The effects of Dynavision rehabilitation on behind-the-wheel driving ability and selected psychomotor abilities of persons after stroke.

OBJECTIVE Many conventional rehabilitation exercises, such as pencil-and-paper and computer tasks, may not train perceptual and motor skills as applied to a complex, multiskill activity such as driving. The present study examined the usefulness of the Dynavision apparatus for driving-related rehabilitation. The Dynavision was designed to train visual scanning, peripheral visual awareness, visual attention, and visual-motor reaction time across a broad, active visual field. METHOD Ten persons with a cerebrovascular accident participated in the study. All had failed behind-the-wheel driving assessments. Subjects participated in a 6-week Dynavision training program using exercises designed to impose various motor, perceptual, and cognitive demands. RESULTS Dynavision training resulted in significantly improved behind-the-wheel driving assessments as compared to expected outcomes. Comparisons between pretests, posttests, and follow-up tests on a number of Dynavision, response, and reaction time variables showed significant improvements and maintenance effects. Dynavision performance, and, to a lesser extent, choice visual reaction and response times, were found to differentiate between persons assessed as safe and unsafe to drive, and between older and younger drivers. Subject self-reports suggested that a variety of training-related improvements had occurred in everyday functioning. CONCLUSION Dynavision training shows some rehabilitative promise for improving driving and basic psychomotor skills. Future research on the benefits and limitations of this apparatus should use finer laboratory skill measures and more comprehensive tests of driving and daily functioning to assess more thoroughly skill improvements in persons after stroke.

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