Search

Study Design: Mixed-methods., Objectives: (1) To explore psychosocial and quality of life outcomes between those injured early versus later in life, and (2) to explore their post-injury experiences., Setting: GF Strong Rehabilitation Centre, Vancouver, Canada., Methods: For this community-based study, we recruited individuals with SCI (>55 years of age) who were either injured between the ages of 15-30 (n = 15) or after the age of 50 (n = 15). We collected quantitative data about participants' sociodemographics and participants completed standardised questionnaires assessing personal factors, environmental factors, life habits, and quality of life. An independent samples t test was performed for continuous variables and the Chi-square test was conducted for the categorical variables. Qualitative data were collected via semi-structured interviews. Thematic content analysis was performed on the interview transcripts., Results: We found no statistically significant differences between the two groups on any of the psychosocial outcomes. However, those injured later in life were significantly more likely to be female, have a higher income, and live in residential care. We identified three main qualitative themes that were consistent across the two groups: 'dealing with health and changes in occupation', 'enacting interdependence', and 'living in the community'. Some sub-themes varied between groups., Conclusions: To facilitate better rehabilitation, clinicians need to be aware of disparities among people with SCI relating to age of injury. Across age cohorts, it is important to increase independence, provide greater support when entering or returning to the workforce, and reduce societal stigma., (© 2022. The Author(s), under exclusive licence to International Spinal Cord Society.)

Importance: Scanning the environment is critical for driving safety. The ScanCourse is a functional assessment that assesses a person's ability to scan the environment for visual information while in motion. Measurement properties for the ScanCourse have been reported; however, its predictive validity is unknown., Objective: To determine the predictive validity of the ScanCourse for on-road driving performance and establish clinical cutoff scores., Design: Retrospective chart reviews were conducted over a 6-mo period., Setting: Four Canadian driver rehabilitation programs., Participants: Charts from patients with neurological or vision conditions were eligible if they contained ScanCourse and on-road driving evaluation results between September 1, 2008, and August 30, 2018. Three hundred twenty-five charts were included for analysis., Outcomes and Measures: Area under the curve (AUC) analysis was used to determine the predictive validity of ScanCourse scores for on-road outcomes; cutoff scores were established by optimizing sensitivity and specificity., Results: The ScanCourse had an AUC of .702. The optimal cutoff score was 18/20 with a sensitivity of 76.7% and a specificity of 47.1%., Conclusions and Relevance: Assessing the scanning abilities of at-risk drivers who intend to return to driving after sustaining an injury can help identify safety risks and inform interventions. The ScanCourse was found to have acceptable discriminatory ability for on-road driving performance. This study provides evidence supporting its continued use as a screening tool to assess driver fitness with an identified optimal cutoff score for clinical use., What This Article Adds: Measuring the predictive ability of the ScanCourse assessment in relation to on-road driving performance provides occupational therapists with an evidence-based clinical tool to assist with screening fitness to drive among at-risk people., (Copyright © 2021 by the American Occupational Therapy Association, Inc.)

Importance: Occupational therapists frequently assess the fitness to drive of people with visual field impairment, but the relationship between these assessments and driving performance over time is not well understood., Objective: To determine traffic violation and crash incidence over a 1-yr period for drivers with visual field impairment., Design: Retrospective review of medical and driving records., Setting: British Columbia, Canada., Participants: Participants (N = 445) were ages 26-74 yr with binocular, corrected visual acuity of ≥20/50. Goldmann visual field tests were reviewed to stratify participants on the basis of visual field impairment and whether impairments exceeded licensing standards., Outcome and Measures: Traffic records were reviewed to determine group-specific traffic violations and crash incidence during the year after the visual field test., Results: Of 445 participants, 292 held a valid driver's license during the designated period. Participants not meeting the licensing standards were less likely to become licensed than participants who met the standards. The results indicate that drivers with visual field impairment did not have a higher probability of crashes or violations than drivers without visual field impairment., Conclusion: Drivers with visual field impairment who retained a driver's license did not have an increased probability of crashes in the following year. A larger, prospective, mixed methods study of long-term driving behaviors among people with visual field impairment is recommended., What This Article Adds: This study provides preliminary data on the 1-yr incidence of traffic violations and crashes among people with visual field impairment., (Copyright © 2019 by the American Occupational Therapy Association, Inc.)