Vision loss and driving performance, stroke and physical impairment

September 24, 2002

The current issue of the Journal of Rehabilitation Research and Development includes a dozen manuscripts on an array of rehabilitation research, including the evaluation of tests to assess driving performance in adults with vision loss and physical fitness in person who have had a stroke. Below are abstracts of select articles featured in Volume 39, Issue 4 of the journal. Full-text manuscripts are available, free of charge, on-line at www.vard.org/jour/jourindx.htm.

Evaluation of driving tests in predicting driving performance
Evaluated whether commonly used neuropsychological batteries correlated with driving simulator skills. Data suggest that mental tracking ability, mental flexibility, and immediate verbal memory ability were significantly correlated with driving measures, including out-of-lane events, speed, and braking pressure.

Driving performance in patients with glaucoma
25 patients with glaucoma and 29 age-equivalent normally sighted control subjects participated in an interactive driving simulator test and provided real-world accident history for the previous 5-year period. Findings reveal that reduced contrast sensitivity may be important in indicating the level of driving skills for individuals with glaucoma who have normal or near-normal visual acuity and mild to moderate visual field loss.

Influence of stroke-related impairments on performance in 6-minute walk test
Assessed which stroke-related physical impairments influence performance in the 6-minute walk test and evaluated if this test provides a measure of functional walking endurance after stroke. Motor deficits of the lower limb and decreased balance contribute to the distance an adult with stroke can walk in 6 minutes. Changes in pulse and systolic blood pressure suggest that the walk test does provide a clinical measure of fitness for adults with stroke.

Remote monitoring of sitting behavior of people with spinal injury
Examined the feasibility of using a remote pressure logger, which records sitting behavior of the wheelchair user, for long-term monitoring of sitting pressure distributions during daylong wheelchair activities. Investigators found that the system identifies factors relating to sitting behavior, including pressure relief habits and asymmetry.

Effects of cueing treatments on action naming in aphasia
Investigates the effects of Phonological Cueing Treatment (PCT) and Semantic Cueing Treatment (SCT) on three chronic speakers with aphasia. Findings indicate that PCT and SCT may facilitate action naming for some speakers with aphasia but that the effects of these treatments may vary across grammatical forms.

Wheelchair use and satisfaction following stroke
49 veterans who have had a stroke were interviewed to determine if wheelchairs prescribed during rehabilitation are used and perceived as satisfactorily meeting individual mobility, functional, psychological, and social needs. Findings suggest the need for reevaluation of mobility needs and wheelchair utilization during the years following rehabilitation for a stroke.

Dysphagia research in the 21st century and beyond
Summarizes a dysphagia meeting responding to a heightened healthcare need and to determine the course of dysphagia research. Dysphagia affects a person's ability to swallow and may result in an ability to consume enough calories to nourish the body. The article identifies issues in dysphagia research, such as study design, population selection, and the standardization of diagnostic and treatment protocols.

New treatment for aphasia enhances naming ability
Developed a novel treatment to facilitate naming in patients with aphasia, a neurologic disorder that impacts an individual's language expression and comprehension. Three subjects with stable, chronic nonfluent aphasia were trained by a therapist to perform a complex nonsymbolic movement sequence with their nondominant hand prior to naming. Study results demonstrate that nonfluent aphasic patients can improve their picture naming ability by performing a complex action with the nondominant hand while naming.

Augmented blood removal after medicinal leech feeding in congested tissue
Discusses the development of a device to augment blood removal during the passive-bleeding phase of leech therapy. Results indicated that use of the device resulted in significant increases in blood retrieval relative to reports of passive bleeding alone.

Mechanical device holds promise to replace medicinal leeches
Describes the development and testing of mechanical prototypes for the treatment of venous congestion, a complication of reconstructive surgery. Four prototypes were tested using congested fasciocutaneous flaps in swine. Blood removed by each prototype was measured for up to 4 hours. On average, the four prototypes removed 609%, 643%, 843%, and 810% more blood from congested flaps versus a leech.

The Journal of Rehabilitation Research and Development is the only peer-reviewed, scientifically indexed publication covering all rehabilitation research disciplines: neurology, orthopedics, engineering, audiology, ophthalmology and optometry, outcomes, restorative, prosthetics, geriatrics, psychiatrics, and community reintegration. Formerly the Bulletin of Prosthetics Research, the Journal debuted in 1983 to include cross-disciplinary findings in rehabilitation. The Rehabilitation Research and Development Service, Department of Veterans Affairs, accepts original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers who investigate disability rehabilitation.
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Veterans Affairs Research Communications

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