Useful field of view after traumatic brain injury

Deficits in multiple object-tracking and visual attention following mild traumatic brain injury

Difficulty in the ability to allocate and maintain visual attention is frequently reported by patients with traumatic brain injury (TBI). In the present study, we used a multiple object tracking (MOT) task to investigate the degree to which TBI affects the allocation and maintenance of visual attention to multiple moving targets. Fifteen adults with mild TBI and 20 control participants took part in this study. All participants were matched for age, gender, and IQ. The sensitivity and time taken to perform the MOT task were measured for different conditions in which the duration of the tracking, number of target, and distractor dots were systematically varied. When the number of target dots required to be tracked increased, sensitivity in correctly detecting them decreased for both groups but was significantly greater for patients with mild TBI. Similarly, increasing the number of distractor dots had a greater effect on reducing task sensitivity for patients with mild TBI than control participants. Finally, across all conditions, poorer detection performance was observed for patients with mild TBI when the tracking duration was longer compared to control participants. The present study showed that patients with mild TBI have greater deficits (compared to control participants) in their ability to maintain visual attention on tracking multiple moving objects, which was particularly hindered by increased tracking load and distraction.

Consistency of neuropsychological and driving simulator assessment after neurological impairment

Deficits in attentional and executive functioning may interfere with driving ability and result in a lower level of fitness to drive. Studies show mixed results in relation to the consistency of neuropsychological and driving simulator assessment. The objective of this study was to investigate the consistency of both types of assessment. Ninety-nine patients with various neurological impairments (72 males; M = 48.98 years; SD = 17.27) performed a 30-minute drive in a driving simulation in three different road settings; a (non-)residential rural area, a highway and an urban area. They also underwent neuropsychological assessment of attention and executive function. An exploratory correlational analysis was conducted. We found weak, but significant correlations between attention and executive function measures and more efficient driving in the driving simulator. Distractibility was associated with the most simulator variables in all three simulated road settings. Participants who were better at maintaining attention, eliminating irrelevant information and suppressing inappropriate responses, were less likely to drive above the speed limit, produced a less jerky ride, and used the rearview mirror more regularly. A lack of moderate or strong significant correlations (inconsistency) between traditional neuropsychological and simulator assessment variables may indicate that they don't evaluate the same cognitive processes.

Changes in the components of visual attention following traumatic brain injury: A systematic review and meta-analysis

Purpose

We conducted a systematic review and meta-analysis to understand the impact of traumatic brain injury (TBI) on visual attention and whether different components and processes of visual attention (such as selective, sustained, divided, and covert orientation of visual attention) are affected following brain injury.

Methods

A literature search between January 1980 to May 2021 was conducted using Medline, Scopus, PubMed, and Google Scholar databases was undertaken for studies that assessed visual attention using different tasks that target specific or multiple components of visual attention. Three hundred twenty-nine potentially relevant articles were identified, and 20 studies met our inclusion criteria.

Results

A total of 123 effect sizes (ES) were estimated from 20 studies that included 519 patients with TBI and 530 normal participants. The overall combined ES was statistically significant and large (ES = 0.92), but with high heterogeneity (Q = 614.83, p < 0.0001, I² = 80.32%). Subgroup analysis showed that the impact of TBI severity, with the ES for moderate-severe TBI significantly higher than mild TBI (t (112) = 3.11, p = 0.002). Additionally, the component of visual attention was differentially affected by TBI (F (2, 120) = 10.25, p<0.0001); the ES for selective attention (ES = 1.13) and covert orientation of visual attention (ES = 1.14) were large, whilst for sustained attention, the ES was medium at 0.43. A subgroup analysis comparing outcome measures showed that reaction time (ES = 1.12) was significantly more affected compared to performance accuracy (ES = 0.43), F (1, 96) = 25.98, p<0.0001).

Conclusion

Large and significant deficits in visual attention was found following TBI which can last for years after the initial injury. However, different components of visual attention were not affected to the same extent, with selective visual attention and orientation of visual attention most affected following TBI.

