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Driving Rehabilitation in Parkinson's Disease

帕金森病的驾驶康复

基本信息

批准号：
7888194
负责人：
ERGUN Y UC
金额：
--
依托单位：
IOWA CITY VA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-01 至 2011-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7888194
关键词：
Affect Age Aging Alzheimer&apos s Disease American Automobile Driving Awareness Cognition Cognitive Complex Development Disease Elderly Evaluation Feedback Functional disorder Future Goals Impaired cognition Impairment Intervention Life Motor Neurological Models Parkinson Disease Participant Patients Perception Performance Phase III Clinical Trials Pilot Projects Preparation Protocols documentation Public Health Quality of life Randomized Controlled Clinical Trials Rehabilitation therapy Research Personnel Risk Safety Severities Stroke Testing Training Training Programs Traumatic Brain Injury Vehicle crash Veterans Video Recording Videotape Vision Visual Perception Visual attention Writing base cognitive function efficacy testing expectation hazard high risk improved indexing instrument intervention program motor deficit motor impairment multitask nervous system disorder post stroke procedural memory programs rehabilitation strategy research study systematic review visual motor

项目摘要

Automobile driving is a crucial aspect of everyday life, yet vehicular crashes pose a serious public health problem. Parkinson's disease (PD) affects about one million Americans, and drivers with PD are at special risk for driving cessation or crashes due to progressive impairments of motor function, cognition, and vision. In our ongoing study on predicting driver safety in PD (R01 NS044930, PI:Uc), we are finding that drivers with PD perform worse than elderly drivers without neurological disease in driving tasks conducted on-road in an instrumented vehicle (IV) and on experimental driving scenarios presented on a high-fidelity driving simulator. Even drivers with early PD of mild severity have impairments on cognitive and visual functions, and show particular problems with multitasking while driving, performing complex driving maneuvers, and are at increased risk of collisions. Cognitive impairment and reduced visual perception contribute to poor driving performance and safety errors more than the typical motor dysfunction of PD. Based on our own and other researchers' empirical findings on the types and circumstances of common safety errors, as well as on the underlying causes and mechanisms of driving problems in PD, we have devised a new intervention for at-risk drivers with PD. The intervention consists of a systematic review of the subject's own road drive in the IV using verbal, video, and written feedback, followed by simulator training sessions for improving visual attention, performing complex maneuvers, multitasking during driving, hazard perception, and collision avoidance. The conceptual basis of our intervention is improving procedural memory and error awareness through feedback and practice in the simulator, with the expectation that this improvement would transfer to driving on the road. This is a pilot study proposal to further develop and refine our intervention, and test its short term efficacy to see if this intervention merits further testing in a Phase III trial. Development of effective rehabilitation programs for impaired drivers with PD will reduce the risk of motor vehicle crashes and help protect and preserve the mobility and quality of life of these patients. Furthermore, this driving rehabilitation program can be adapted for use in other neurological disorders such as Alzheimer's disease, stroke, and traumatic brain injury, conditions seen in both older and younger veterans.

汽车驾驶是日常生活中的一个重要方面，但车祸对公众健康构成了严重的威胁有问题。帕金森氏症(PD)影响着大约100万美国人，患有PD的司机面临着特殊的风险用于因运动功能、认知和视力的进行性损害而停止驾驶或撞车。在我们正在进行的关于预测PD(R01 NS044930，PI：UC)司机安全的研究中，我们发现司机有帕金森病的老年司机在道路上执行的驾驶任务中的表现比没有神经疾病的老年司机差仪表车(四)和高保真驾驶的实验驾驶场景模拟器。即使是早期轻度帕金森病的司机，认知和视觉功能也会受到损害，在驾驶、执行复杂的驾驶动作时显示多任务处理的特殊问题，并在增加了碰撞的风险。认知障碍和视觉减退是导致不良驾驶的原因之一性能和安全错误多于典型的帕金森病患者的运动障碍。基于我们自己和其他研究人员对常见疾病的类型和情况的经验发现安全错误，以及PD驾驶问题的根本原因和机制，我们有为帕金森病高危司机设计了一种新的干预措施。干预措施包括对受试者在IV中使用口头、视频和书面反馈进行自己的道路驾驶，然后进行模拟器培训改善视觉注意力、执行复杂动作、在驾驶过程中多任务处理、危险感知和避免碰撞。我们干预的概念基础是改善程序记忆以及通过在模拟器中的反馈和练习而意识到错误，并期望这改进将转移到在道路上驾驶。这是一项试点研究建议，旨在进一步发展和完善我们的干预措施，并测试其短期效果，看看这种干预措施是否值得在第三阶段进一步测试审判。为帕金森病受损司机制定有效的康复计划将降低运动风险车辆碰撞，并有助于保护和保存这些患者的机动性和生活质量。此外，这一驾驶康复计划可用于其他神经疾病，如阿尔茨海默氏症疾病、中风和创伤性脑损伤，这些情况在年长和年轻的退伍军人中都可以看到。