The development and evaluation of an electric scooter simulation program

Michiel JA Jannink (PhD)*, V. Erren (PT), A.C. de Kort (MD),Ir. H. vd Kooij (Phd), Ir. C. Haarmeijer

* Roessingh Research and Development, Enschede, the Netherlands

Rehabilitation Centre ‘Het Roessingh’

University of Twente

VR facilities

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)

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

User requirements based on scenario developmentStory line

John suffered from a hemiplegics stroke 6 months ago. As a result he has ambulatory problems. To compensate this he will receive an electric scooter. To drive safely in different traffic situations, he will be trained by means of an electric scooter simulation program. Training session duration = half an hour. His performance will be stored on the computer.

User requirementsSystem requirements

Full immersive VE to train future users of electric scooters. Acquire relevant date regarding driving skills- HMD/screens- Interface electric scooter - VE- Training protocols - Understand performance- Storage and processing unit - Interpretation of collisions- Free driving context/maps

3 training levels: Level 1

Level 2

Level 3

ScoMoSi set-up

3 PC’s

Subjective questionnaire* Screens vs HMD

• Fun;• Difficulty;• Realistic;• Dizziness;• Sickness;

Based on following items:

• 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

Results:

group Subject FERS Pre FERS Post FERS pre-post Progress (%)

experimental PP04 18.00 16.00 2.00 5.6

PP06 21.00 18.00 3.00 8.3

PP07 14.00 13.00 1.00 2.8

PP10 19.00 14.00 5.00 13.9

PP11 16.00 14.00 2.00 5.6

Mean 17.60 15.00 2.60 7.2

control PP01 17.00 14.00 3.00 8.3

PP02 17.00 17.00 .00 0.0

PP03 18.00 - - -

PP05 21.00 18.00 3.00 8.3

PP08 16.00 12.00 4.00 11.1

Mean 17.80 15.25 2.50 6.9

Subjects SORT (max. 56)

Content(max. 12)

Performance (max. 16)

Safety (max. 12)

Comfort (max. 16)

Exp PP04 51.0 11.0 13.0 11.0 16.0

PP06 50.5 11.5 13.5 11.0 14.5

PP07 53.0 10.0 15.5 11.5 16.0

PP10 51.0 9.0 14.0 12.0 16.0

PP11 51.0 10.0 13.0 12.0 16.0

Total 51.3 10.3 13.8 11.5 15.7

Control PP01 51.3 11.0 14.0 10.7 15.7

PP02 53.0 12.0 16.0 10.5 15.5

PP03 56.0 12.0 16.0 12.0 16.0

PP05 51.0 11.0 14.0 11.0 15.0

PP08 52.0 12.0 15.0 11.0 14.0

Total 52.7 11.6 15.0 11.0 15.2

Current SCOMOSI environment

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

Thank you for your attention