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Predicting Behind the Wheel Driving Readiness
e76 Research Poster 494 Perceptions of Recovery Among Adolescents and Young Adults With Acquired Spinal Cord Injuries Carol Haywood (University of Southern California) Research Objectives: To understand meanings and ideals for recovery among adolescents and young adults (AYAs) with an acquired spinal cord injury (SCI) and their caregivers. Design: A qualitative design was employed. Setting: Rehabilitation sites and participants’ homes in a large, diverse metropolitan area. Participants: Participants included AYAs with an acquired SCI (nZ9) and their caregivers (nZ8). AYAs represented a broad range of individual circumstances with varying ages (16-22 years), levels of SCI (high cervical to low thoracic), mechanisms of injury (traumatic and non-traumatic), and time since injury (4 weeks to 4.5 years). Participants were also diverse in their races and ethnicities, as well as socioeconomic backgrounds. Interventions: Participants completed up to three interviews- one individually and two in groups. Individual and group interviews were exploratory and narratively structured; they were not an intervention. Main Outcome Measure(s): Narrative interview questions focused on lived experiences in rehabilitation and during transitions to community life. Probes specifically elicited information about self-care routines, injury and disability experiences, negotiations with caregivers, rehabilitation goals, and barriers and facilitators of participation after SCI. All interviews were audio recorded and transcribed for qualitative analysis in NVivo software. Results: Personal narratives revealed that aˆVœrecoveryaˆV is variably interpreted after an acquired SCI, and goals range widely. There was tension between the AYAs’ sense of hope and their providers’ assessment of prognosis, particularly when those living with SCI did not differentiate between neurological recovery and adaptation. Data illustrated significant ways that peer modeling and environmental characteristics impacted embodied knowledge of functional possibilities. Conclusions: These findings can inform how providers structure education and goal setting with AYAs with an acquired SCI and their families in rehabilitation. Key Words: Adolescent, Young Adult, Spinal Cord Injuries, Goals, Hope Disclosures: None disclosed.
Research Poster 496 Cerebral Palsy Adult Transition Study (CPAT): Health Passport Consultation Follow-up Study David Robertson (Children’s Hospital Colorado), Patricia Heyn, Zhaoxing Pan, James Carollo Research Objectives: We evaluated the effectiveness of a person-centered wellness visit (aka Health Passport) designed to enhance quality of life and health of adults with Cerebral Palsy (CP) who participated in the NIDILRR CPAT study. Design: Prospective cross-sectional cohort, health assessment and motivational consultation follow-up survey. Setting: A nationally accredited clinical motion laboratory at a regional children’s hospital Participants: 25 young adults with CP. Interventions: Not Applicable. Main Outcome Measure(s): Follow-up health recommendations survey and health education effectiveness. Results: A total of 25 participants (12 male, 13 female) with CP, completed a comprehensive health and physical assessment including a Health Passport (HP) consultation. After w 6 months they responded to a phone survey evaluating their HP session. 81% of the participants
Research Posters understood the HP recommendation and 80% expressed that these were achievable recommendations. 72% improved in self-care, and 80% reported that the recommendations had a positive impact in their quality of life. 64% is walking more, 24% improved their body weight and 36% their diet. Notably, 60% showed the HP results to a healthcare professional and 46.7% said that they followed their doctor’s recommendations. Conclusions: Although these are preliminary results from the first two years of a three year study, these results suggest that providing health and lifestyle education and recommendations to adults with CP has positive impact on their self-reported quality of life, self-care, and overall health. Empowering young adult with disabilities to take an active role in their own health has a positive effect on self-care and health management behavior. Key Words: cerebral palsy, transition, functional outcomes, gait Disclosures: None to disclose. Research Poster 497 Predicting Behind the Wheel Driving Readiness Emily Rosario (Casa Colina Hospital and Centers for Healthcare), Stephanie Kaplan, Rachel Tabak, Celeste Dunlap, Sarah Meredith, David Russak, Kelsey Fitzgerald Research Objectives: To establish normative values for predicting behind the wheel driving readiness in a non-impaired population using neuropsychological assessments and a driving simulator. Design: Establish norms. Setting: Outpatient Rehabilitation setting. Participants: Non-impaired adults ranging in age from 18 to 80 years of age with a valid drivers’ license. Interventions: N/A. Main Outcome Measure(s): Physical measures included range of motion, muscle strength, and coordination, cognitive measures included a “Rules of the Road Test” a “Sign Identification Test,” both based on the written driving test given by the California Department of Motor Vehicles to assess ability to follow the rules of the road in various driving scenarios, Trails A and B, and the clock drawing test. Visual measures included the Dynavision D2 system and motor-free visual perceptual test (MVPT). Finally, the driving simulator, Systems Technology Incorporated (STIÒ version M300), used the metro drive assessment, which consisted of negotiating several obstacles in a metropolitan area including