. After an injury, it is important to assess driving ability, in terms of physical and psychological conditions, and to test the effects of prescribed drugs. Within this framework, driving simulators are suitable tools for training driving skills; however, available tools are expensive or lack appropriate sets of behavioral measures to fully characterize the drivers' ability.

METHODS

This work presents the first step toward the development of ADRIS, a new open-source, accessible, realistic virtual reality simulator for training and testing driving skills of people with sensory-motor disability. This includes a prototype based on an open-source simulator for autonomous driving research (CARLA), with the addition of customized features such as adaptable driving controllers, a virtual reality headset, and the possibility to collect behavioral and physiological data. Also, the new system allows to set different environmental conditions, to include and control the timing of potentially dangerous situations, and to set scenarios with various difficulty levels.

RESULTS

Tests on 17 healthy participants demonstrated that the simulator is well tolerated in terms of discomfort, physical fatigue, and mental effort. Also, the system is easy to use and is capable of providing a realistic driving experience, allowing the extraction of reliable behavioral parameters.

CONCLUSIONS

ADRIS combines a high-fidelity virtual world, with customizable features specifically designed for the training and testing of people living with a disability, thus making it usable in many contexts such as home training, rehabilitation, education, and research.

An Analysis of Driving Behavior of Educated Youth in Bangladesh Considering Physiological, Cultural and Socioeconomic Variables

One of the alarming aspects of Bangladesh’s traffic safety is the massive growth in the number of drivers without previous driving instruction or licenses. Proper traffic safety is defined as systems and techniques used to safeguard road users against dying or being severely injured. A driving simulator policy and an environmental model are validated in this research. It aims to create a safe mass transit system with a minimal number of fatalities and injuries. The study focuses on current road and transportation strategies. Educated and internet-using Bangladeshi drivers took part in a questionnaire about their emotional stability on an online platform with more than 100 questions comprising two parts. While one of the part outlines the physiological, cultural, and socioeconomic factors and driver education, in another part, an 18-point Driver’s Behavior Questionnaire was introduced to the responders. About 40% of the surveyed drivers in the poll were inexperienced. However, 49% of people prefer to ride two-wheelers. Moreover, 70% of surveyed drivers hold valid driver’s licenses. At the same time, 35.2% of those were college graduates. Even 34.8% of accidents were caused by excessive speed and non-aggressive driving. In addition, age and degree of education were significant indicators of distracted driving violations. The study’s findings will raise awareness about the country’s undesirable driving patterns, resulting in a safer transit system with fewer accidents and deaths. In addition, the findings may be utilized to improve present road and transit policies and lead to the development of a driving simulator program for Bangladeshis.

Investigating feasibility and preliminary efficacy of a simulator-based driving intervention for people with acquired brain injury: A randomised controlled pilot study

OBJECTIVE

To investigate the feasibility and preliminary efficacy of a driving simulator intervention on driving outcomes following acquired brain injury.

DESIGN

Pilot randomised controlled trial.

SETTING

Occupational therapy driver assessment and rehabilitation service.

SUBJECTS

Individuals post-acquired brain injury aiming to return to driving.

INTERVENTION

Eight sessions of simulated driver training over four weeks, in addition to usual care. Control: Usual care only.

MAIN MEASURES

Feasibility outcomes: Participant recruitment and retention; data completeness; therapy attendance and fidelity; adverse events. Performance outcomes: on-road driving performance; Simulator Sickness Questionnaire; Brain Injury Driving Self-Awareness Measure and Driving Comfort Scale - Daytime, assessed at baseline and five weeks post-randomisation.

RESULTS

Out of 523 individuals screened, 22 (4%) were recruited and randomised, with 20 completing their allocated group (n = 12 Simulator, n = 8 Usual Care). For those who completed training, session attendance was 100% with simulator sickness rated, on average, as mild. Six individuals (50%) in the Simulator group failed the on-road assessment, versus two (25%) in the Usual Care group (P = 0.373). On average, the Simulator group reported a positive change in confidence ratings (M = 5.77, SD = 13.96) compared to the Usual Care group, who reported a negative change (M = -6.97, SD = 8.47), P = 0.034. The Simulator group (M = 0.67, SD = 3.34) demonstrated no significant change in self-awareness relative to the Usual Care group (M = -0.83, SD = 1.83, P = 0.325).

CONCLUSIONS

With adjustments to inclusion criteria and recruitment strategies, it may be feasible to deliver the intervention and conduct a larger trial. There is potential benefit of simulator training for improving driver confidence after acquired brain injury.

User experiences and perspectives of a driving simulator intervention for individuals with acquired brain injury: A qualitative study

Driving a motor vehicle is a common rehabilitation goal following acquired brain injury (ABI). There is increasing interest in the use of driving simulators for driver rehabilitation post-ABI; however, there is still limited research demonstrating efficacy and acceptability. This study sought to examine the user experience of a driving simulator intervention for ABI survivors. Semi-structured interviews were conducted with 14 individuals, including 12 ABI survivors (42% male; Mean age = 53.92 years, SD age = 17.63) who completed the intervention, and 2 occupational therapist driver assessors who facilitated the intervention. Thematic analysis was adopted to analyse interview data. Findings suggest that individual differences (e.g., anxiety, previous experience) influenced participant response to training. The intervention allowed participants to practise various driving skills, re-familiarize themselves with the task of driving, and prepare for return to on-road driving within a safe environment. The intervention was perceived to be useful for enhancing driver self-awareness, autonomy, confidence and patience. Fidelity and simulator sickness were considered limitations of the simulator technology. Subjective accounts of the appropriateness of intervention components are also documented. Overall, the simulator intervention was reported to be a positive experience for participants. Themes emerging from this study can inform future driving simulator interventions for ABI survivors.