Christina Cordes

Mobility scooter driving ability in visually impaired individuals

Abstract Purpose: To investigate how well visually impaired individuals can learn to use mobility scooters and which parts of the driving task deserve special attention. Materials and methods: A mobility scooter driving skill test was developed to compare driving skills (e.g. reverse driving, turning) between 48 visually impaired (very low visual acuity = 14, low visual acuity = 10, peripheral field defects = 11, multiple visual impairments = 13) and 37 normal-sighted controls without any prior experience with mobility scooters. Performance on this test was rated on a three-point scale. Furthermore, the number of extra repetitions on the different elements were noted. Results: Results showed that visually impaired participants were able to gain sufficient driving skills to be able to use mobility scooters. Participants with visual field defects combined with low visual acuity showed most problems learning different skills and needed more training. Reverse driving and stopping seemed to be most difficult. Conclusions: The present findings suggest that visually impaired individuals are able to learn to drive mobility scooters. Mobility scooter allocators should be aware that these individuals might need more training on certain elements of the driving task. Implications for rehabilitation Visual impairments do not necessarily lead to an inability to acquire mobility scooter driving skills. Individuals with peripheral field defects (especially in combination with reduced visual acuity) need more driving ability training compared to normal-sighted people – especially to accomplish reversing. Individual assessment of visually impaired people is recommended, since participants in this study showed a wide variation in ability to learn driving a mobility scooter.

Vision-related fitness to drive mobility scooters: A practical driving test

OBJECTIVE To investigate practical fitness to drive mobility scooters, comparing visually impaired participants with healthy controls. DESIGN Between-subjects design. SUBJECTS Forty-six visually impaired (13 with very low visual acuity, 10 with low visual acuity, 11 with peripheral field defects, 12 with multiple visual impairment) and 35 normal-sighted controls. METHODS Participants completed a practical mobility scooter test-drive, which was recorded on video. Two independent occupational therapists specialized in orientation and mobility evaluated the videos systematically. RESULTS Approximately 90% of the visually impaired participants passed the driving test. On average, participants with visual impairments performed worse than normal-sighted controls, but were judged sufficiently safe. In particular, difficulties were observed in participants with peripheral visual field defects and those with a combination of low visual acuity and visual field defects. CONCLUSION People with visual impairment are, in practice, fit to drive mobility scooters; thus visual impairment on its own should not be viewed as a determinant of safety to drive mobility scooters. However, special attention should be paid to individuals with visual field defects with or without a combined low visual acuity. The use of an individual practical fitness-to-drive test is advised.

Driving slow motorised vehicles with visual impairment : A simulator study

Abstract Purpose: To compare different driving parameters between visually impaired people and normal sighted controls in a mobility scooter and microcar driving simulator. Materials and methods: A mobility scooter and microcar driving simulator and different virtual environments were developed for the purpose of this experiment. Participants completed 4 drives in the microcar driving simulator and 8 drives in the mobility scooter driving simulator. Driving performance was compared between visually impaired and normal sighted participants, using the parameters speed, lateral position, time-to-collision, and number and type of collision. Results: Visually impaired participants did not differ significantly from normal sighted controls with regard to speed and overall lateral position. In contrast, number of collisions was higher in visually impaired participants in almost all drives. Time-to-collision differed in some, but not all of the drives. Small obstacles with low contrast posed the highest risk of collision for impaired drivers. Conclusions: The present findings showed that visually impaired participants were able to maintain a steady position on the street, but showed more difficulties in traffic situations that included obstacles and other traffic participants. Familiarity with the driving tasks seemed to improve performance, however, further research is necessary to confirm this observation.

The neuropsychological rehabilitation of visual agnosia and Balint’s syndrome

ABSTRACT Visual agnosia and Balint’s syndrome are complex neurological disorders of the higher visual system that can have a remarkable impact on individuals’ lives. Rehabilitation of these individuals is important to enable participation in everyday activities despite the impairment. However, the literature about the rehabilitation of these disorders is virtually silent. Therefore, the aim of this systematic review is to give an overview of available literature describing treatment approaches and their effectiveness with regard to these disorders. The search engines Psychinfo, Amed, and Medline were used, resulting in 22 articles meeting the criteria for inclusion. Only articles describing acquired disorders were considered. These articles revealed that there is some information available on the major subtypes of visual agnosia as well as on Balint’s syndrome which practising clinicians can consult for guidance. With regard to the type of rehabilitation, compensatory strategies have proven to be beneficial in most of the cases. Restorative training on the other hand has produced mixed results. Concluding, although still scarce, a scientific foundation about the rehabilitation of visual agnosia and Balint’s syndrome is evolving. The available approaches give valuable information that can be built upon in the future.

The effects of habituation and adding a rest-frame on experienced simulator sickness in an advanced mobility scooter driving simulator

Abstract The aim of this article is to investigate the effect of a physical rest-frame, habituation and age on simulator sickness in an advanced mobility scooter driving simulator. Twenty-six young and 34 older adults completed a total of 12 drives in an advanced mobility scooter driving simulator over two visits. A 2x2 crossover design was used to measure the effect of a rest frame that was added to the driving simulator on either the first or second visit. The Simulator Sickness Questionnaire was used to measure simulator sickness symptoms. A significant decrease in simulator sickness was observed between the first and the second visit. Older adults reported more severe simulator sickness symptoms compared to younger participants. No effect of rest-frame could be found. Habituation appears to be the most effective method to reduce simulator sickness in an advanced mobility scooter driving simulator. More research is needed to investigate simulator sickness in patient groups. Practitioner summary: Experiencing simulator sickness is a major problem across all types of simulators. The present experiment investigated the effect of a rest-frame, habituation and age on developing simulator sickness symptoms in an advanced mobility scooter driving simulator. Habituation appeared to be the most effective method to reduce simulator sickness.