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Aul C, Brau JM, Sugarman A, DeGutis JM, Germine LT, Esterman M, McGlinchey RE, Fortenbaugh FC. The functional relevance of visuospatial processing speed across the lifespan. Cogn Res Princ Implic 2023; 8:51. [PMID: 37542181 PMCID: PMC10403489 DOI: 10.1186/s41235-023-00504-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/06/2023] [Indexed: 08/06/2023] Open
Abstract
Visuospatial processing speed underlies several cognitive functions critical for successful completion of everyday tasks, including driving and walking. While it is widely accepted that visuospatial processing speed peaks in early adulthood, performance across the lifespan remains incompletely characterized. Additionally, there remains a lack of paradigms available to assess visuospatial processing speed in unsupervised web-based testing environments. To address these gaps, we developed a novel visuospatial processing speed (VIPS) task adapted from two tests sensitive to visuospatial processing speed declines in older adults, the Useful Field of View paradigm and the PERformance CEntered Portable Test. The VIPS task requires participants to make a central orientation discrimination and complete a simultaneous peripheral visual search task. Data were collected from 86 in-lab volunteers (18-30 years) to compare performance to traditional neuropsychological measures. Consistent with previous literature, performance on the novel VIPS task significantly correlated with measures of selective attention, executive functioning, visual speed, and working memory. An additional 4395 volunteers (12-62 years) were recruited on TestMyBrain.org to establish lifespan trajectories of visuospatial processing speed and associations with functional disability. VIPS task performance peaked in the early 20's, and steadily decreased such that thresholds doubled in 60-year-olds relative to 20-year-olds (817 ms vs. 412 ms). VIPS task performance significantly correlated with self-reported cognitive functioning deficits broadly across the lifespan but was specifically related to mobility issues in middle-age. These findings have important implications for early detection of cognitive decline and provide insights into potential early intervention targets for younger and middle-aged adults.
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Affiliation(s)
- Courtney Aul
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Julia M Brau
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Alexander Sugarman
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
| | - Joseph M DeGutis
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Michael Esterman
- Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Francesca C Fortenbaugh
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Alhashmi D, Lalor A, Fossey E. Methods to evaluate driving competence for people with acquired brain injury (ABI): A systematic review. FRONTIERS IN REHABILITATION SCIENCES 2023; 3:1020420. [PMID: 36684687 PMCID: PMC9846792 DOI: 10.3389/fresc.2022.1020420] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023]
Abstract
Driving is essential for independence, community involvement and quality of life. Driving is the primary transportation method in Saudi Arabia. Despite the high rates of brain injuries and disability in Saudi Arabia, currently there are no guidelines regarding driver assessment and rehabilitation to facilitate people with brain injuries to resume driving. Therefore, this systematic review aimed to understand the assessment methods used internationally to evaluate driving competence for people with acquired brain injuries (ABI). A systematic search of six electronic databases was conducted by two authors and twenty-six studies were identified for review. Four main approaches to driver assessment: clinical assessments such as neuropsychological tests, off-road screening tools, simulator testing, and comprehensive driving assessment were identified. However, our findings revealed a lack of consistency in their use to assess driving competence after ABI. On-road driving performance tests were predominantly used to determine driving competence either independently or in combination with another method in over two-thirds of the reviewed studies. While clinical assessments of cognitive impairments showed some capacity to predict driving performance of people with ABI, they should be used with caution since they cannot replace on-road driving performance tests. Driver assessment should be part of rehabilitation following high prevalence conditions such as ABI. This systematic review offers guidance for Saudi clinicians, as well as policymakers, about providing rehabilitation services for people with ABI, and recommendations for further research and collaborations to improve this much-needed area of practice.
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Affiliation(s)
- Doha Alhashmi
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia,Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia,Correspondence: Doha Hassan Alhashmi
| | - Aislinn Lalor
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia,Rehabilitation, Ageing and Independent Living Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia,Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
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Schulz P, Schaebitz WR, Driessen M, Beblo T, Toepper M. Recovery of driving fitness after stroke: A matter of time? J Am Geriatr Soc 2022; 70:1578-1580. [PMID: 35150128 DOI: 10.1111/jgs.17681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Philipp Schulz
- Epilepsie-Zentrum Bethel, Krankenhaus MARA, Bielefeld, Germany
| | | | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Max Toepper
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
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Samuelsson K, Lundqvist A, Selander H, Wressle E. Fitness to drive after acquired brain injury: Results from patient cognitive screening and on-road assessment compared to age-adjusted norm values. Scand J Psychol 2021; 63:55-63. [PMID: 34558073 DOI: 10.1111/sjop.12774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/16/2021] [Accepted: 08/10/2021] [Indexed: 01/13/2023]
Abstract
Fitness to drive after acquired brain injury or disease is a common question in rehabilitation settings. The aim of the study was to compare age-matched norms with patient cognitive test results used to predict fitness to drive. A second aim was to analyze the contribution from an on-road assessment to a final decision on resumption of driving after an acquired brain injury. Retrospective cognitive test results from four traffic medicine units (n = 333) were compared with results from a healthy norm population (n = 410) in Sweden. Patients were dichotomized according to the final decision as fit or unfit to drive made by the traffic medicine team. The norm group had significantly better results in all age groups for all cognitive tests compared with the patients considered unfit to drive and fit to drive. A binary regression analysis for the patient group showed an explained value for fit to drive/unfit to drive of 88%, including results for the Nordic Stroke Driver Screening Assessment total score, Useful Field of View total score and the final outcome from an on-road assessment. Results from the present study illustrate the importance of using several tests, methods and contexts for the final decision regarding fitness to drive.
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Affiliation(s)
- Kersti Samuelsson
- Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Anna Lundqvist
- Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Helena Selander
- Department of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Swedish National Transport Research Institute, Stockholm, Sweden
| | - Ewa Wressle
- Department of Geriatric Medicine and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Sakamaki K, Nishizawa S, Katsuki M, Kawamura S, Koh A. On-Road Driving Assessment in a Driving School Course and the Results of a Cognitive Function Test After Stroke in a Depopulated Rural Area in Japan: Case Series of Eight Patients. Cureus 2021; 13:e15293. [PMID: 34211804 PMCID: PMC8236213 DOI: 10.7759/cureus.15293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction Returning to driving after a stroke is a step toward independence and improving quality of life. Cognitive function after stroke is one of the essential factors that affect driving ability, and on-road driving assessment in driving school courses is beginning to spread in Japan. We started on-road driving assessment in 2018, and we herein report eight patients who underwent on-road driving assessment in the last three years, presenting both off-road cognitive function tests and on-road driving assessment results. Methods Of the 320 consecutive stroke patients from 2018 to 2020, we retrospectively investigated the eight patients’ characteristics who underwent on-road driving assessment. We performed cognitive function tests, including behavioral inattention test (BIT), trail-making test, Wechsler Adult Intelligence Scale-III, and behavioral assessment of the dysexecutive syndrome. Patients who meet BIT > 35, at least three other subitem criteria, and no unevaluable subitems can undergo on-road driving assessment by a driving instructor. With the recommendation of the driving instructors, we comprehensively decided the permission to drive. Results All eight patients could return to driving after on-road driving assessment. Two patients could return to driving after nearly a year. Conclusion The patients did not meet all the cut-offs of the cognitive function test, but they were judged to return to driving by driving instructors. We finally permitted all eight patients to drive. On-road driving assessment in the driving school course might be helpful for determining the permission to return to driving.