Return to driving post stroke; patients' perspectives and challenges in Saudi Arabia

BackgroundReturning to driving remains one of the most important goals for stroke survivors. In Saudi Arabia, there are no structured processes to address the issue of return to driving in individuals with disabilities. There are increasing rates of strokes in the country and road traffic accidents are the highest in the region. Returning to driving among male stroke survivors in Saudi Arabia is of particular importance due to socio-economic and cultural reasons.AimsThe study aims to explore the factors involved in return to driving among stroke survivors in Saudi population.MethodsThis cross-sectional study was carried out on 100 male stroke survivors who had completed an inpatient rehabilitation program and had at least one follow-up assessment three months post-discharge. Information was collected regarding demographics, stroke characteristics, and factors related to pre and post-stroke driving. Data were analyzed using SPSS.ResultsMajority (60%) of patients were 51 years of age and above. Most commonly reported stroke impairments were weakness and spasticity with majority of participants having right-sided body involvement. Out of 94 stroke survivors who were driving prior to stroke, only 7 resumed driving. None of the stroke survivors who returned to driving reported receiving any formal driving assessment. Only one patient who reported being aware of the need of driving assessment did not resume driving after stroke.ConclusionsThere is a dire need to increase awareness and to develop a structured integrated system in Saudi Arabia to facilitate stroke survivors to return to driving.

Driving and Low Vision: Validity of Assessments for Predicting Performance of Drivers

The authors conducted a systematic review to examine whether vision-related assessments can predict the driving performance of individuals who have low vision. The results indicate that measures of visual field, contrast sensitivity, cognitive and attention-based tests, and driver screening tools have variable utility for predicting real-world driving performance.

The clinical relevance of visualising the peripheral retina

Recent developments in imaging technologies now allow the documentation, qualitative and quantitative evaluation of peripheral retinal lesions. As wide field retinal imaging, capturing both the central and peripheral retina up to 200° eccentricity, is becoming readily available the question is: what is it that we gain by imaging the periphery? Based on accumulating evidence it is clear that findings in the periphery do not always associate to those observed in the posterior pole. However, the newly acquired information may provide useful clues to previously unrecognised disease features and may facilitate more accurate disease prognostication. In this review, we explore the anatomy and physiology of the peripheral retina, focusing on how it differs from the posterior pole, recount the history of peripheral retinal imaging, describe various peripheral retinal lesions and evaluate the overall relevance of peripheral retinal findings to different diseases.

Gun trauma and ophthalmic outcomes

PurposeThis retrospective cohort study assesses the visual outcomes of patients who survive gunshot wounds to the head.MethodsThe Elmhurst City Hospital Trauma Registry and Mount Sinai Data Warehouse were queried for gun trauma resulting in ocular injury over a 16-year period. Thirty-one patients over 16 years of age were found who suffered a gunshot wound to the head and resultant ocular trauma: orbital fracture, ruptured globe, foreign body, or optic nerve injury. Gun types included all firearms and air guns. Nine patients were excluded due to incorrect coding or unavailable charts. Statistical analysis was performed using a simple bivariate analysis (χ²).ResultsOf the 915 victims of gun trauma to the head, 27 (3.0%) sustained ocular injuries. Of the 22 patients whose records were accessible, 18 survived. Eight of the 18 surviving patients (44%) suffered long-term visual damage, defined as permanent loss of vision in at least one eye to the level of counting fingers or worse. Neither location of injury (P=0.243), nor type of gun used (P=0.296), nor cause of gun trauma (P=0.348) predicted visual loss outcome. The Glasgow Coma Scale eye response score on arrival to the hospital also did not predict visual loss outcome (P=0.793).ConclusionThere has been a dearth of research into gun trauma and even less research on the visual outcomes following gun trauma. Our study finds that survivors of gun trauma to the head suffer long-term visual damage 44% of the time after injury.

Incremental validity of Useful Field of View subtests for the prediction of instrumental activities of daily living

INTRODUCTION

The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults' ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions, and the underlying constructs of UFOV performance remain a topic of debate.

METHOD

We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We then explored the cognitive and visual abilities assessed by UFOV using a range of neuropsychological and vision tests administered in the SKILL study.

RESULTS

In the four subtest variant of UFOV, only Subtests 2 and 3 consistently made independent contributions to the prediction of IADL performance across three different behavioral measures. In all cases, the incremental validity of UFOV Subtests 1 and 4 was negligible. Furthermore, we found that UFOV was related to processing speed, general nonspeeded cognition, and visual function; the omission of Subtests 1 and 4 from the test score did not affect these associations.

