The development and evaluation of an electric scooter simulation program * Roessingh Research and Development, Enschede, the Netherlands Michiel JA Jannink (PhD)*, V. Erren (PT), A.C. de Kort (MD), Ir. H. vd Kooij (Phd), Ir. C. Haarmeijer
Motivation VR • Steady increase in age in western society; • 2006 > estimation: 20.7% of the people are over 60 y • 2020 > estimation: 25.9% of the people are over 60 Y • Substantial pressure on health care resources; Physical Medicine and Rehabilitaion new technologies like VR??
Electric Scooter Simulation Program (ScoMoSi)
Background ScoMoSi project: • Electric mobility scooters are provided by local authorities • 183.000 users in the Netherlands (1998) • Per year 15.000 new users • 8 to 17 km/h (on pavement, but also on road/lanes) • However • Not every person receives • a training period; • If training, safety patient • and health care professional • can be a problem; • no objective protocols.
Goal ScoMoSi project: To explore if it is possible to train the driving skills of future users of electric mobility scooters by means of an electric scooter simulation program in addition to conventional electric scooter training Question (a priori): Is Scomosi training at least as effective as conventional training
Methods: • Literature search; • Expert interviews; • Scenario Development; • Explorative RCT
Literature Search: • Literature search: (1975- July 2005) -Medline -Embase -CIRRIE -Cochrane controlled Trials database
Selection of literature • Goal • Pronk et al. 1980 Driving skills 2D • Cooper et al. 1995 Exercise training 2D • Hasdai et al. 1997 Driving skills 2D • O’conner et al. 2000 Exercise training 2D • Webster et al. 2001 Driving skills 2D • Harrison et al. 2002 Driving skills 2D • Cooper et al. 2002 Driving skills 2D • Weiss et al. 2003 Leisure activity 3D
Literature conclusions: • The results of the studies indicate that VR might be a useful application to train powered wheelchair users. • A positive training effect (in a simulator) resulted in an improved performance on real-life driving skills. • The number of collisions decreased and the time needed to complete the course improved
ScoMoSi set-up 3 PC’s
Subjective questionnaire* Screens vs HMD Based on following items: • Fun; • Difficulty; • Realistic; • Dizziness; • Sickness; • Fatigue; • Comfort; • Control; • Safety; • Distraction. * Based on Cooper et al. 1995; Harrison et al. 2002
Results: No difference between screens and HMD with regard to: difficulty, realism, fatigue, control, safety and distraction. HMD: more fun, less dizziness and sickness, better comfort
Explorative RCT • Clinical evaluation SCOMOSI • 10 stroke patients • RCT design • Experimental group (n=5) • Control group (n=5) • Driving skills measured on T0 and T1 according to Functional Evaluating Rating Scale (Hasdai et al. 1997) • Subjective experiences measured on T1
Conclusion • The electric scooter simulation program is potentially useful an safe for training patients in handling electric powered scooters; • Standardized assessment and training protocols need to be developed; • Usability evaluation