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Affiliation(s)
- Keita Sakamaki
- Department of Rehabilitation Medicine, Itoigawa General Hospital, Itoigawa, JPN
| | - Shin Nishizawa
- Department of Rehabilitation Medicine, Itoigawa General Hospital, Itoigawa, JPN
| | - Masahito Katsuki
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
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Chau E, Nishi A, Kristalovich L, Holowaychuk A, Mortenson WB. Establishing the Predictive Validity of the ScanCourse for Assessing On-Road Driving Performance. Am J Occup Ther 2021; 75:7501205120p1-7501205120p8. [PMID: 33399060 DOI: 10.5014/ajot.2021.041608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Scanning the environment is critical for driving safety. The ScanCourse is a functional assessment that assesses a person's ability to scan the environment for visual information while in motion. Measurement properties for the ScanCourse have been reported; however, its predictive validity is unknown. OBJECTIVE To determine the predictive validity of the ScanCourse for on-road driving performance and establish clinical cutoff scores. DESIGN Retrospective chart reviews were conducted over a 6-mo period. SETTING Four Canadian driver rehabilitation programs. PARTICIPANTS Charts from patients with neurological or vision conditions were eligible if they contained ScanCourse and on-road driving evaluation results between September 1, 2008, and August 30, 2018. Three hundred twenty-five charts were included for analysis. OUTCOMES AND MEASURES Area under the curve (AUC) analysis was used to determine the predictive validity of ScanCourse scores for on-road outcomes; cutoff scores were established by optimizing sensitivity and specificity. RESULTS The ScanCourse had an AUC of .702. The optimal cutoff score was 18/20 with a sensitivity of 76.7% and a specificity of 47.1%. CONCLUSIONS AND RELEVANCE Assessing the scanning abilities of at-risk drivers who intend to return to driving after sustaining an injury can help identify safety risks and inform interventions. The ScanCourse was found to have acceptable discriminatory ability for on-road driving performance. This study provides evidence supporting its continued use as a screening tool to assess driver fitness with an identified optimal cutoff score for clinical use. WHAT THIS ARTICLE ADDS Measuring the predictive ability of the ScanCourse assessment in relation to on-road driving performance provides occupational therapists with an evidence-based clinical tool to assist with screening fitness to drive among at-risk people.
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Affiliation(s)
- Eric Chau
- Eric Chau, BKin, MOT, OT, is Occupational Therapist, Private Practice, Vancouver, British Columbia, Canada. At the time of the research, Chau was Graduate Student, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam Nishi
- Adam Nishi, BKin, MOT, OT, is Occupational Therapist, Private Practice, Vancouver, British Columbia, Canada. At the time of the research, Nishi was Graduate Student, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lisa Kristalovich
- Lisa Kristalovich, BMR(OT), MRSc, OT, is Clinical Instructor, Department of Occupational Science and Occupational Therapy, University of British Columbia, and Occupational Therapist, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
| | - Ana Holowaychuk
- Ana Holowaychuk, MScOT (C), is Occupational Therapist, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - W Ben Mortenson
- W. Ben Mortenson, BScOT, MSc, PhD, OT, is Associate Professor, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Principal Investigator, International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre at Vancouver General Hospital, Vancouver, British Columbia, Canada; and Principal Investigator, Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada;
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Feasibility and Validity of a Low-Cost Racing Simulator in Driving Assessment after Stroke. Geriatrics (Basel) 2020; 5:geriatrics5020035. [PMID: 32485824 PMCID: PMC7345038 DOI: 10.3390/geriatrics5020035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 11/17/2022] Open
Abstract
There is a myriad of methodologies to assess driving performance after a stroke. These include psychometric tests, driving simulation, questionnaires, and/or road tests. Research-based driving simulators have emerged as a safe, convenient way to assess driving performance after a stroke. Such traditional research simulators are useful in recreating street traffic scenarios, but are often expensive, with limited physics models and graphics rendering. In contrast, racing simulators developed for motorsport professionals and enthusiasts offer high levels of realism, run on consumer-grade hardware, and can provide rich telemetric data. However, most offer limited simulation of traffic scenarios. This pilot study compares the feasibility of research simulation and racing simulation in a sample with minor stroke. We determine that the racing simulator is tolerated well in subjects with a minor stroke. There were correlations between research and racing simulator outcomes with psychometric tests associated with driving performance, such as the Trails Making Test Part A, Snellgrove Maze Task, and the Motricity Index. We found correlations between measures of driving speed on a complex research simulator scenario and racing simulator lap time and maximum tires off track. Finally, we present two models, using outcomes from either the research or racing simulator, predicting road test failure as linked to a previously published fitness-to-drive calculator that uses psychometric screening.
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8
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Metzler MJ, Maiani M, Jamieson B, Dukelow SP. Clinical provision of compensatory visual training after neurological injury: example of a multisite outpatient program. Disabil Rehabil 2019; 43:118-125. [PMID: 31120310 DOI: 10.1080/09638288.2019.1616835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM Treatment efficacy is established via controlled research trials, but treatment in real-world clinical environments is typically highly variable and may differ from research protocols by necessity. Here, we examined provision of visual retraining for adults after neurological injury at an outpatient rehabilitation program in Calgary, Canada. METHODS Retrospective chart audits extracted demographic data, assessment outcomes, and details related to provision of training. RESULTS Treatment was provided to individuals with both visual field and visual-perceptual impairments due to neurological injury (mostly stroke). Tools and techniques of visual retraining at this program are discussed, the common denominator being repetitive practice of compensatory visual behaviors. Across this multisite program, there was significant variability in the number of treatment sessions, 13.00 (±10.21) sessions for those with visual-perceptual impairments and 14.41 (±9.63) sessions for those with field loss. Descriptive statistics and confidence intervals suggest improved outcomes on some measures for those with visual field and visual perceptual impairments. CONCLUSIONS Our data suggest that visual retraining is feasible in this clinical outpatient setting. Implications for rehabilitation This program of visual retraining was provided to individuals with visual impairment (e.g., hemianopia) and visual perceptual impairment (e.g., unilateral spatial neglect) as a result of neurological injury. In this outpatient program, visual rehabilitation was feasible and appeared to improve outcomes among a heterogeneous clinical population. Fundamental characteristics of visual compensatory training at this program included repetitive practice of adaptive scanning behaviors across multiple contexts to promote automaticity and generalization of skills.
