Simulator helps stroke patients learn to drive again

A high-fidelity simulator that allows people to practice driving on a computer-generated course can help stroke patients learn to drive again, researchers have found.

Patients who received simulator training were also almost twice as likely as stroke patients without the training to pass an official driving test at the end of a five-week training period, according to Dr. Abiodun Akinwuntan, a Medical College of Georgia physical therapy instructor and the lead researcher on the study published in the Sept. 27 issue of Neurology.

"Traditionally, to help patients learn to drive again, therapists have relied on conventional methods like paper-and-pencil-based training and sometimes an on-road training method," Dr. Akinwuntan says. "I have never been a proponent of the on-road method because it can be unsafe. Healthy drivers find the roads dangerous enough."

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

"Rural, small roads have less traffic and test basic skills," he says. "The urban setting has more traffic and can test how well patients perform when their attention is divided among many distractions, and the highway setting gives an idea whether they understand what it means to overtake another car – can they effectively react to other drivers and their maneuvers."

For training, patients drive in a specially equipped 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 the driver's test and to retain the skill level achieved in training.

The possibilities to apply simulator training to other areas are endless, Dr. Akinwuntan says. For example, the simulator could be used to help determine the types of driving skills affected at different stages of Parkinson's disease and how interventions like deep brain stimulation help people overcome some of the problems.

Dr. Akinwuntan also plans to help develop a unit at MCG that would use simulators and virtual reality systems to assist doctors and therapists in determining the challenges patients face after leaving the hospital.

"Such information could be used to modify interventions or influence the rehabilitation programs of patients," Dr. Akinwuntan says.