CONCLUSIONS

UFOV Subtests 1 and 4 appear to be of limited use to predict IADL and possibly other everyday activities. Future research should investigate whether shortening UFOV by omitting these subtests is a reliable and valid assessment approach.

Driving after traumatic brain injury: evaluation and rehabilitation interventions

The ability to return to driving is a common goal for individuals who have sustained a traumatic brain injury. However, specific and empirically validated guidelines for clinicians who make the return-to-drive decision are sparse. In this article, we attempt to integrate previous findings on driving after brain injury and detail the cognitive, motor, and sensory factors necessary for safe driving that may be affected by brain injury. Various forms of evaluation (both in clinic and behind-the-wheel) are discussed, as well as driver retraining and modifications that may be necessary.

Predicting older driver on-road performance by means of the useful field of view and trail making test part B

The Useful Field of View(®) (UFOV) and Trail Making Test Part B (Trails B) are measures of divided attention. We determined which measure was more accurate in predicting on-road outcomes among drivers (N = 198, mean age = 73.86, standard deviation = 6.05). Receiver operating characteristic curves for the UFOV (Risk Index [RI] and Subtests 1-3) and Trails B significantly predicted on-road outcomes. Contrasting Trails B with the UFOV RI and subtests, the only difference was found between the UFOV RI and Trails B, indicating the UFOV RI was the best predictor of on-road outcomes. Misclassifications of drivers totaled 28 for the UFOV RI, 62 for Trails B, and 58 for UFOV Subtest 2. The UFOV RI is a superior test in predicting on-road outcomes, but the Trails B has acceptable accuracy and is comparable to the other UFOV subtests.

Rehabilitation for improving automobile driving after stroke

BACKGROUND

Interventions to improve driving ability after stroke, including driving simulation and retraining visual skills, have limited evaluation of their effectiveness to guide policy and practice.

OBJECTIVES

To determine whether any intervention, with the specific aim of maximising driving skills, improves the driving performance of people after stroke.

SEARCH METHODS

We searched the Cochrane Stroke Group Trials register (August 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2012, Issue 3), MEDLINE (1950 to October 2013), EMBASE (1980 to October 2013), and six additional databases. To identify further published, unpublished and ongoing trials, we handsearched relevant journals and conference proceedings, searched trials and research registers, checked reference lists and contacted key researchers in the area.

SELECTION CRITERIA

Randomised controlled trials (RCTs), quasi-randomised trials and cluster studies of rehabilitation interventions, with the specific aim of maximising driving skills or with an outcome of assessing driving skills in adults after stroke. The primary outcome of interest was the performance in an on-road assessment after training. SECONDARY OUTCOMES included assessments of vision, cognition and driving behaviour.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected trials based on pre-defined inclusion criteria, extracted the data and assessed risk of bias. A third review author moderated disagreements as required. The review authors contacted all investigators to obtain missing information.

MAIN RESULTS

We included four trials involving 245 participants in the review. Study sample sizes were generally small, and interventions, controls and outcome measures varied, and thus it was inappropriate to pool studies. Included studies were at a low risk of bias for the majority of domains, with a high/unclear risk of bias identified in the areas of: performance (participants not blinded to allocation), and attrition (incomplete outcome data due to withdrawal) bias. Intervention approaches included the contextual approach of driving simulation and underlying skill development approach, including the retraining of speed of visual processing and visual motor skills. The studies were conducted with people who were relatively young and the timing after stroke was varied.

PRIMARY OUTCOME

there was no clear evidence of improved on-road scores immediately after training in any of the four studies, or at six months (mean difference 15 points on the Test Ride for Investigating Practical Fitness to Drive - Belgian version, 95% confidence intervals (CI) 4.56 to 34.56, P value = 0.15, one study, 83 participants).

SECONDARY OUTCOMES

road sign recognition was better in people who underwent training compared with control (mean difference 1.69 points on the Road Sign Recognition Task of the Stroke Driver Screening Assessment, 95% CI 0.51 to 2.87, P value = 0.007, one study, 73 participants). Significant findings were in favour of a simulator-based driving rehabilitation programme (based on one study with 73 participants) but these results should be interpreted with caution as they were based on a single study. Adverse effects were not reported. There was insufficient evidence to draw conclusions on the effects on vision, other measures of cognition, motor and functional activities, and driving behaviour with the intervention.