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Affiliation(s)
- Megan J Metzler
- Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, Canada
| | - Meghan Maiani
- Community Accessible Rehabilitation, Alberta Health Services, Calgary, Canada
| | - Brittany Jamieson
- Community Accessible Rehabilitation, Alberta Health Services, Calgary, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
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Selander H, Wressle E, Samuelsson K. Cognitive prerequisites for fitness to drive: Norm values for the TMT, UFOV and NorSDSA tests. Scand J Occup Ther 2019; 27:231-239. [PMID: 31088186 DOI: 10.1080/11038128.2019.1614214] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: Fitness-to-drive assessment is a growing area for occupational therapists. There are few off-road tests specially developed to assess fitness to drive, and several cognitive tests have no age-specific norms.Aims/objectives: The aim was to identify and describe age-related norm values for the Trail Making Test, Nordic Stroke Driver Screening Assessment and Useful Field of View test, and to study inter-correlation between test results.Materials and methods: The sample included 410 volunteers; 149 men and 261 women, mean age 52 ± 16.8 years. Commonly used off-road tests were used: TMT A and B, UFOV and NorSDSA.Results: Normative data for the specific subtests and total score for NorSDSA and UFOV are provided and presented in four age groups. Age correlated with the results for most of the subtests.Conclusions: Off-road cognitive test scores are necessary and valuable for occupational therapists in their contribution to the final decision on continued driving. In clinical practice, it can be difficult to interpret cognitive test results when working with driving assessments. Age-based norm values are suggested to be a way to provide clinicians with a benchmark against which scores can be compared.Significance: Age-based norms can guide occupational therapists working with fitness to drive.
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Affiliation(s)
- Helena Selander
- Swedish National Transport Research Institute, Gothenburg, Sweden.,Department or Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ewa Wressle
- Department of Geriatric Medicine and Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Kersti Samuelsson
- Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Inoue T, Ooba H, Hirano M, Takehara I, Watanabe S, Hitosugi M. Assessment for resumed driving in stroke patients via Functional Independence Measure1. Work 2019; 60:393-399. [PMID: 30040778 DOI: 10.3233/wor-182747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Some stroke survivors hope to resume driving after hospital discharge. For those who had driven frequently before their stroke, a normal daily life depends on being able to drive. OBJECTIVE Our objective was to determine whether Functional Independence Measure (FIM) scores predict patient driving ability, which would make them a suitable index for determining if a stroke patient can resume driving. METHODS This was a retrospective study of 71 patients who suffered from stroke. We divided them into three groups based on their driving status after discharge: (1) resumed driving (Driver), (2) wish to resume driving (Wisher), and (3) no wish to resume driving (Non-wisher). We compared total FIM scores and subcategories of FIM scores across groups. RESULTS Scores on the Motor-FIM and Cognitive-FIM were highest in the Driver group, followed by the Wisher and Non-wisher groups. Moreover, scores on the 'problem solving' and 'memory' subcategories of the Cognitive-FIM were significantly higher in the Driver group than in the Wisher group. CONCLUSIONS The FIM could be a useful assessment tool for determining whether or not stroke patients can resume driving. Moreover, among the Cognitive-FIM sub-categories, problem solving and memory ability might be the scores most relevant for this decision.
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Affiliation(s)
- Takuya Inoue
- Department of Legal Medicine, Shiga University of Medical Science, Shiga, Japan.,Department of Legal Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Hideki Ooba
- Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
| | | | - Itaru Takehara
- Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
| | - Shu Watanabe
- The Jikei University School of Medicine, Tokyo, Japan
| | - Masahito Hitosugi
- Department of Legal Medicine, Shiga University of Medical Science, Shiga, Japan
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11
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Akinwuntan AE, Backus D, Grayson J, Devos H. Validation of a short cognitive battery to screen for fitness-to-drive of people with multiple sclerosis. Eur J Neurol 2018; 25:1250-1254. [PMID: 29802779 DOI: 10.1111/ene.13690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/22/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Some symptoms of multiple sclerosis (MS) affect driving. In a recent study, performance on five cognitive tests predicted the on-road test performance of individuals with relapsing-remitting MS with 91% accuracy, 70% sensitivity and 97% specificity. However, the accuracy with which the battery will predict the driving performance of a different cohort that includes all types of MS is unknown. METHODS Participants (n = 118; 48 ± 9 years of age; 97 females) performed a comprehensive off-road evaluation that lasted about 3 h and a standardized on-road test that lasted approximately 45 min over a 2-day period within the same week. Performance on the five cognitive tests was used to predict participants' performance on the standardized on-road test. RESULTS Performance on the five tests together predicted outcome of the on-road test with 82% accuracy, 42% sensitivity and 90% specificity. CONCLUSIONS The accuracy of predicting the on-road performance of a new MS cohort using performance on the battery of five cognitive tests remained very high (82%). The battery, which was administrable in <45 min and cost ~$150, was better at identifying those who actually passed the on-road test (90% specificity). The sensitivity (42%) of the battery indicated that it should not be used as the sole determinant of poor driving-related cognitive skills. A fail performance on the battery should only imply that more comprehensive testing is warranted.
