Roger A. Kelsch, RKT and CDRS, and Joseph Neczek, RKT and CDRS, work at the Driver Rehabilitation Center in the Physical Medicine and Rehabilitation Division of the Edward Hines Jr. VA Hospital in Chicago. This regional facility is the only VA hospital in Illinois that provides driver rehabilitation services. The center serves patients throughout the Chicagoland area as well as in southern Wisconsin, southwestern Michigan and northwestern Indiana. While most patients of the Hines VA Hospital are veterans, some are active duty military personnel.
The Center purchased a DriveSafety CDS-250 Clinical Simulator in 2011 because it needed a way to quickly and precisely assess patients’ functional losses in a safe environment. With the CDS-250, the team can test factors such as steering and brake reaction time, acceleration time, skill on hills and curves, and so on. For patients suffering from Post Traumatic Stress Disorder (PTSD), the simulator can assess how they handle bridges, overpasses, crowds, vehicles following too closely, and more.
“We use the product with every patient to screen, test and assess their needs. And we use it in all phases of rehabilitation,” said Kelsch. “With a simulator we can get patients comfortable with scenarios that would otherwise cause anxiety and then bridge them over into real driving once they’ve developed confidence.”
The team at the Driver Rehabilitation Center can provide patients suffering from memory loss, dementia, amputation or spinal cord injuries a realistic experience in a simulator so they can get used to the idea of driving again. They can even add hand controls so patients can practice the physical coordination necessary to drive without using their feet. “Because our DriveSafety simulator is built using a real car cab structure, it’s much more lifelike for patients. That coupled with the triple viewing screens and the rear view mirrors enables patients to gain more confidence when it comes time for the real thing,” said Neczek.
The team can easily create custom routes or introduce various hazards and observe how a driver performs. For example, some patients prefer to drive rural routes but become anxious in a city setting. The simulator will surface that issue and enable the therapist to focus rehabilitation efforts in city driving environments.
“We can do a lot of customizing with our simulator—more than any other I’ve used in the past 25 years. When you zero in on certain aspects of driving for a given patient and then tailor the usage of the simulator to fill that need, it’s incredibly empowering,” noted Kelsch.
The additional capabilities of the CDS-250 are now beginning to emerge, and the team is exploring other forms of functional losses and cognitive skills to assess and rehabilitate. “We are continually discovering new uses for the product,” added Neczek.
Based in Michigan, Origami Brain Injury Rehabilitation Center focuses on maximizing recovery and restoring independence and quality of life for individuals who have sustained a brain injury or have other neurologic conditions. For many of their clients, cognitive function has declined to a level that makes essential tasks like driving difficult and sometimes unsafe.
Origami offers a range of care for individuals, including driver rehabilitation. A key component of its driving program is the DriveSafety CDS 200 driving simulator, which creates a realistic driving experience for users. The CDS 200 is designed expressly for rehabilitation clinics, like Origami, that need to assess not only driving abilities, but also cognitive, sensory and motor abilities that underlie driving and other activities of daily living.
“Through repetitive training exercises on the simulator, we can see how clients react to different scenarios”, said Natasha Huffine, OTRL and Certified Brain Injury Specialist at Origami. “We are able to incorporate high level, functional testing here on site that we weren’t able to do before and can come to our own conclusions based on objective measures without having to refer the client on for further evaluation elsewhere.”
Origami’s simulator includes three 19” high-resolution LCD screens, a steering wheel with adjustable mount and dynamic electric torque feedback, an accelerator and brake pedals and built-in software with dozens of driving scenarios for creating a highly realistic driving experience all while keeping the individual and occupational therapist safe.
“Our occupational therapists are able to utilize the driving simulator for individuals with post traumatic stress disorder (PTSD) related to motor vehicle accidents” said Amanda Carr, OTRL, Certified Brain Injury Specialist and Origami Clinical Manager. “Testing and training can be completed within a low risk environment, which can be comforting to clients. Co-treatments with psychologists can be utilized to form the compensatory skills needed for emotional stability prior to advancing with treatment on the road.”
In addition to using the simulator to make recommendations about the individual’s readiness and ability to drive, Origami uses the simulator as a modality for treatment. For example, using a carefully selected driving scenario, therapists can create a cognitively challenging environment to address divided attention, sequencing, and processing speed.
The driving simulator can assist with clients understanding and acceptance of the recommendations being made in therapy as well. At times, clients can have a difficult time understanding how data correlates from paper and pencil standardized assessments to driving ability. Now, with the DriveSafety simulator, therapists have objective data that relates specifically to the driving area impairment. The numbers are easy to understand and give an objective goal for clients to work towards to return to drive.
As one of the Nation’s leading providers of physical, occupational, speech, and respiratory therapy services, Genesis Rehab Services (GRS) serves over 55,000 patients in its 1,700+ locations each day. Expanding on its mission to improve the lives of every patient by delivering high-quality care and compassion, GRS also partners with skilled nursing centers, assisted living facilities, independent living facilities, hospitals, home health companies, adult day care programs, and outpatient clinics to provide comprehensive therapy services.
Adding to its extensive list of services, in 2014, GRS started a driving rehabilitation program to serve patients in the eastern United States. A key component of its driving program is the DriveSafety CDS 200 driving simulator, which creates a realistic driving experience for its users. The CDS 200 is used at PowerBack Rehabilitation in Voorhees, New Jersey and provides OTs with the tools they need to assess not only driving abilities, but also cognitive, sensory and motor abilities that underlie driving and other activities of daily living.
“Driving requires vision, cognition, coordination and visual perceptual skills,” said Susan Touchinsky, GRS’s Director of Driving Rehabilitation. “DriveSafety’s CDS 200 simulator gives us an incredible opportunity to see if all the patient’s performance skills necessary for driving are coming together in a safe environment. Our therapists can uncover deficiencies without going for a drive with the patients and potentially putting their safety at risk.”
GRS’s simulator includes three high-resolution LCD screens, an authentic instrument cluster and adjustable steering wheel with dynamic electric torque feedback, an accelerator and brake pedals and built-in software with dozens of client exercises and driving scenarios for creating a highly realistic driving experience that serves as a great asset for treating a wide range of patients. GRS OTs use the simulator to help patients who have lost limbs in battle learn to drive with the use of adaptive equipment along with elderly patients with declining visual and cognitive abilities that make driving more difficult and less safe.
“Learning to use adaptive driving equipment because of a limb loss can be a daunting task for many rehabilitation patients,” added Susan. “Working with OTs in the simulator can really help patients curb their own anxiety because it gives them a platform where they aren’t afraid to fail.”
Additionally, the CDS 200 has served as a great tool for attracting not only patients to PowerBack Rehabilitation, but top tier Occupational Therapists as well. The sleek design provides great curb appeal to the facility and an immediate avenue for OTs and patients to start talking about driving, a topic that is often avoided in other therapy settings. GRS predicts an expansion of clinics that adopt the use of a simulator and hopes that it leads to more opportunities for cross discipline use.
GRS is one of many providers using a DriveSafety simulator to improve treatment for their clients. Within the clinical arena, customers include rehabilitation clinics, VA hospitals, neurological centers and universities throughout the U.S. and Europe.