Driving errors in Parkinson's disease: moving closer to predicting on-road outcomes / Sherrilene Classen in American Journal of Occupational Therapy, Vol. 68/1 (janvier-février 2014)

Public ISBD [article]  inAmerican Journal of Occupational Therapy > Vol. 68/1 (janvier-février 2014) . - p.77-85 Titre : Driving errors in Parkinson's disease: moving closer to predicting on-road outcomes Type de document : texte imprimé Auteurs : Sherrilene Classen ; Babette BRUMBACK ; Miriam MONAHAN ; et al. Année de publication : 2014 Article en page(s) : p.77-85 Langues : Anglais (eng) Mots-clés : Conduite automobile  Maladie Parkinson  Performance  Sécurité Résumé : Age-related medical conditions such as Parkinson’s disease (PD) compromise driver fitness. Results from studies are unclear on the specific driving errors that underlie passing or failing an on-road assessment. In this study, we determined the between-group differences and quantified the on-road driving errors that predicted pass or fail on-road outcomes in 101 drivers with PD (mean age = 69.38 + 7.43) and 138 healthy control (HC) drivers (mean age = 71.76 + 5.08). Participants with PD had minor differences in demographics and driving habits and history but made more and different driving errors than HC participants. Drivers with PD failed the on-road test to a greater extent than HC drivers (41% vs. 9%), χ2(1) = 35.54, HC N = 138, PD N = 99, p < .001. The driving errors predicting on-road pass or fail outcomes (95% confidence interval, Nagelkerke R2 =.771) were made in visual scanning, signaling, vehicle positioning, speeding (mainly underspeeding, t(61) = 7.004, p < .001, and total errors. Although it is difficult to predict on-road outcomes, this study provides a foundation for doing so. Permalink : ./index.php?lvl=notice_display&id=19437 [article] Driving errors in Parkinson's disease: moving closer to predicting on-road outcomes [texte imprimé] / Sherrilene Classen ; Babette BRUMBACK ; Miriam MONAHAN ; et al. . - 2014 . - p.77-85. Langues : Anglais (eng) in American Journal of Occupational Therapy > Vol. 68/1 (janvier-février 2014) . - p.77-85 Mots-clés : Conduite automobile  Maladie Parkinson  Performance  Sécurité Résumé : Age-related medical conditions such as Parkinson’s disease (PD) compromise driver fitness. Results from studies are unclear on the specific driving errors that underlie passing or failing an on-road assessment. In this study, we determined the between-group differences and quantified the on-road driving errors that predicted pass or fail on-road outcomes in 101 drivers with PD (mean age = 69.38 + 7.43) and 138 healthy control (HC) drivers (mean age = 71.76 + 5.08). Participants with PD had minor differences in demographics and driving habits and history but made more and different driving errors than HC participants. Drivers with PD failed the on-road test to a greater extent than HC drivers (41% vs. 9%), χ2(1) = 35.54, HC N = 138, PD N = 99, p < .001. The driving errors predicting on-road pass or fail outcomes (95% confidence interval, Nagelkerke R2 =.771) were made in visual scanning, signaling, vehicle positioning, speeding (mainly underspeeding, t(61) = 7.004, p < .001, and total errors. Although it is difficult to predict on-road outcomes, this study provides a foundation for doing so. Permalink : ./index.php?lvl=notice_display&id=19437

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Evidence-Based Review of Interventions for Medically At-Risk Older Drivers / Sherrilene Classen in American Journal of Occupational Therapy, Vol. 68/4 (juillet - août 2014)

Public ISBD [article]  inAmerican Journal of Occupational Therapy > Vol. 68/4 (juillet - août 2014) . - p. 463 Titre : Evidence-Based Review of Interventions for Medically At-Risk Older Drivers Type de document : texte imprimé Auteurs : Sherrilene Classen ; et al. ; Beth AUTEN ; Miriam MONAHAN Année de publication : 2014 Article en page(s) : p. 463 Langues : Anglais (eng) Résumé : OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual–perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers. Permalink : ./index.php?lvl=notice_display&id=34419 [article] Evidence-Based Review of Interventions for Medically At-Risk Older Drivers [texte imprimé] / Sherrilene Classen ; et al. ; Beth AUTEN ; Miriam MONAHAN . - 2014 . - p. 463. Langues : Anglais (eng) in American Journal of Occupational Therapy > Vol. 68/4 (juillet - août 2014) . - p. 463 Résumé : OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention. RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual–perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I). CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers. Permalink : ./index.php?lvl=notice_display&id=34419

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Utility of an Occupational Therapy Driving Intervention for a Combat Veteran / Sherrilene Classen in American Journal of Occupational Therapy, Vol. 68/4 (juillet - août 2014)

Public ISBD [article]  inAmerican Journal of Occupational Therapy > Vol. 68/4 (juillet - août 2014) . - p. 405-411 Titre : Utility of an Occupational Therapy Driving Intervention for a Combat Veteran Type de document : texte imprimé Auteurs : Sherrilene Classen ; et al. ; Maria CANONIZADO ; Miriam MONAHAN Année de publication : 2014 Article en page(s) : p. 405-411 Langues : Anglais (eng) Mots-clés : Conduite automobile  Stress Résumé : Many combat veterans are injured in motor vehicle crashes shortly after returning to civilian life, yet little evidence exists on effective driving interventions. In this single-subject design study, we compared clinical test results and driving errors in a returning combat veteran before and after an occupational therapy driving intervention. A certified driving rehabilitation specialist administered baseline clinical and simulated driving assessments; conducted three intervention sessions that discussed driving errors, retrained visual search skills, and invited commentary on driving; and administered a postintervention evaluation in conditions resembling those at baseline. Clinical test results were similar pre- and postintervention. Baseline versus postintervention driving errors were as follows: lane maintenance, 23 versus 7; vehicle positioning, 5 versus 1; signaling, 2 versus 0; speed regulation, 1 versus 1; visual scanning, 1 versus 0; and gap acceptance, 1 versus 0. Although the intervention appeared efficacious for this participant, threats to validity must be recognized and controlled for in a follow-up study. Permalink : ./index.php?lvl=notice_display&id=34431 [article] Utility of an Occupational Therapy Driving Intervention for a Combat Veteran [texte imprimé] / Sherrilene Classen ; et al. ; Maria CANONIZADO ; Miriam MONAHAN . - 2014 . - p. 405-411. Langues : Anglais (eng) in American Journal of Occupational Therapy > Vol. 68/4 (juillet - août 2014) . - p. 405-411 Mots-clés : Conduite automobile  Stress Résumé : Many combat veterans are injured in motor vehicle crashes shortly after returning to civilian life, yet little evidence exists on effective driving interventions. In this single-subject design study, we compared clinical test results and driving errors in a returning combat veteran before and after an occupational therapy driving intervention. A certified driving rehabilitation specialist administered baseline clinical and simulated driving assessments; conducted three intervention sessions that discussed driving errors, retrained visual search skills, and invited commentary on driving; and administered a postintervention evaluation in conditions resembling those at baseline. Clinical test results were similar pre- and postintervention. Baseline versus postintervention driving errors were as follows: lane maintenance, 23 versus 7; vehicle positioning, 5 versus 1; signaling, 2 versus 0; speed regulation, 1 versus 1; visual scanning, 1 versus 0; and gap acceptance, 1 versus 0. Although the intervention appeared efficacious for this participant, threats to validity must be recognized and controlled for in a follow-up study. Permalink : ./index.php?lvl=notice_display&id=34431

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