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Affiliation(s)
- A E Akinwuntan
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - D Backus
- MS Rehabilitation and Wellness Program, Shepherd Center, Atlanta, GA, USA
| | - J Grayson
- Department of Business Administration, Augusta University, Augusta, GA, USA
| | - H Devos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
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12
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McNamara A, John Barr C, Bond MJ, George S. A pilot study: Can the UFOV assessment be used as a repeated measure to determine timing of on-road assessment in stroke? Aust Occup Ther J 2018; 66:5-12. [PMID: 29460955 DOI: 10.1111/1440-1630.12456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND/AIMS Useful Field of View scores are predictive of on-road performance post-stroke. No objective data exist to determine if the Useful Field of View (UFOV) assessment can be used as a repeated measure in the post-stroke population to determine timing of occupational therapy on-road assessment as recovery occurs. The aims of this study were to determine whether there is a practice effect if the UFOV is administered at one, two and three months' post-stroke and to assess optimal time post-stroke to refer to an on-road assessment. METHOD Forty-two participants, 17 men (40.5%), with a mean age of 71 years (SD 9.33) were randomly allocated to 1. Assessment group - UFOV at one, two and three months' post-stroke, 2. Control group-UFOV at three months' post-stroke. Parametric and non-parametric tests were utilised depending on data distribution. RESULTS No significance was found between; three months' subtest 1 (P = 0.463), three months' subtest 2 (P = 0.729) and three months' subtest 3 (P = 0.534) between the assessment and control groups. Both group's scores were combined to examine pass/fail rates of UFOV assessment to indicate timing of referral to on-road assessments. At one month, 16.9% stroke survivors passed the UFOV, when reassessed at three months 69.1% passed and 28.6% again failed. CONCLUSION Improvements in scores at one month intervals over three months are due to improvements in abilities assessed by the UFOV as no practice effect was found to influence scores. UFOV scores performed at monthly intervals post-stroke can be used to guide the timing of an occupational therapy on-road assessment, with an increased likelihood of passing, as recovery occurs. This repeated use of the UFOV assessment can assist referral practices that best utilise driving rehabilitation programmes. Larger studies need to be conducted to confirm these results.
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Affiliation(s)
- Annabel McNamara
- College of Nursing and Health Sciences, Rehabilitation and Aged Studies Unit, Bedford Park, South Australia, Australia
| | - Christopher John Barr
- College of Nursing and Health Sciences, Rehabilitation and Aged Studies Unit, Bedford Park, South Australia, Australia
| | - Malcolm J Bond
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Stacey George
- College of Nursing and Health Sciences, Rehabilitation and Aged Studies Unit, Bedford Park, South Australia, Australia
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Yeh TT, Chang KC, Wu CY, Lee YY, Chen PY, Hung JW. Effects and mechanism of the HECT study (hybrid exercise-cognitive trainings) in mild ischemic stroke with cognitive decline: fMRI for brain plasticity, biomarker and behavioral analysis. Contemp Clin Trials Commun 2018; 9:164-171. [PMID: 29696239 PMCID: PMC5898488 DOI: 10.1016/j.conctc.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/07/2018] [Accepted: 02/13/2018] [Indexed: 12/11/2022] Open
Abstract
Purpose Cognitive decline after stroke is highly associated with functional disability. Empirical evidence shows that exercise combined cognitive training may induce neuroplastic changes that modulate cognitive function. However, it is unclear whether hybridized exercise-cognitive training can facilitate cortical activity and physiological outcome measures and further influence on the cognitive function after stroke. This study will investigate the effects of two hybridized exercise-cognitive trainings on brain plasticity, physiological biomarkers and behavioral outcomes in stroke survivors with cognitive decline. Methods and significance This study is a single-blind randomized controlled trial. A target sample size of 75 participants is needed to obtain a statistical power of 95% with a significance level of 5%. Stroke survivors with mild cognitive decline will be stratified by Mini-Mental State Examination scores and then randomized 1:1:1 to sequential exercise-cognitive training, dual-task exercise-cognitive training or control groups. All groups will undergo training 60 min/day, 3 days/week, for a total of 12 weeks. The primary outcome is the resting-state functional connectivity and neural activation in the frontal, parietal and occipital lobes in functional magnetic resonance imaging. Secondary outcomes include physiological biomarkers, cognitive functions, physical function, daily functions and quality of life. This study may differentiate the effects of two hybridized trainings on cognitive function and health-related conditions and detect appropriate neurological and physiological indices to predict training effects. This study capitalizes on the groundwork for a non-pharmacological intervention of cognitive decline after stroke.
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Affiliation(s)
- Ting-Ting Yeh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ku-Chou Chang
- Division of Cerebrovascular Diseases, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Discharge Planning Service Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Senior Citizen Service Management, Yuh-Ing Junior College, Kaohsiung, Taiwan
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ya-Yun Lee
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Yu Chen
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jen-Wen Hung
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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14
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Hird MA, Vesely KA, Tasneem T, Saposnik G, Macdonald RL, Schweizer TA. A Case-Control Study Investigating Simulated Driving Errors in Ischemic Stroke and Subarachnoid Hemorrhage. Front Neurol 2018; 9:54. [PMID: 29487561 PMCID: PMC5816745 DOI: 10.3389/fneur.2018.00054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 01/22/2018] [Indexed: 01/13/2023] Open
Abstract
Background Stroke can affect a variety of cognitive, perceptual, and motor abilities that are important for safe driving. Results of studies assessing post-stroke driving ability are quite variable in the areas and degree of driving impairment among patients. This highlights the need to consider clinical characteristics, including stroke subtype, when assessing driving performance. Methods We compared the simulated driving performance of 30 chronic stroke patients (>3 months), including 15 patients with ischemic stroke (IS) and 15 patients with subarachnoid hemorrhage (SAH), and 20 age-matched controls. A preliminary analysis was performed, subdividing IS patients into right (n = 8) and left (n = 6) hemispheric lesions and SAH patients into middle cerebral artery (MCA, n = 5) and anterior communicating artery (n = 6) territory. A secondary analysis was conducted to investigate the cognitive correlates of driving. Results Nine patients (30%) exhibited impaired simulated driving performance, including four patients with IS (26.7%) and five patients with SAH (33.3%). Both patients with IS (2.3 vs. 0.3, U = 76, p < 0.05) and SAH (1.5 vs. 0.3, U = 45, p < 0.001) exhibited difficulty with lane maintenance (% distance out of lane) compared to controls. In addition, patients with IS exhibited difficulty with speed maintenance (% distance over speed limit; 8.9 vs. 4.1, U = 81, p < 0.05), whereas SAH patients exhibited difficulty with turning performance (total turning errors; 5.4 vs. 1.6, U = 39.5, p < 0.001). The Trail Making Test (TMT) and Useful Field of View test were significantly associated with lane maintenance among patients with IS (rs > 0.6, p < 0.05). No cognitive tests showed utility among patients with SAH. Conclusion Both IS and SAH exhibited difficulty with lane maintenance. Patients with IS additionally exhibited difficulty with speed maintenance, whereas SAH patients exhibited difficulty with turning performance. Current results support the importance of differentiating between stroke subtypes and considering other important clinical characteristics (e.g., side of lesion, vascular territory) when assessing driving performance and reinforce the importance of physicians discussing driving safety with patients after stroke.
