Retraining visual processing skills to improve driving ability after stroke.

UNLABELLED: Crotty M, George S. Retraining visual processing skills to improve driving ability after stroke. OBJECTIVE: To evaluate the effectiveness of retraining using the Dynavision on driving performance of people with stroke. DESIGN: Randomized controlled trial. SETTING: Outpatient rehabilitation clinic in Australia. PARTICIPANTS: People with stroke (N=26) referred for driving assessment. INTERVENTIONS: Eligible participants were randomized to either receive retraining with the Dynavision apparatus for 18 sessions or to receive no intervention and go onto a waitlist. MAIN OUTCOME MEASURES: The primary outcome was an assessment of on-road ability. Secondary outcomes included measures of response speed, visual scanning, and self-efficacy. All assessments were conducted by assessors blinded to group assignment. RESULTS: No significant difference (P=.223) was found between the intervention and control groups in results of on-road assessment in terms of pass or fail; the primary outcome measure; or the results on the secondary outcome measures of response speed, visual scanning, and self-efficacy. CONCLUSIONS: In this small trial, training underlying skills (such as executing a continuous wide scan, combining motor and visual processing into a motor response) using the Dynavision apparatus did not improve the outcomes of an on-road assessment for people after strokes. Larger trials are needed to evaluate devices that claim to retrain underlying skills related to driving.