Abstract
Background - Very little is known about driving training techniques for post-stroke clients and there is a need to regroup the most efficient and feasible techniques to improve this important aspect of rehabilitation. Survey’s results and a literature review recently highlighted the relevance of creating a new driving training protocol for subjects with stroke and cognitive limitations. The objectives of this research article are to present the development of a new driving protocol and show its applicability was tested in clinical context.
Methods - The 1st research design was a content validation to ensure the choice of the driving training methods and the elaboration of the training protocol in 9 levels. A pilot was done to pre-test its applicability (2nd research design). The setting of the research was in a Driving rehabilitation program in a rehab center. The participants involved were occupational therapist specialists (n=5) and post-stroke clients (n=5). On road re-evaluation was used, as well as off-road evaluations before and after the training protocol: Motor Free Visual Test, Trail Making Test, Useful Field Of View, Bells Test and Automatic Brake Reaction Timer.
Results - Adapted commentary driving and on-road training were perceived as being the most effective training methods. The protocol was feasible: training was completed in one month with 100% of participation. Three to seven training sessions (one hour) were needed to complete the 6 levels of adapted commentary driving and, to achieve the last 3 levels of the protocol, 4 behind-the-wheel training sessions were done.
Conclusion - This clinical protocol gives a better tool to rehabilitation specialists to train their post-stroke clients having cognitive limitations considering the specific and complex demands of the activity of driving.