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Affiliation(s)
- Megan A Hird
- Neuroscience Research Program, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Kristin A Vesely
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
| | - Tahira Tasneem
- Neuroscience Research Program, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Gustavo Saposnik
- Neuroscience Research Program, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.,Stroke Research Unit, Mobility Program, St. Michael's Hospital, Toronto, ON, Canada.,Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - R Loch Macdonald
- Neuroscience Research Program, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.,Department of Surgery, Neurosurgery Division, University of Toronto, Toronto, ON, Canada
| | - Tom A Schweizer
- Neuroscience Research Program, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.,Department of Surgery, Neurosurgery Division, University of Toronto, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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15
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A cognitive function predicted method by Useful Field of View tests among elder people in Beijing. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2017. [DOI: 10.1016/j.jtcms.2017.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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16
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Yeh TT, Wu CY, Hsieh YW, Chang KC, Lee LC, Hung JW, Lin KC, Teng CH, Liao YH. Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial. Trials 2017; 18:405. [PMID: 28859664 PMCID: PMC5579904 DOI: 10.1186/s13063-017-2153-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/16/2017] [Indexed: 12/16/2022] Open
Abstract
Background Aerobic exercise and cognitive training have been effective in improving cognitive functions; however, whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown. This study aimed to determine the treatment effects of a sequential combination of aerobic exercise and cognitive training on cognitive function and clinical outcomes. Methods/design Stroke survivors (n = 75) with cognitive decline will be recruited and randomly assigned to cognitive training, aerobic exercise, and sequential combination of aerobic exercise and cognitive training groups. All participants will receive training for 60 minutes per day, 3 days per week for 12 weeks. The aerobic exercise group will receive stationary bicycle training, the cognitive training group will receive cognitive-based training, and the sequential group will first receive 30 minutes of aerobic exercise, followed by 30 minutes of cognitive training. The outcome measures involve cognitive functions, physiological biomarkers, daily function and quality of life, physical functions, and social participation. Participants will be assessed before and immediately after the interventions, and 6 months after the interventions. Repeated measures of analysis of variance will be used to evaluate the changes in outcome measures at the three assessments. Discussion This trial aims to explore the benefits of innovative intervention approaches to improve the cognitive function, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline. The findings will provide evidence to advance post-stroke cognitive rehabilitation. Trial registration ClinicalTrials.gov, NCT02550990. Registered on 6 September 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2153-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ting-Ting Yeh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. .,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
| | - Yu-Wei Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ku-Chou Chang
- Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
| | - Lin-Chien Lee
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Jen-Wen Hung
- Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hung Teng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Han Liao
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
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17
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Assessing Cognitive Ability and Simulator-Based Driving Performance in Poststroke Adults. Behav Neurol 2017; 2017:1378308. [PMID: 28559646 PMCID: PMC5438860 DOI: 10.1155/2017/1378308] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/14/2017] [Indexed: 01/13/2023] Open
Abstract
Driving is an important activity of daily living, which is increasingly relied upon as the population ages. It has been well-established that cognitive processes decline following a stroke and these processes may influence driving performance. There is much debate on the use of off-road neurological assessments and driving simulators as tools to predict driving performance; however, the majority of research uses unlicensed poststroke drivers, making the comparability of poststroke adults to that of a control group difficult. It stands to reason that in order to determine whether simulators and cognitive assessments can accurately assess driving performance, the baseline should be set by licenced drivers. Therefore, the aim of this study was to assess differences in cognitive ability and driving simulator performance in licensed community-dwelling poststroke drivers and controls. Two groups of licensed drivers (37 poststroke and 43 controls) were assessed using several cognitive tasks and using a driving simulator. The poststroke adults exhibited poorer cognitive ability; however, there were no differences in simulator performance between groups except that the poststroke drivers demonstrated less variability in driver headway. The application of these results as a prescreening toolbox for poststroke drivers is discussed.
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18
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Wiese LK, Wolff L. Supporting Safety in the Older Adult Driver: A Public Health Nursing Opportunity. Public Health Nurs 2016; 33:460-71. [PMID: 27263475 DOI: 10.1111/phn.12274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The effective operation of a motor vehicle encompasses a wide range of cognitive processes that can decline due to age-related changes in neuroanatomical structures and cognitive functionality. The increasing number of older adult drivers in our rapidly aging population heightens the public safety concern of unsafe driving associated with these changes. Nurses caring for older adults in public health settings are well positioned to make a difference in the management of older patients who may be at risk of endangering themselves or others on the roadways. In this article, information is provided for increasing nurses' awareness of the cognitive factors inhibiting effective driving, recognizing older adults who may be at risk for unsafe driving, and facilitating a patient/family to seek a driving evaluation.
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Affiliation(s)
- Lisa Kirk Wiese
- C.E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida.
