September 12, 2017
By Greg Peters
Drivers will literally be able to take the wheel in their own hands when it comes to evaluating their ability to drive safely on the open road thanks to a new research, assessment and rehabilitation facility opening this summer at the University of Kansas Medical Center.
The KU Health Partners Driving and Mobility Service will provide clinical services to its clients, while its associated research partner, the Laboratory for Advanced Rehabilitation Research in Simulation (LARRS), employs virtual and augmented reality-equipped devices to assess and treat people with visual, cognitive and mobility issues, ranging from Parkinson's and Alzheimer's diseases to dementia, stroke, concussions, glaucoma and macular degeneration.
While researchers have been busy getting LARRS operational and recruiting subjects for testing during the past few months, the KU Health Partners Driving and Mobility Service will start accepting clients in September. All clients must be referred to the service for assessment or treatment by a physician.
"There are three major components to our services," said Abiodun Akinwuntan, Ph.D., MPH, MBA, dean of the KU School of Health Professions. "First, we need to determine whether a person has adequate physical, visual and cognitive skills for safe driving. Second, in cases where these skills appear impaired but possibly retrain-able, our services will offer training options for the clients.
"Lastly, since we use a fully integrated driving simulator, clients will be advised on the most-effective adaptive devices they can use to make driving safer, and then they will receive training on how to use the devices before they are installed in their own cars."
In the driver's seat
The centerpiece of the facility is a driving simulator (STISIM Drive), featuring a car cockpit surrounded by three large computer screens where simulated road conditions can be produced while an eye-scanning device tracks a person's gaze during testing. Akinwuntan began scheming the idea for the driving simulator as a doctoral student in Belgium before building and programming the first-generation while teaching at Augusta University prior to coming to KU.
Amber Conn, an occupational therapist who is also certified as a driving and rehabilitation, will lead the KU Health Partners Driving and Mobility Service. The facility will give the community access to comprehensive driving evaluations that will be much more in-depth than they might be able to receive from their family doctor or vision specialist.
This testing will help determine whether drivers are safe to return to the road on their own, require restrictions such as "daylight only" driving, or need medical rehabilitation and accommodations like spinner knobs for one-handed driving. The Driving and Mobility Service is open to everyone, but Conn and her team require patients to have a written referral from their primary care physician or medical specialist to ensure the person's specific needs are addressed.
"There was a need for evidence-based research on driving for individuals with functional deficits as a result of medical conditions," explains LARRS Director Hannes Devos, Ph.D., who was part of the team at Augusta University. "The tools we had were paper-and-pencil tests that lacked face validity to test for driving safety. Driving simulators became more accessible and easier to operate with the advancement of technology. Driving simulators give us the unique advantage of testing driving skills in an environment that resembles real-world performance, without the real-world hazards."
This service could prove to be of great importance to elderly drivers and their caregivers. Individuals and their loved ones who may be concerned about the safety of their driving can use the lab's resources for in-depth testing of cognitive and motor skills that apply to a person's ability to drive. These results can then be discussed with the individual's primary care doctor to determine if the person is safe to drive a motor vehicle.
Mission to LARRS
The driving simulator isn't the only piece of leading-edge technology LARRS has to offer. The lab also is equipped with several other devices to help people with different modes of mobility issues, including a specially made treadmill that is equipped with a virtual reality surface that allows patterns and obstacles to be projected by researchers and clinicians to test a person's cognitive and motor responses. The treadmill faces an oversized video monitor where items can be projected while the subject is walking, so researchers can use eye-tracking devices to assess cognitive behavior.
Researchers in the lab also have access to an electroencephalogram (EEG), which looks a bit like a swim cap with electrodes attached, that they will use to track brain function in subjects while they are put through a battery of tests using simulations displayed on computer screens or virtual-reality devices.
A participant's vision can be assessed using a Keystone Vision Screener, a FOVIO Eye Tracker, an SMI Eye Tracker and a host of paper- and computer-based tests. The lab also has access to two portable versions of the driving simulator that can be taken to sites off-campus allowing for remote assessments and therapies.
So far, Devos and the lab team have been working with a variety of colleagues both on and off campus, and that number promises to expand in the future. Among the many research partnerships, Devos and Akinwuntan are working with Shelley Bhattacharya, M.D., William Brooks, Ph.D., Jeffrey Burns, M.D., M.S., Kathleen Gustafson, Ph.D., Sharon Lynch, M.D., Kelly Lyons, Ph.D., Jonathan Mahnken, Ph.D., and Rajesh Pahwa, M.D., from the KU School of Medicine. They are working nationally with researchers from the University of Georgia, Augusta University, the University of Iowa, University of Illinois, and Washington University Saint Louis, among others. The lab has ongoing international collaborations with the Belgian Road Safety Institute, the French Institute of Science and Technology for Transport, Development and Networks, and the University of Osaka.
On the road to tomorrow
LARRS and the Driving and Mobility Service have the potential to touch the lives of many people across Kansas and beyond. The lab is already committed to be part of a multi-campus consortium funded by the United States Department of Transportation, investigating ways to make the nation's roadways safer by creating a driving fitness test to measure the visual and cognitive skills of transportation workers. KU Medical Center officials hope to launch the Driver's Safety Institute in the near future, a community resource to improve the fitness of drivers, especially those hauling hazardous materials.
The lab's leaders will continue to grow partnerships on campus with entities such as the KU Alzheimer's Disease Center, the Landon Center on Aging and The University of Kansas Health System. Akinwuntan and Devos are working with Honda Motor Company to receive a donated car, sans motor, that will have the driving simulation hardware and software embedded inside. The car will allow clients to not just take the wheel, but also have the physical feelings associated with an authentic driving experience.