vehicles abruptly changing lanes, pedestrians crossing streets, and negotiating construction zones. Results: We observed age-related differences with Trails A and B, the clock test, dynavision, and MVPT. Data from the simulator showed interesting age differences but the oldest age group was not consistently the “worst” drivers. The 18- 40 years were over the speed limit most often and received the most traffic light tickets. The cognitive and visual assessments significantly correlated with the driving simulator results. Specifically, Trails and the clock test correlated with reaction time and driving violations while the MVPT correlated with time outside of the lanes and collisions. Conclusions: Findings from this study can be used to create norms by age for predicting behind the wheel driver readiness. Key Words: Driving, cognitive assessments, driving simulator Disclosures: None disclosed. Research Poster 498 Post-Traumatic Amnesia (PTA) and Severity of Brain Injury Demonstrated by Head Computed Tomography (CT) Scans Linda Isaac (Santa Clara Valley Medical Center), Nhung Quach, Samantha Sechrist, Laura Jamison, Reza Ehsanian, Thao Duong, James Crew
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Research Poster 496 Cerebral Palsy Adult Transition Study (CPAT): Health Passport Consultation Follow-up Study David Robertson (Children’s Hospital Colorado), Patricia Heyn, Zhaoxing Pan, James Carollo Research Objectives: We evaluated the effectiveness of a person-centered wellness visit (aka Health Passport) designed to enhance quality of life and health of adults with Cerebral Palsy (CP) who participated in the NIDILRR CPAT study. Design: Prospective cross-sectional cohort, health assessment and motivational consultation follow-up survey. Setting: A nationally accredited clinical motion laboratory at a regional children’s hospital Participants: 25 young adults with CP. Interventions: Not Applicable. Main Outcome Measure(s): Follow-up health recommendations survey and health education effectiveness. Results: A total of 25 participants (12 male, 13 female) with CP, completed a comprehensive health and physical assessment including a Health Passport (HP) consultation. After w 6 months they responded to a phone survey evaluating their HP session. 81% of the participants
Research Posters understood the HP recommendation and 80% expressed that these were achievable recommendations. 72% improved in self-care, and 80% reported that the recommendations had a positive impact in their quality of life. 64% is walking more, 24% improved their body weight and 36% their diet. Notably, 60% showed the HP results to a healthcare professional and 46.7% said that they followed their doctor’s recommendations. Conclusions: Although these are preliminary results from the first two years of a three year study, these results suggest that providing health and lifestyle education and recommendations to adults with CP has positive impact on their self-reported quality of life, self-care, and overall health. Empowering young adult with disabilities to take an active role in their own health has a positive effect on self-care and health management behavior. Key Words: cerebral palsy, transition, functional outcomes, gait Disclosures: None to disclose. Research Poster 497 Predicting Behind the Wheel Driving Readiness Emily Rosario (Casa Colina Hospital and Centers for Healthcare), Stephanie Kaplan, Rachel Tabak, Celeste Dunlap, Sarah Meredith, David Russak, Kelsey Fitzgerald Research Objectives: To establish normative values for predicting behind the wheel driving readiness in a non-impaired population using neuropsychological assessments and a driving simulator. Design: Establish norms. Setting: Outpatient Rehabilitation setting. Participants: Non-impaired adults ranging in age from 18 to 80 years of age with a valid drivers’ license. Interventions: N/A. Main Outcome Measure(s): Physical measures included range of motion, muscle strength, and coordination, cognitive measures included a “Rules of the Road Test” a “Sign Identification Test,” both based on the written driving test given by the California Department of Motor Vehicles to assess ability to follow the rules of the road in various driving scenarios, Trails A and B, and the clock drawing test. Visual measures included the Dynavision D2 system and motor-free visual perceptual test (MVPT). Finally, the driving simulator, Systems Technology Incorporated (STIÒ version M300), used the metro drive assessment, which consisted of negotiating several obstacles in a metropolitan area including vehicles abruptly changing lanes, pedestrians crossing streets, and negotiating construction zones. Results: We observed age-related differences with Trails A and B, the clock test, dynavision, and MVPT. Data from the simulator showed interesting age differences but the oldest age group was not consistently the “worst” drivers. The 18- 40 years were over the speed limit most often and received the most traffic light tickets. The cognitive and visual assessments significantly correlated with the driving simulator results. Specifically, Trails and the clock test correlated with reaction time and driving violations while the MVPT correlated with time outside of the lanes and collisions. Conclusions: Findings from this study can be used to create norms by age for predicting behind the wheel driver readiness. Key Words: Driving, cognitive assessments, driving simulator Disclosures: None disclosed. Research Poster 498 Post-Traumatic Amnesia (PTA) and Severity of Brain Injury Demonstrated by Head Computed Tomography (CT) Scans Linda Isaac (Santa Clara Valley Medical Center), Nhung Quach, Samantha Sechrist, Laura Jamison, Reza Ehsanian, Thao Duong, James Crew
www.archives-pmr.org