| | - Logan Wolff
- College of Psychology, Nova Southeastern University, Fort Lauderdale, Florida
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19
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Fuermaier ABM, Tucha L, Evans BL, Koerts J, de Waard D, Brookhuis K, Aschenbrenner S, Thome J, Lange KW, Tucha O. Driving and attention deficit hyperactivity disorder. J Neural Transm (Vienna) 2015; 124:55-67. [PMID: 26419597 PMCID: PMC5281661 DOI: 10.1007/s00702-015-1465-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 09/18/2015] [Indexed: 12/01/2022]
Abstract
Adults with attention deficit hyperactivity disorder (ADHD) suffer from various impairments of cognitive, emotional and social functioning, which can have considerable consequences for many areas of daily living. One of those areas is driving a vehicle. Driving is an important activity of everyday life and requires an efficient interplay between multiple cognitive, perceptual, and motor skills. In the present study, a selective review of the literature on driving-related difficulties associated with ADHD is performed, seeking to answer whether individuals with ADHD show increased levels of unsafe driving behaviours, which cognitive (dys)functions of individuals with ADHD are related to driving difficulty, and whether pharmacological treatment significantly improves the driving behaviour of individuals with ADHD. The available research provides convincing evidence that individuals with ADHD have different and more adverse driving outcomes than individuals without the condition. However, it appears that not all individuals with ADHD are affected uniformly. Despite various cognitive functions being related with driving difficulties, these functions do not appear helpful in detecting high risk drivers with ADHD, nor in predicting driving outcomes in individuals with ADHD, since impairments in these functions are defining criteria for the diagnoses of ADHD (e.g., inattention and impulsivity). Pharmacological treatment of ADHD, in particular stimulant drug treatment, appears to be beneficial to the driving difficulties experienced by individuals with ADHD. However, additional research is needed, in particular further studies that address the numerous methodological weaknesses of many of the previous studies.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Ben Lewis Evans
- Traffic and Environmental Psychology Group, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Dick de Waard
- Traffic and Environmental Psychology Group, University of Groningen, Groningen, The Netherlands
| | - Karel Brookhuis
- Traffic and Environmental Psychology Group, University of Groningen, Groningen, The Netherlands
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Johannes Thome
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Klaus W Lange
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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20
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Hird MA, Vesely KA, Christie LE, Alves MA, Pongmoragot J, Saposnik G, Schweizer TA. Is it safe to drive after acute mild stroke? A preliminary report. J Neurol Sci 2015; 354:46-50. [DOI: 10.1016/j.jns.2015.04.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/07/2015] [Accepted: 04/27/2015] [Indexed: 01/13/2023]
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21
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Emmanuel Akinwuntan A, Gantt D, Gibson G, Kimmons K, Ross V, Newman Rosen P, Wachtel J. United States Version of the Stroke Driver Screening Assessment: A Pilot Study. Top Stroke Rehabil 2015; 20:87-92. [DOI: 10.1310/tsr2001-87] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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D'Amico M. Update on productive aging research in the American Journal of Occupational Therapy, 2013, and overview of research published 2009-2013. Am J Occup Ther 2014; 68:e247-60. [PMID: 25397772 DOI: 10.5014/ajot.2014.013581] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In light of the Centennial Vision charge of supporting practice through evidence, this article reviews productive aging research published in the American Journal of Occupational Therapy (AJOT) in 2013 and as a whole from 2009 to 2013. Thirteen such articles were published in 2013, consisting of 4 systematic reviews that identified effective occupational therapy interventions for older adults with low vision; 1 randomized controlled trial that examined changes in occupational therapists' mental health practices with DVD training; and 8 descriptive articles addressing instrument development, practitioner decision making, patient management of medications, and effects of task activities on pain and participation levels. From 2009 to 2013, the quantity and quality of AJOT articles on productive aging increased; 63 articles were published, including 24 effectiveness studies, 14 basic research studies, 15 articles on instrument development and testing, 1 article linking occupational engagement and health, 6 articles on professional education, and 3 articles addressing professional questions.
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Affiliation(s)
- Mariana D'Amico
- Mariana D'Amico, EdD, OTR/L, BCP, is Associate Professor, Department of Occupational Therapy, College of Allied Health Sciences and School of Graduate Studies, Georgia Regents University Augusta, 1120 15th Street, EC2330, Augusta, GA 30912-0700; ,
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23
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Cognitive, On-road, and Simulator-based Driving Assessment after Stroke. J Stroke Cerebrovasc Dis 2014; 23:2654-2670. [DOI: 10.1016/j.jstrokecerebrovasdis.2014.06.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/21/2014] [Accepted: 06/10/2014] [Indexed: 11/21/2022] Open
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24
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McNamara A, Walker R, Ratcliffe J, George S. Perceived confidence relates to driving habits post-stroke. Disabil Rehabil 2014; 37:1228-33. [DOI: 10.3109/09638288.2014.958619] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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25
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Yuen HK, Austin SL. Systematic Review of Studies on Measurement Properties of Instruments for Adults Published in the American Journal of Occupational Therapy, 2009–2013. Am J Occup Ther 2014; 68:e97-106. [DOI: 10.5014/ajot.2014.011171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. We describe the methodological quality of recent studies on instrument development and testing published in the American Journal of Occupational Therapy (AJOT).
METHOD. We conducted a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist to appraise 48 articles on measurement properties of assessments for adults published in AJOT between 2009 and 2013.
RESULTS. Most studies had adequate methodological quality in design and statistical analysis. Common methodological limitations included that methods used to examine internal consistency were not consistently linked to the theoretical constructs underpinning assessments; participants in some test–retest reliability studies were not stable during the interim period; and in several studies of reliability and convergent validity, sample sizes were inadequate.
CONCLUSION. AJOT’s dissemination of psychometric research evidence has made important contributions to moving the profession toward the American Occupational Therapy Association’s Centennial Vision. This study’s results provide a benchmark by which to evaluate future accomplishments.
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Affiliation(s)
- Hon K. Yuen
- Hon K. Yuen, PhD, OTR/L, is Professor and Director of Research, Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1530 Third Avenue South, Birmingham, AL 35294;
| | - Sarah L. Austin
- Sarah L. Austin, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Chicago State University, College of Health Sciences, Chicago, IL
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26
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Hines A, Bundy AC. Predicting driving ability using DriveSafe and DriveAware in people with cognitive impairments: A replication study. Aust Occup Ther J 2014; 61:224-9. [DOI: 10.1111/1440-1630.12112] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Ashleigh Hines
- Discipline of Occupational Therapy; Faculty of Health Sciences; The University of Sydney; Sydney New South Wales Australia
| | - Anita C. Bundy
- Discipline of Occupational Therapy; Faculty of Health Sciences; The University of Sydney; Sydney New South Wales Australia
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27
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Abstract
The useful field of view test was developed to reflect the visual difficulties that older adults experience with everyday tasks. Importantly, the useful field of view test (UFOV) is one of the most extensively researched and promising predictor tests for a range of driving outcomes measures, including driving ability and crash risk as well as other everyday tasks. Currently available commercial versions of the test can be administered using personal computers; these measure the speed of visual processing for rapid detection and localization of targets under conditions of divided visual attention and in the presence and absence of visual clutter. The test is believed to assess higher-order cognitive abilities, but performance also relies on visual sensory function because in order for targets to be attended to, they must be visible. The format of the UFOV has been modified over the years; the original version estimated the spatial extent of useful field of view, while the latest version measures visual processing speed. While deficits in the useful field of view are associated with functional impairments in everyday activities in older adults, there is also emerging evidence from several research groups that improvements in visual processing speed can be achieved through training. These improvements have been shown to reduce crash risk, and can have a positive impact on health and functional well-being, with the potential to increase the mobility and hence the independence of older adults.
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Affiliation(s)
- Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Qld., Australia
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28
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Barco PP, Wallendorf MJ, Snellgrove CA, Ott BR, Carr DB. Predicting road test performance in drivers with stroke. Am J Occup Ther 2014; 68:221-9. [PMID: 24581409 DOI: 10.5014/ajot.2014.008938] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE. The aim of this study was to develop a brief screening battery to predict the on-road performance of drivers who had experienced a stroke. METHOD. We examined 72 people with stroke referred by community physicians to an academic rehabilitation center. The outcome variable was pass or fail on the modified Washington University Road Test. Predictor measures were tests of visual, motor, and cognitive functioning. RESULTS. The best predictive model for failure on the road test included Trail Making Test Part A and the Snellgrove Maze Task(®). CONCLUSION. A screening battery that can be performed in less than 5 min was able to assist in the prediction of road test performance in a sample of drivers with stroke. A probability of failure calculator may be useful for clinicians in their decision to refer clients with stroke for a comprehensive driving evaluation.
