Driving evaluation methods for able-bodied persons and individuals with lower extremity disabilities: a review of assessment modalities

[Driving improvement in spinal cord injury patients using virtual reality. Systematic review]

INTRODUCTION

Spinal cord injury is a pathology which causes motor and sensory impairment under the region damaged by the lesion. This results in limitations in daily activities such as driving. In recent years, improvement in this task has been achieved by means of virtual reality treatment in the rehabilitation of patients with spinal cord injury. The aim of the present study was to analyze, through a systematic review, the effectiveness of using virtual reality on driving skills in patients with spinal cord injury.

MATERIALS AND METHODS

The literature search was carried out using the following databases: PubMed, Web of Science, PEDro, Cochrane Central Register of Controlled Trials, Medline, Scopus and CINAHL, including articles published from January 2000 to May 2021.

RESULTS

After the research process, out of a total of 51 articles, 7 were included: 2 applied immersive VR and 5 semi-immersive VR. Road driving simulation was addressed by 4 of them: 1 on sailing, 1 on motorbike and 1 on bicycle.

CONCLUSIONS

The use of virtual reality in driving skills training has led to improvements in quality of life, driving skills and reduction of fear of driving. Despite these findings, more research, patients, sessions and improvements are needed for a clearer understanding of this topic and its usefulness.

An Evaluation Method of Safe Driving for Senior Adults Using ECG Signals

The elderly are more susceptible to stress than younger people. In particular, heart palpitations are one of the causes of heart failure, which can lead to serious accidents. To prevent heart palpitations, we have devised the Safe Driving Intensity (SDI) and Cardiac Reaction Time (CRT) as new methods of estimating the correlations between effects on the driver's heart and the movement of a vehicle. In SDI measurement, recommended acceleration value of vehicle for safe driving is inferred from the suggested correlation algorithm using machine learning. A higher SDI value than other people means less pressure on the heart. CRT is an estimated value of the occurring time of heart palpitations caused by stressful driving. In particular, it is proved by SDI that elderly subjects tend to overestimate their driving abilities in personal assessment questionnaires. Furthermore, we validated our SDI using other general statistical methods. When comparing the results using a t-test, we obtained reliable results for the equivalent variance. Our results can be used as a basis for evaluating elderly people's driving ability, as well as allowing for the implementation of a personalized safe driving system for the elderly.

A novel low-cost solution for driving assessment in individuals with and without disabilities

Brake reaction time is a key component to studying driving performance and evaluating fitness to drive. Although commercial simulators can measure brake reaction time, their cost remains a major barrier to clinical access. Therefore, we developed open-source software written in C-sharp (C#) for measuring driving related reaction times, which includes a subject-controlled vehicle with straight-line dynamics and several testing scenarios. The software measures both simple and cognitive load based reaction times and can use any human interface device compliant steering wheel and pedals. Measures from the software were validated against a commercial simulator and tested for reproducibility. Further, experiments were performed using hand controls in both able-bodied and spinal cord injured patients to determine clinical feasibility for disabled populations. The software demonstrated high validity when measuring brake reaction times, showed excellent test-retest reliability, and was sensitive enough to determine significant brake reaction time differences between able-bodied and spinal cord injured subjects. These results indicate that the proposed simulator is a simple and feasible low-cost solution to perform brake reaction time tests and evaluate fitness to drive.