Retraining Moderately Impaired Stroke Survivors in Driving-Related Visual Attention Skills

• Published in: Topics in stroke rehabilitation 2010-09, Vol.17 (5), p.328-336
• Main Authors: Akinwuntan, Abiodun E., Devos, Hannes, Verheyden, Geert, Baten, Guido, Kiekens, Carlotte, Feys, Hilde, De Weerdt, Willy
• Format: Article
• Language: English
• Subjects: Adult; Aged; Attention - physiology; Automobile Driving - psychology; Clinical trials; Cognitive Therapy - methods; divided attention; driving simulator; Female; Follow-Up Studies; Humans; Male; Middle Aged; Motor Skills - physiology; Rehabilitation; selective attention; speed of processing; Stroke; Stroke - physiopathology; Stroke Rehabilitation; Survivor; Training; Treatment Outcome; Visual Fields - physiology; Visualization
• ISSN: 1074-9357; 1945-5119
• DOI: 10.1310/tsr1705-328

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.