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Affiliation(s)
- Peggy P Barco
- Peggy P. Barco, OTD, OTR/L, SCDCM, is Instructor, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Michael J Wallendorf
- Michael J. Wallendorf, PhD, is Research Statistician, Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Carol A Snellgrove
- Carol A. Snellgrove, PhD, is Chief Psychologist, South Australia Police Department, Adelaide, South Australia, Australia
| | - Brian R Ott
- Brian R. Ott, MD, is Professor, Department of Neurology, Warren Alpert Medical School, Brown University, and Director, Alzheimer's Disease and Memory Disorders Center, Rhode Island Hospital, Providence, RI
| | - David B Carr
- David B. Carr, MD, is Professor of Medicine and Neurology and Clinical Director, Division of Geriatrics and Nutritional Science, Washington University, 4488 Forest Park Boulevard, St. Louis, MO 63108;
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29
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Akinwuntan AE, O'Connor C, McGonegal E, Turchi K, Smith S, Williams M, Wachtel J. Prediction of driving ability in people with relapsing-remitting multiple sclerosis using the stroke driver screening assessment. Int J MS Care 2014; 14:65-70. [PMID: 24453736 DOI: 10.7224/1537-2073-14.2.65] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The ability to drive is often affected in individuals with multiple sclerosis (MS) because of the motor, visual, or cognitive deficits commonly associated with the condition. In this study, we investigated the accuracy with which the Stroke Driver Screening Assessment (SDSA), an established battery for the prediction of driving performance of stroke survivors, would predict driving performance of individuals with MS. Driving performance of 44 individuals with relapsing-remitting MS (mean ± SD age, 46 ± 11 years; 37 females and 7 males) who were currently driving at least once a month was predicted using their performance on the SDSA. Outcomes of a road test and the Useful Field of View (UFOV) test were used as measures of driving ability. Participants' performance on both the road and UFOV tests was predicted with more than 80% accuracy. The SDSA was more accurate in predicting who would pass the two tests than who would fail the tests. The SDSA battery appears to be a good predictor of driving performance of individuals with relapsing-remitting MS, especially those who have sufficient cognitive skills to continue driving. Larger studies are needed to definitively establish its predictive accuracy and confirm the validity of the predictions.
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Affiliation(s)
- Abiodun Emmanuel Akinwuntan
- Department of Physical Therapy (AEA, CO, EM, KT) and the Department of Neurology (AEA, SS), Georgia Health Sciences University, Augusta, GA, USA; MS Center of Atlanta, Atlanta, GA, USA (MW); and The Veridian Group, Berkeley, CA, USA (JW)
| | - Christina O'Connor
- Department of Physical Therapy (AEA, CO, EM, KT) and the Department of Neurology (AEA, SS), Georgia Health Sciences University, Augusta, GA, USA; MS Center of Atlanta, Atlanta, GA, USA (MW); and The Veridian Group, Berkeley, CA, USA (JW)
| | - Erin McGonegal
- Department of Physical Therapy (AEA, CO, EM, KT) and the Department of Neurology (AEA, SS), Georgia Health Sciences University, Augusta, GA, USA; MS Center of Atlanta, Atlanta, GA, USA (MW); and The Veridian Group, Berkeley, CA, USA (JW)
| | - Kristen Turchi
- Department of Physical Therapy (AEA, CO, EM, KT) and the Department of Neurology (AEA, SS), Georgia Health Sciences University, Augusta, GA, USA; MS Center of Atlanta, Atlanta, GA, USA (MW); and The Veridian Group, Berkeley, CA, USA (JW)
| | - Suzanne Smith
- Department of Physical Therapy (AEA, CO, EM, KT) and the Department of Neurology (AEA, SS), Georgia Health Sciences University, Augusta, GA, USA; MS Center of Atlanta, Atlanta, GA, USA (MW); and The Veridian Group, Berkeley, CA, USA (JW)
| | - Mitzi Williams
- Department of Physical Therapy (AEA, CO, EM, KT) and the Department of Neurology (AEA, SS), Georgia Health Sciences University, Augusta, GA, USA; MS Center of Atlanta, Atlanta, GA, USA (MW); and The Veridian Group, Berkeley, CA, USA (JW)
| | - Jerry Wachtel
- Department of Physical Therapy (AEA, CO, EM, KT) and the Department of Neurology (AEA, SS), Georgia Health Sciences University, Augusta, GA, USA; MS Center of Atlanta, Atlanta, GA, USA (MW); and The Veridian Group, Berkeley, CA, USA (JW)
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Abstract
PURPOSE The Useful Field of View (UFOV) test has been shown to be highly effective in predicting crash risk among older adults. An important question which we examined in this study is whether this association is due to the ability of the UFOV to predict difficulties in attention-demanding driving situations that involve either visual or auditory distracters. METHODS Participants included 92 community-living adults (mean age 73.6 ± 5.4 years; range 65-88 years) who completed all three subtests of the UFOV involving assessment of visual processing speed (subtest 1), divided attention (subtest 2), and selective attention (subtest 3); driving safety risk was also classified using the UFOV scoring system. Driving performance was assessed separately on a closed-road circuit while driving under three conditions: no distracters, visual distracters, and auditory distracters. Driving outcome measures included road sign recognition, hazard detection, gap perception, time to complete the course, and performance on the distracter tasks. RESULTS Those rated as safe on the UFOV (safety rating categories 1 and 2), as well as those responding faster than the recommended cut-off on the selective attention subtest (350 msec), performed significantly better in terms of overall driving performance and also experienced less interference from distracters. Of the three UFOV subtests, the selective attention subtest best predicted overall driving performance in the presence of distracters. CONCLUSIONS Older adults who were rated as higher risk on the UFOV, particularly on the selective attention subtest, demonstrated poorest driving performance in the presence of distracters. This finding suggests that the selective attention subtest of the UFOV may be differentially more effective in predicting driving difficulties in situations of divided attention which are commonly associated with crashes.
