Driving Rehabilitation Specialists use DriveSafety driving simulators to evaluate and rehabilitate drivers who have sustained functional loss due to accidents, trauma, age or medical conditions. For high-risk impairments, simulators can provide needed client insight into their risk behind the wheel in the safety of the clinic, without exposing either the client or the clinician to the real dangers of the road.
DriveSafety simulators feature the acclaimed SimClinic™ library of clinical activities that support progressive functional exercises targeting a client’s underlying sensory, cognitive and/or motor abilities that are required for not only driving, but also for many other essential activities of daily living. Such evaluations and interventions are aligned with many countries’ occupational and/or physical therapy and rehabilitation codes, and may facilitate reimbursement for health care services delivered.
Sensory-related functions that can be exercised and measured using these interactive tools include visual perception and information processing, visual-motor integration, visual fields, and proprioception.
DriveSafety simulators provide unique tools for evaluating as well as for practicing and strengthening cognitive skills such as divided and selective attention, working memory, problem solving and anticipatory thinking.
Therapists also use DriveSafety simulators to assess and help rehabilitate clients’ motor function. Interactive exercises and driving scenarios target clients’ physical strength, reaction time, control, endurance, and neuromuscular reeducation of movement and coordination.
With realistic automotive controls and driver feedback, DriveSafety simulators provide an excellent platform for exercise and evaluation of driving skills. This begins with a focus on basic vehicle control, including the driver’s use of primary controls (steering wheel, gas and brake pedals, gear-select, etc.), and simple driving skills such as lane keeping, changing lanes, and speed management.
Exclusive to DriveSafety simulators is the SimClinic™ library featuring dozens of purpose-built exercises and driving scenarios that can help Driving Rehabilitation Specialists deliver progressive training and/or interventions that guide clients step by step from basic controls to more demanding roadway situations and driving tasks.
DriveSafety simulators and SimClinic™ scenarios include realistic and challenging drives that facilitate the rehearsal and testing of advanced safety skills, such as situational awareness, defensive driving and hazard detection and response.
Limitations of driving simulators are due mainly to limitations in the fidelity of their models of the real world and the queuing system used to present those models to the driver. Such may include imperfections in the models of the environment, roadway, vehicle dynamics and entity behaviors (such as other traffic), as well as limitations in the quality of the perceptual cues provided by visual, audio, haptic (control loading), vibration and motion subsystems. While the fidelity of simulations has increased dramatically in recent years, driving a simulator is still not the same as driving a real car.
Simulation offers several benefits including a safe, controlled rehearsal/practice space, the ability to break a complex task down into its component parts and focus on specific skills, repeatability, a high level of engagement and interaction, objective performance measures, presentation of rare or hazardous events, progressive interventions, and a bridge from conceptual learning to behind-the-wheel performance skills. Simulation allows for intervention in several health care disciplines, including Occupational Therapy, Driving Rehabilitation, Physical Therapy, Kinesiotherapy, Speech Therapy, Neurological Rehabilitation, Clinical and Neuro-Psychology and Autism.
3. ADDITIONAL BENEFITS
An interactive simulation system that is done well can provide therapists uniquely powerful tools for exercising a client’s functional abilities in several areas, most notably in the very rich ground of:
> vision and visual perception
> cognitive functions
> motor control and other physical functioning
Driving Rehabilitation Specialists frequently work with patients with physical impairments that may require adaptive equipment to operate a vehicle. DriveSafety driving simulators readily accommodate a wide range of adaptive equipment, including spinner knobs and hand controls. All DriveSafety simulators come with a left-foot accelerator pedal that can be stowed when not in use. Both the CDS 200 and CDS 250W simulator models allow patients to drive while seated in their own wheelchair, and are electrically height adjustable to fit any size wheelchair and patient height.
Often a driving assessment will reveal that a patient is no longer able to safely perform routine driving tasks, and a CDRS must make the recommendation that they no longer drive a vehicle. DriveSafety driving simulators make reporting easy and objective, so a CDRS can clearly explain driving deficiencies to patients and recommend additional therapy or alternate forms of transportation.
HINES VA HOSPITAL
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, 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 ways to assess and rehabilitate other forms of functional losses and cognitive skills. “We are continually discovering new uses for the product,” added Neczek.
We use our driving simulator with every patient to screen, test and assess their needs. And we use it in all phases of rehabilitation. 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’re developed confidence.