AUTHORS' CONCLUSIONS

There was insufficient evidence to reach conclusions about the use of rehabilitation to improve on-road driving skills after stroke. We found limited evidence that the use of a driving simulator may be beneficial in improving visuocognitive abilities, such as road sign recognition that are related to driving. Moreover, we were unable to find any RCTs that evaluated on-road driving lessons as an intervention. At present, it is unclear which impairments that influence driving ability after stroke are amenable to rehabilitation, and whether the contextual or remedial approaches, or a combination of both, are more efficacious.

Driving Characteristics of Teens With Attention Deficit Hyperactivity and Autism Spectrum Disorder

Vehicle crashes are a leading cause of death among teens. Teens with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or both (ADHD–ASD) may have a greater crash risk. We examined the between-groups demographic, clinical, and predriving performance differences of 22 teens with ADHD–ASD (mean age = 15.05, standard deviation [SD] = 0.95) and 22 healthy control (HC) teens (mean age = 14.32, SD = 0.72). Compared with HC teens, the teens with ADHD–ASD performed more poorly on right-eye visual acuity, selective attention, visual–motor integration, cognition, and motor performance and made more errors on the driving simulator pertaining to visual scanning, speed regulation, lane maintenance, adjustment to stimuli, and total number of driving errors. Teens with ADHD–ASD, compared with HC teens, may have more predriving deficits and as such require the skills of a certified driving rehabilitation specialist to assess readiness to drive.

Driving indicators in teens with attention deficit hyperactivity and/or autism spectrum disorder

Background.

Motor vehicle crashes are leading causes of death among teens. Those teens with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or a dual diagnosis of ADHD/ASD have defining characteristics placing them at a greater risk for crashes.

Purpose.

This study examined the between-group demographic, clinical, and simulated driving differences in teens, representing three diagnostic groups, compared to healthy controls (HCs).

Method.

In this prospective observational study, we used a convenience sample of teens recruited from a variety of community settings.

Findings.

Compared to the 22 HCs (mean age = 14.32, SD = ±.72), teen drivers representing the diagnostic groups (ADHD/ASD, n = 6, mean age = 15.00, SD = ±.63; ADHD, n = 9, mean age = 15.00, SD = ±1.00; ASD, n = 7, mean age = 15.14, SD = ±.1.22) performed poorer on visual function, visual-motor integration, cognition, and motor performance and made more errors on the driving simulator.

Implications.

Teens from diagnostic groups have more deficits driving on a driving simulator and may require a comprehensive driving evaluation.

Pre-driving evaluation of a teen with attention deficit hyperactivity disorder and autism spectrum disorder

BACKGROUND

Vehicle crashes are the leading cause of death among teens, and those teens with attention-deficit/hyperactivity disorder and autism spectrum disorder (ADHD/ASD) may have a greater crash risk.

PURPOSE

This case study compared the pre-driving skills of a teen with ADHD/ASD to an age- and gender-matched healthy control (HC).

METHOD

Data were collected from performance on clinical tests and on a driving simulator.

FINDINGS

The main impairments of the teen with ADHD/ASD were the ability to shift attention, perform simple sequential tasks, integrate visual-motor responses, and coordinate motor responses, whereas the HC demonstrated intact skills in these abilities. The teen with ADHD/ASD made 44 driving errors during the drive, and the HC made 17. The teen with ADHD/ASD had more lane maintenance, visual scanning, and speeding errors compared to the HC.

IMPLICATIONS

Teens with ADHD/ASD may have more pre-driving deficits and may require a certified driving rehabilitation specialist to assess readiness to drive, but a larger study is needed to confirm this.

Retraining moderately impaired stroke survivors in driving-related visual attention skills

BACKGROUND

Visual inattention is a major cause of road accidents and is a problem commonly experienced after stroke.

PURPOSE

This study investigated the effects of 2 training programs on performance in the Useful Field of View (UFOV), a validated test of driving-related visual attention skills.

METHOD

Data from 69 first-ever, moderately impaired stroke survivors who participated in a randomized controlled trial (RCT) to determine the effects of simulator training on driving after stroke were analyzed. In addition to regular interventions at a rehabilitation center, participants received 15 hours of either simulator-based driving-related training or non-computer-based cognitive training over 5 weeks.

