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再训练有中度障碍的脑卒中幸存者的驾驶相关视觉注意力技能。

Retraining moderately impaired stroke survivors in driving-related visual attention skills.

机构信息

Department of Physical Therapy, School of Allied Health Sciences, Medical College of Georgia, Augusta, Georgia.

出版信息

Top Stroke Rehabil. 2010 Sep-Oct;17(5):328-36. doi: 10.1310/tsr1705-328.

Abstract

BACKGROUND

Visual inattention is a major cause of road accidents and is a problem commonly experienced after stroke.

PURPOSE

This study investigated the effects of 2 training programs on performance in the Useful Field of View (UFOV), a validated test of driving-related visual attention skills.

METHOD

Data from 69 first-ever, moderately impaired stroke survivors who participated in a randomized controlled trial (RCT) to determine the effects of simulator training on driving after stroke were analyzed. In addition to regular interventions at a rehabilitation center, participants received 15 hours of either simulator-based driving-related training or non-computer-based cognitive training over 5 weeks.

RESULTS

Total percentage reduction in UFOV and performance in divided and selective attention and speed of processing subtests were documented at 6 to 9 weeks (pretraining), 11 to 15 weeks (posttraining), and 6 months post stroke (follow-up). Generalized estimating equation (GEE) model revealed neither group effects nor significant interaction effects of group with time in the UFOV total score and the 3 subtests. However, there were significant within-group improvements from pre- through posttraining to follow-up for all the UFOV parameters. Post-hoc GEE analysis revealed that most improvement in both groups occurred from pre- to posttraining.

CONCLUSION

Both training programs significantly improved visual attention skills of moderately impaired stroke survivors after 15 hours of training and retention of benefit lasted up to 6 months after stroke. Neither of the training programs was better than the other.

摘要

背景

视觉注意力不集中是道路交通事故的主要原因,也是中风后常见的问题。

目的

本研究旨在探讨两种训练方案对有用视野(UFOV)测试中驾驶相关视觉注意力技能的影响,UFOV 是一种经过验证的测试。

方法

对 69 名首次发病、中度受损的中风幸存者进行了数据分析,这些患者参与了一项随机对照试验(RCT),以确定中风后模拟器训练对驾驶的影响。除了在康复中心接受常规干预外,参与者还在 5 周内接受了 15 小时的基于模拟器的驾驶相关训练或基于非计算机的认知训练。

结果

UFOV 总得分以及注意力分散和选择性注意力及处理速度子测试的百分比降低分别在 6 至 9 周(预训练)、11 至 15 周(后训练)和中风后 6 个月(随访)进行记录。广义估计方程(GEE)模型显示,在 UFOV 总分和 3 个子测试中,组间均无效果,组与时间也无显著交互作用。然而,在 UFOV 的所有参数中,均显示出从预训练到后训练再到随访的显著组内改善。事后 GEE 分析显示,两组的大多数改善均发生在从预训练到后训练的过程中。

结论

两种训练方案均在 15 小时的训练后显著改善了中度受损中风幸存者的视觉注意力技能,且获益的保持时间最长可达中风后 6 个月。两种训练方案之间没有优劣之分。

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