Simulator Can Help Stroke Patients Drive Again

Patients who receivedsimulator training were also almost twice as likely as stroke patientswithout the training to pass an official driving test at the end of afive-week training period, according to Dr. Abiodun Akinwuntan, aMedical College of Georgia physical therapy instructor and the leadresearcher on the study published in the Sept. 27 issue of Neurology.

“Traditionally,to help patients learn to drive again, therapists have relied onconventional methods like paper-and-pencil-based training and sometimesan on-road training method,” Dr. Akinwuntan says. “I have never been aproponent of the on-road method because it can be unsafe. Healthydrivers find the roads dangerous enough.”

In 2003, Dr. Akinwuntanand his colleagues at the Katholieke Universiteit in Leuven, Belgium,the Belgian Road Safety Institute in Brussels and University Hospitalin Pellenberg, Belgium, studied 83 stroke patients in therehabilitation unit of the hospital. Using a 20-mile computer-simulatedcourse that Dr. Akinwuntan developed, patients practiced driving in avariety of traffic situations. Virtual rural and open roads, urbansettings and highways each tested a different skill level.

“Rural,small roads have less traffic and test basic skills,” he says. “Theurban setting has more traffic and can test how well patients performwhen their attention is divided among many distractions, and thehighway setting gives an idea whether they understand what it means toovertake another car – can they effectively react to other drivers andtheir maneuvers.”

For training, patients drive in a speciallyequipped car on a course projected on a large screen in front of them.Mistakes are monitored both by computer and an observing evaluator.Patients using simulator training were more likely both to pass thedriver’s test and to retain the skill level achieved in training.

Thepossibilities to apply simulator training to other areas are endless,Dr. Akinwuntan says. For example, the simulator could be used to helpdetermine the types of driving skills affected at different stages ofParkinson’s disease and how interventions like deep brain stimulationhelp people overcome some of the problems.

Dr. Akinwuntan alsoplans to help develop a unit at MCG that would use simulators andvirtual reality systems to assist doctors and therapists in determiningthe challenges patients face after leaving the hospital.
“Suchinformation could be used to modify interventions or influence therehabilitation programs of patients,” Dr. Akinwuntan says.