Prediction and evaluation of driving and visuo-spatial performance in homonymous hemianopia after compensational training

Publisher Website
Google Scholar
Abstract
Interest in neuropsychological testing in order to evaluate and predict driving performance in patients with homonymous hemianopia (HH) is growing. An earlier study found that visual performance during driving could be predicted by visuo-spatial neuropsychological test performance and that HH patients showed low to modest visuo-spatial performance, suggesting the need for specific therapeutic intervention. Seventeen HH patients (without neglect) took part in a saccadic compensation training to reduce visuo-spatial limitation, with special focus on compensation during driving. We compared and interrelated the visuo-spatial performance during driving with that during neuropsychological tests, before and after training. We further investigated whether the effect of the intervention could be predicted. Generally, the analyses corroborated the results of the earlier study, confirming that visual performance during driving was moderately correlated with visuo-spatial neuropsychological test performance. After rehabilitation, we found an improvement in visuo-spatial driving performance, but not in other aspects of driving or in neuropsychological test performance. This argues against a nonspecific placebo effect. Despite the improvement in visuo-spatial driving performance, overall driving performance did not meet the necessary standards in most patients, suggesting that either more rehabilitation time is required or lower mobility rehabilitation goals should be set. The fact that not all patients failed the driving test, however, suggests that HH is not an absolute contra-indication for fitness to drive. Finally, we conclude that visuo-spatial limitation, common and apparent in HH and consequential for fitness to drive, can be reduced by the compensation training.

This publication has 14 references indexed in Scilit: