The Effects Of Adapted Virtual Reality Driving Simulator Training For Subjects With Spinal Cord Injury

Abstract

Being able to drive is an important issue for subjects with spinal cord injury (SCI); the driving performance and seated posture control ability influence the ability of independent driving. However, only few studies concerned these two factors together. Furthermore, although being trained and getting license were important demands for SCI, and virtual reality driving simulator (VRDS) was suggested to be useful in training, the protocol and effects of training with VRDS for SCI have not been established. PURPOSE: To develop a proper VRDS and training program and to evaluate the effects of VRDS training for SCI. METHODS: Twelve SCI subjects were randomly assigned to either VRDS with moving base group (MB) or VRDS with stationary base group (SB). All subjects received ten 30 minutes VRDS training sessions, as well as driving performance in VRDS (total driving time, speed and speed variation, steering control, collisions, and traffic signal violation), balance control ability, cybersicknesss, enjoyment, workload and realism were measures as outcome variables. The variables between pre- and post- intervention were analysis by Friedman 2-way analysis of variances by ranks. And Wilcoxon Signed-Ranks test. Mann-Whitely U tests were then used to compare the difference between two groups. The a level of.05 was set for the statistical significance. RESULTS: The VRDS training program was realistic and enjoyable without adverse effects of cybersickness. All subjects reported the VRDS training program decreases the fear of driving. Taking 5 sessions of VRDS training resulted in significant improvement on speed control (average speed: 34.08±2.99 vs. 37.15±2.18km/hr); the steering control is harder and takes more training times to improve. After 5 training sessions, MB had better driving performance training effects than SB (average speed: 38.62±1.27 vs. 35.67±1.91 km/hr). MB also had lower physical demands (1 vs.7, p<.05) and lower frustration (1 vs. 6, p<.05) than SB in the 7-point scale. However, no significant improvement was found in balance control ability of both groups after VRSD training program. CONCLUSIONS: This is the very first study as we know to investigate the effects of the VRDS training with multiple sessions. The VRDS program is effective tool and moving base has better training effects than stationary base.