Driver Safety Evaluation in Virtual Reality

A Driving Performance Laboratory has been established at Sharp Memorial Rehabilitation Services to evaluate and train patients with stroke and brain injury who wish to resume driving. A driving simulator similar to those used to train pilots is the centerpiece of a group of computer-based technologies that allows clinicians and therapists to work with patients soon after a stroke and other conditions affecting brain function.

About 700,000 people have a stroke in the United States annually, and one-third of the 500,000 of those that survive resume driving without formal testing, training, or counseling. Dr. A. R. Akinwuntan, an instructor in the Physical Therapy Department at the Medical College of Georgia, recently reported in the journal Neurology (Sept. 27, 2005) that stroke patients who received five weeks of training in a driving simulator are almost twice as likely as stroke patients without training to pass a formal road test.

According to Dr. Peter Rosen, Reese-Stealy ophthalmologist and director of the Driving Performance Laboratory, there are a number of advantages to the driving simulator over the road test: “First is safety. Assessment and training of skills and abilities of drivers in hazardous situations can be done in realistic, virtual driving environments without adverse consequences. Secondly, driving scenarios can be replayed for review and critical analysis by patients and therapists. A third advantage is to use the simulator as a training device to improve driving skills of attention, speed of processing visual information, and situational awareness. Training sessions can be tailored to the individual needs of patients that will enable them to practice and make improvements in their specific areas of deficit.”

Recent research highlights the benefits of early training after stroke and other brain injuries to enhance the brain’s ability to restore normal functioning by stimulating normal brain areas to take over functions from injured ones. This process, neural plasticity, allows the brain to re-organize its ability to carry out various activities and functions after brain injury. In addition, patients with Alzheimer’s disease, Parkinson’s disease, sleep apnea, attention deficit disorders, and patients with chronic pain or psychiatric disorders on neuroleptic, pain, or sedating drugs can also be specifically tested for driving fitness. Physicians whose patients’ families are concerned about their driving now have a resource to assess cognitive and motor-driving skills. The San Diego region has never had this type of comprehensive, simulated driver evaluation. It can be accessed by a referral to Sharp Memorial Rehab Services. If you would like to speak to Dr. Rosen about a referral, he can be reached directly at (619) 397-3090 or at peter.rosen@sharp.com.

The Sharp Driving Performance Laboratory will utilize the driving simulator and other technologies in research projects correlating driving performance with fMRI in the evaluation of eye gaze, attention, and short-term working memory after strokes and brain injuries. Other areas of research will include the use of home-based, computer-assisted therapy using standalone applications and the Internet for inter-active, tele-medicine sessions with therapists and doctors.

Sharp Memorial Rehab also offers NovaVision Vision Restoration Therapy, a treatment for visual field loss after stroke and traumatic brain injury that uses home-based, computerized programs to expand the visual field even late after stroke. It has the potential to improve the ability to read and perhaps allow safe driving in some patients with severe visual-field defects.