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Akinwuntan AE, Wachtel J, Rosen PN. Driving Simulation for Evaluation and Rehabilitation of Driving After Stroke. J Stroke Cerebrovasc Dis 2012; 21:478-86. [DOI: 10.1016/j.jstrokecerebrovasdis.2010.12.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 12/02/2010] [Indexed: 01/27/2023] Open
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Akinwuntan AE, Devos H, Stepleman L, Casillas R, Rahn R, Smith S, Williams MJ. Predictors of driving in individuals with relapsing–remitting multiple sclerosis. Mult Scler 2012; 19:344-50. [DOI: 10.1177/1352458512451944] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: We previously reported that performance on the Stroke Driver Screening Assessment (SDSA), a battery of four cognitive tests that takes less than 30 min to administer, predicted the driving performance of participants with multiple sclerosis (MS) on a road test with 86% accuracy, 80% sensitivity, and 88% specificity. Objectives: In this study, we further investigated if the addition of driving-related physical and visual tests and other previously identified cognitive predictors, including performance on the Useful Field of View test, will result in a better accuracy of predicting participants’ on-road driving performance. Methods: Forty-four individuals with relapsing–remitting MS (age = 46 ± 11 years, 37 females) and Expanded Disability Status Scale values between 1 and 7 were administered selected physical, visual and cognitive tests including the SDSA. The model that explained the highest variance of participants’ performance on a standardized road test was identified using multiple regression analysis. A discriminant equation containing the tests included in the best model was used to predict pass or fail performance on the test. Results: Performance on 12 cognitive and three visual tests were significantly associated with performance on the road test. Five of the tests together explained 59% of the variance and predicted the pass or fail outcome of the road test with 91% accuracy, 70% sensitivity, and 97% specificity. Conclusion: Participants’ on-road performance was more accurately predicted by the model identified in this study than using only performance on the SDSA test battery. The five psychometric/off-road tests should be used as a screening battery, after which a follow-up road test should be conducted to finally decide the fitness to drive of individuals with relapsing–remitting MS. Future studies are needed to confirm and validate the findings in this study.
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Affiliation(s)
- Abiodun Emmanuel Akinwuntan
- Department of Physical Therapy, Georgia Health Sciences University, Augusta, USA
- Department of Neurology, Georgia Health Sciences University, Augusta, USA
| | - Hannes Devos
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium
| | - Lara Stepleman
- Department of Psychiatry, Georgia Health Sciences University, Augusta, USA
| | - Rhonda Casillas
- Department of Psychiatry, Georgia Health Sciences University, Augusta, USA
| | - Rebecca Rahn
- Department of Neurology, Georgia Health Sciences University, Augusta, USA
| | - Suzanne Smith
- Department of Neurology, Georgia Health Sciences University, Augusta, USA
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Chua M, McCluskey A, Smead JM. Retrospective analysis of factors that affect driving assessment outcomes after stroke. Aust Occup Ther J 2012; 59:121-30. [DOI: 10.1111/j.1440-1630.2012.01005.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Michelle Chua
- Discipline of Occupational Therapy; Faculty of Health Sciences; The University of Sydney; Lidcombe; NSW; Australia
| | | | - Janice M. Smead
- Driving Assessment and Rehabilitation Centre (DARC); Department of Occupational Therapy; Royal Rehabilitation Centre Sydney; Ryde; NSW; Australia
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George SR. Tools to inform general practitioners' decision making on driving following a stroke. Med J Aust 2012; 196:37-8. [PMID: 22256930 DOI: 10.5694/mja11.10160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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I. Kneebone I, B. Lincoln N. Psychological Problems after Stroke and Their Management: State of Knowledge. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/nm.2012.31013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Unsworth CA, Baker A, Taitz C, Chan SP, Pallant JF, Russell KJ, Odell M. Development of a standardised Occupational Therapy--Driver Off-Road Assessment Battery to assess older and/or functionally impaired drivers. Aust Occup Ther J 2011; 59:23-36. [PMID: 22272880 DOI: 10.1111/j.1440-1630.2011.00979.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Research has been conducted over several years to develop a new off-road assessment battery referred to as the Occupational Therapy - Driver Off-Road Assessment Battery. This article documents the development of the Battery, and provides preliminary research evidence to support its content and predictive validity. METHODS Literature reviews and a focus group with nine driver assessor occupational therapists were undertaken, as well as data collection using the Occupational Therapy - Driver Off-Road Assessment Battery with 246 clients. A Classification and Regression Tree model was constructed to ascertain the predictive validity of the Battery, with fitness-to-drive as the outcome. RESULTS Twenty-one physical, 13 sensory and seven assessments of cognition/perception were identified as being reflective of the skills required for driving. Following rating of their psychometric properties, the best assessments were presented to focus group members. The driver assessors supported the inclusion of several assessments and encouraged the development of new assessments. A draft version of the Occupational Therapy - Driver Off-Road Assessment Battery was tested and found to have excellent predictive validity for client on-road performance of 82.6%. The Classification and Regression Tree model showed that client performance on tests included in the Battery should be used together, rather than in isolation, to support fitness-to-drive recommendations. CONCLUSION This research identified the most suitable physical, sensory and cognitive assessments to include in the Occupational Therapy - Driver Off-Road Assessment Battery, and provided support for its validity. The development of this standardised battery assists driver assessors to accurately and consistently assess and report the off-road driving capacity of clients.
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Affiliation(s)
- Carolyn A Unsworth
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.
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Abstract
Abstract
The American Occupational Therapy Association’s Centennial VisionAmerican Occupational Therapy Association (2007) articulates the strategic goals for the profession to be science driven and evidence based in major practice areas. In the practice area of productive aging, a previous review of research published in the American Journal of Occupational Therapy (AJOT Murphy, 2010) found mostly basic research with far fewer effectiveness studies. The current review article is divided into two parts. Part 1 provides an update on the types of research published on productive aging in AJOT in the past 2 yr (2009–2010). Part 2 examines the range and scope of occupational therapy effectiveness research on productive aging published in a similar time frame in other occupational therapy journals and outside of the discipline.
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Affiliation(s)
- Susan L. Murphy
- Susan L. Murphy, ScD, OTR/L, is Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Michigan, 9th Floor, 300 North Ingalls Street, Ann Arbor, MI 48109-2007, and Research Health Science Specialist, Geriatric Research, Education and Clinical Center, Veterans Affairs Ann Arbor Health Care System;
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Akinwuntan AE, Devos H, Verheyden G, Baten G, Kiekens C, Feys H, De Weerdt W. Retraining moderately impaired stroke survivors in driving-related visual attention skills. Top Stroke Rehabil 2011; 17:328-36. [PMID: 21131257 DOI: 10.1310/tsr1705-328] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- Abiodun E Akinwuntan
- Department of Physical Therapy, School of Allied Health Sciences, Medical College of Georgia, Augusta, Georgia
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