RESULTS

Total percentage reduction in UFOV and performance in divided and selective attention and speed of processing subtests were documented at 6 to 9 weeks (pretraining), 11 to 15 weeks (posttraining), and 6 months post stroke (follow-up). Generalized estimating equation (GEE) model revealed neither group effects nor significant interaction effects of group with time in the UFOV total score and the 3 subtests. However, there were significant within-group improvements from pre- through posttraining to follow-up for all the UFOV parameters. Post-hoc GEE analysis revealed that most improvement in both groups occurred from pre- to posttraining.

CONCLUSION

Both training programs significantly improved visual attention skills of moderately impaired stroke survivors after 15 hours of training and retention of benefit lasted up to 6 months after stroke. Neither of the training programs was better than the other.

Useful field of view as a reliable screening measure of driving performance in people with Parkinson's disease: results of a pilot study

PURPOSE

To determine the correlations of the Useful Field of View (UFOV), compared to other clinical tests of Parkinson's disease (PD); vision; and cognition with measures of on-road driving assessments and to quantify the UFOV's ability to indicate passing/failing an on-road test in people with PD.

METHODS

Nineteen randomly selected people with idiopathic PD, mean age = 74.8 (6.1), 14 (73.7%) men, 18 (94.7%) Caucasians, were age-matched to 104 controls without PD. The controls had a mean age of 75.4 (6.4), 59 (56.7%) men, 96 (92.3%) Caucasians. Both groups were referred for a driving evaluation after institutional review board approval.

RESULTS

Compared to neuropsychological and clinical tests of vision and cognition, the UFOV showed the strongest correlations (r > .75, p < 0.05) with measures of failing a standardized road test and number of driving errors. Among PD patients, the UFOV Risk Index score of 3 (range 1-5) was established as the optimal cutoff value for passing the on-road test, with sensitivity 87 percent and specificity 82 percent, AUC = 92 percent (SE 0.61, p = .002). Similarly, the UFOV 2 (divided attention) optimum cutoff value is 223 ms (range 16-500 ms), sensitivity 87.5 percent, specificity 81.8 percent, AUC = 91 percent (SE 0.73, p = .003). The UFOV 3 (selected attention) optimal cutoff value is 273 ms (range 16-500 ms), sensitivity 75 percent, specificity 72.7 percent, AUC = 87 percent (SE 0.81, p = .007).

CONCLUSION

In this pilot study among PD patients, the UFOV may be a superior screening measure (compared to other measures of disease, cognition, and vision) for predicting on-road driving performance but its rigor must be verified in a larger sample of people with PD.

Prevention of traffic accidents:The assessment of perceptual-motor alterations before obtaining a driving license.A longitudinal study of the first years of driving

A longitudinal study was designed with two objectives: first, to provide a wide cognitive, personality and social description of new drivers before they started to drive cars. Second, to examine the relationship between cognitive and other characteristics drivers had before obtaining their driving license and the number and type of accidents they were involved in during the first years as drivers.

RESEARCH DESIGN

The longitudinal study started in 1997 and ended in 2002. The first assessment was made up of 241 individuals at the time they enrolled on the driving course. The follow-up evaluation in the year 2002 was carried out on 144 components of the initial sample after five years driving. Age, gender and education level were matched to represent the population of Spain.

METHOD AND PROCEDURES

Participants were assessed with the Bender Test for visual-motor ability, the B101 Test for practical intelligence, the B19 Test for visual-motor bi-manual coordination, and the TKK-1108 for speed anticipation. Personality was also evaluated with the Rorschach test and the PSY (Psychological Assessment Questionnaire). Five years later, a new examination of all those variables was made as well as a structured interview with each participant in order to collect data relating to significant life events during that time, driving habits, opinions in relation to certain traffic rules and information on accidents, incidents and/or sanctions.

MAIN OUTCOMES AND RESULTS

Serious and/or minor accidents are concentrated on a few drivers. Accidentality is not related to gender or age, but educational level is related to serious accidents. The number of accidents (severe or minor ones) cannot be predicted if considered as a continuous variable, but it is possible if considered as a discrete variable. In this case two different cognitive profiles account for the number and type of accidents.

CONCLUSION

The number and type of accidents during their first years of driving are related to the cognitive profiles of drivers assessed before they obtained their driving license.

UFOV performance and driving ability following traumatic brain injury

PRIMARY OBJECTIVE

To investigate the relationship between performance on the Useful Field of View Test (UFOV) and driving performance following traumatic brain injury (TBI).

