Evaluation of Driving Ability of Stroke Patients Using Cognitive Behavioral Driver's Inventory

OBJECTIVE: We tried to evaluate the driving ability of stroke patients using Cognitive Behavioral Driver's Inventory (CBDI), Psychological Software Service, U.S.A. to find out whether it is helpful in predicting the outcome of driving rehabilitation. METHOD: Subjects were 18 stroke patients who had driven a car before the stroke. Each patient was evaluated with CBDI and got a driving test. We compared driving test results with CBDI scores. RESULTS: Average CBDI score was 63.0 +/- 19.3. There was no significant difference according to lesion sides or types of stroke. Average score of driving test was 85.3 +/- 10.9. Twelve of 18 subjects passed the driving test and six subjects failed. Average score among right hemiplegics was significantly higher than that of left hemiplegics (p<0.05). Average CBDI score of the subjects who passed the driving test was 52.3 +/- 4.7, while that of the failed subjects was 84.7 +/- 19.6. There was significant difference in CBDI score between 2 groups (p<0.05). Among the 28 items of CBDI, 11 items including brake reaction time, Wechsler Adult Intelligence Scale-Revised Picture Completion showed significant correlation with the total score of the driving test (p<0.05). CONCLUSION: CBDI can be used as a useful tool for predicting driving ability of stroke patients.

Age-Related Differences in Rehabilitation Outcome in Cervical Spinal Cord Injury Patients

BACKGROUND: The growing number of spinal cord injured individuals facing old age makes the understanding of age related limitations increasingly important. This study was to investigate the age-related differences in rehabilitation outcome according to the level of cervical spinal cord injury and each category of activity of daily living(ADL). METHODS: Subjects were 79 adults with tetraplegia all of whom were admitted in National Rehabilitation Hospital. The level of injury was classified into upper cervical(C4, C5), mid-cervical(C6), and lower cervical(C7, C8) spinal cord injury. Eight ADL categories including feeding, grooming, bathing, dressing, toileting, bed-transfer, toilet/tub transfer, and indoor mobility were assessed using the scale of Spinal Cord Independence Measure. Age related differences were examined by separating the sample into two age groups(> or =40 and <40 years) RESULTS: There was no age related difference in rehabilitation outcome in upper cervical cord injury patients. In mid-cervical cord injury level, ADL capacities differed only in the feeding and grooming activities. In lower cervical cord injury level, older patients showed lower rehabilitation outcome than younger counterparts in all ADL categories examined. CONCLUSION: Along with injury level, age should be considered when formulating rehabilitation plans and functional prognostic statements in tetraplegic patients.

Effect of Oral Sildenafil Citrate (Viagra(R)) in Erectile Dysfunction Following Spinal Cord Injury

OBJECTIVE: To evaluate the effect of oral sildenafil citrate (Viagra(R)) on erectile dysfunction following spinal cord injury. METHOD: Seventy nine male patients with erectile dysfunction after spinal cord injury, who were free from contrain dications, received 50 mg of sildenafil. Visual-analogue erection scale (VAES) was used to evaluate the rigidity of penis before and after the medication. In addition, the duration of erection and side effects of sildenafil were evaluated. RESULTS: Mean VAES score showed a statistically significant increase after the medication from 5.6 to 7.5 (p=0.000). The mean duration of erection also increased from 3.4 minutes to 27.1 minutes after medication (p=0.000). Sixty seven patients (84.8%) reported improved erection with 50 mg of sildenafil and sixty one patients (77.2%) reported rigid erection enough for sexual intercourse. Ten patients (12.7%) reported side effects: facial flushing (3), dizziness (2), headache (2), chest pain (2), and palpitation (1). CONCLUSION: This study demonstrated that sildenafil is an effective medication in treating erectile dysfunction after spinal cord injury.