Article

Several driving retraining programs have been developed to improve
driving skills after stroke. Those programs rely on different rehabilitation
concepts. OBJECTIVES: The current study sought to examine the specific carryover
effect of driving skills of a comprehensive training program in a driving
simulator when compared with a cognitive training program. METHODS: Further
analysis from a previous randomized controlled trial that investigated the effect
of simulator training on driving after stroke. Forty-two participants received
simulator-based driving training, whereas 41 participants received cognitive
training for 15 hours. Overall performance in the on-road test and each of its 13
items were compared between groups immediately posttraining and at 6 months
poststroke. RESULTS: Generalized estimating equation analysis showed that the
total score on the on-road test and each item score improved significantly over
time for both groups. Those who received driving simulator training achieved
better results when compared with the cognitive training group in the overall
on-road score and the items of anticipation and perception of signs, visual
behavior and communication, quality of traffic participation, and turning left.
Most of the differences in improvement between the 2 interventions were observed
at 6 months poststroke. CONCLUSIONS: Contextual training in a driving simulator
appeared to be superior to cognitive training to treat impaired on-road driving
skills after stroke. The effects were primarily seen in visuointegrative driving
skills. Our results favor the implementation of driving simulator therapy in the
conventional rehabilitation program of subacute stroke patients with mild
deficits.

Langue : ANGLAIS