Cognitive Perceptual Assessment Tool for Evaluation of Driving Ability of Persons with Brain Injury

OBJECTIVE: To develop an evaluation tool of cognitive perceptual function for safe driving of the brain injured patients and to check the suitability of the tool. METHOD: Cognitive Perceptual Assessment for Driving (CPAD) was constructed with 8 tasks of depth perception, sustained attention, divided attention, Stroop test, digit span test, field dependence, trail making test A, and trail making test B. The predriving assessment with CPAD and road test were applied to 101 brain injured patients. The reliability and the validity of CPAD, and the cut-off score to resume driving were determined. RESULTS: The CPAD scores of pass group (n=46) and fail group (n=55) for on-road test were 51.67+/-5.53 and 44.30+/-8.44 respectively (p=0.0001). The internal consistency of the CPAD measured by Cronbach's alpha was 0.85. The cut-off score based on 95% confidence interval was 53 or above for pass group, 42 or below for fail group, 43~52 for borderline group. The positive and negative predictive value was 90.7% and 50.3%, respectively. CONCLUSION: The CPAD could be useful for the evaluation of driving ability of persons with brain injury.

Standing and Gait of the Paraplegics by Spinal Cord Injury after Discharge

OBJECTIVE: The purpose of this follow-up study was to evaluate the status of standing and gait for the paraplegics at their home after discharge. METHOD: A medical doctor interviewed 93 paraplegics by spinal cord injury, who visited the outpatient clinic of the National Rehabilitation Hospital, or who were admitted for the follow up urologic evaluation. RESULTS: Out of 93 paraplegics, 90 patients had done a standing exercise in hospitals, but 42 patients continued a standing exercise after discharge. Seventy-nine patients had done a gait exercise in hospitals, but only 24 patients continued a gait exercise after discharge. Seventy-five patients were prescribed KAFO (Knee-Ankle-Foot orthosis), but only 11 patients used the KAFO continuously after discharge. The reasons to stop using KAFO were loss of motivation, lack of time, no helper, difficulties with wearing orthoses, and etc. The continuous using rates of other standing or exercise equipments were higher than that of KAFO. CONCLUSION: Many paraplegics had done gait training and had been prescribed KAFO in hospitals. But only 14.7% of them had used KAFO for any purpose after discharge. We believe that more careful consideration and explanation are needed to each patient. We think that standing or exercise equipments are good alternatives.