PARTICIPANTS

Sixty people with TBI referred for driving evaluation.

MEASURES

Useful Field of View Test, Global Rating Scale and Driver Assessment Scale.

RESULTS

Subject performance diminished as the complexity of the UFOV sub-tests increased. There was a significant relationship between UFOV performance, particularly on the second sub-test, and on-road driving performance. Subject age and Trail Making Test, Part B were also predictive of driving performance.

CONCLUSIONS

The UFOV can be used as a screening measure to determine readiness to participate in an on-road driving assessment.

Common neuropsychological deficits associated with stroke survivors' impaired performance on a useful field of view test

Useful field of view is a measure of information processing in peripheral vision that has potential for predicting impaired driving performance. The present study was performed to examine whether common neuropsychological deficits resulting from stroke might be associated with useful field of view impairment. 46 stroke survivors had impaired useful field of view test performance when compared to individuals without stroke (t30.6= -4.33, p<.001). The impairments in useful field of view of stroke survivors were associated with impaired peripheral fields, slowed processing speeds, and diminished attention. Such impairment was not localized to lesions in any particular brain area. Results allow the inference that common neuropsychological impairments may have contributed to inefficient extraction of visual information from peripheral vision.

Visual attention deficits are associated with driving accidents in cognitively-impaired HIV-infected individuals

Previous research has found HIV-associated neuropsychological (NP) dysfunction to be associated with impaired driving skills. To determine whether specific impairments in visual attention impart an increased accident risk, we assessed 21 HIV seronegative (HIV-) and 42 seropositive (HIV+) participants on NP tests and the Useful Field of View (UFOV), a computerized test of visual attention. HIV+ participants performed significantly worse than the HIV- participants on the UFOV, particularly on the Divided Attention subtest. Poor UFOV performance was associated with higher accident rates in the past year, with a trend for NP impairment to also predict more accidents. The highest number of accidents occurred in the group with a "high risk" UFOV designation and NP impairment; this category correctly classified 93% of HIV+ participants as to who did, and did not, have an accident. Clinicians should attend to visual attention as well as general cognitive status in estimating which patients are at risk for impaired driving.

The effects of physical activity and sedentary behavior on cognitive health in older adults

Physical activity has been shown to be positively associated with cognitive health, but the mechanisms underlying the benefits of physical activity on cognitive health are unclear. The present study simultaneously examined two hypotheses using structural equation modeling (SEM). The depression-reduction hypothesis states that depression suppresses cognitive ability and that physical activity alleviates dysphoric mood and thereby improves cognitive ability. The social-stimulation hypothesis posits that social contact, which is often facilitated by socially laden physical activities, improves cognitive functioning by stimulating the nervous system. Sedentary behavior in the absence of physical activity is expected to exert an inverse relationship on cognitive health through each of these hypotheses. Community-dwelling elders (N = 158) were administered a variety of measures of cognition, depression, social support, and physical activity. SEM techniques provided partial support for the social-stimulation hypothesis and depression-reduction hypothesis. Implications for treating depression and improving cognitive functioning are discussed.

Acquired brain injury, visual attention, and the useful field of view test: a pilot study

OBJECTIVE

To compare the findings of the Useful Field of View (UFOV) test with those of conventional neuropsychologic tests to determine the utility of the UFOV test as a measure of attention in a population with brain injury.

DESIGN

Cohort study.

SETTING

Freestanding rehabilitation hospital.

PARTICIPANTS

Fifteen inpatients with severe brain injury.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

UFOV test, FIM\T instrument, length of stay (LOS), and standard neuropsychologic testing.

RESULTS

The UFOV subtest UF2 correlated strongly with the other 2 subtests, UF1 and UF3. The UF2 subtest correlated most strongly with paper and pencil tests of visual attention. The UF2 predicted 52% of the FIM change and 60% of the LOS variance, second only to admission FIM score, which predicted 75% and 80% of FIM change and LOS variance, respectively.

CONCLUSIONS

Among the patients in our study, the UFOV test can be used to determine the visual divided attention of patients with acquired brain injury. The results also showed that the UFOV test correlated with LOS and FIM change in patients with acquired brain injury recovering in a rehabilitation facility. Because the UFOV test is much more quickly administered and scored than other measures of attention and divided attention, these results suggest that the UFOV test may provide an easy means to measure a critical variable in the population with head injury.