Biomedical subjects

N A Korner-Bitensky

Publications and source records attributed to N A Korner-Bitensky.

4 recordsLinked to original sources

PubMed1998

Predicting ability to drive after stroke.

OBJECTIVE: To determine the ability of perceptual testing to predict on-road driving outcome in subjects with stroke. STUDY DESIGN: Historical cohort study of 84 individuals with stroke who completed both the perceptual testing and the on-road driving evaluation conducted in a driving evaluation service. MEASURES: Perceptual tests, such as the Motor Free Visual Perception Test (MVPT) and Trail Making B test, and an on-road driving evaluation. Based on driving behaviors, a pass or fail outcome was determined by the examiners. RESULTS: Subjects who passed the on-road evaluation had better average scores on the majority of perceptual tests compared with those who failed. The MVPT was the most predictive of on-road performance (positive predictive value=86.1%; negative predictive value=58.3%). The combination of tests resulting in the most predictive and parsimonious model was the MVPT plus Trail Making B, such that those who scored poorly on both were 22 times more likely to fail the on-road evaluation. CONCLUSION: A screening process is useful in identifying persons who are not ready to undergo an on-road driving evaluation.

Adult↗

PubMed1991

Recovery time of independent function post-stroke.

Stroke patients undergoing physical rehabilitation were monitored daily to determine the length of time needed to recover independent function. Of the 93 patients admitted, there were 45 who could not attain the sitting position independently, 75 who could not walk independently and 75 who could not negotiate the stairs independently. By discharge, 25 of 45 patients (55.6%) were able to attain sitting from supine independently, 35 of 75 patients (46.7%) achieved the ability to walk independently but only 25 of 75 patients (33.3%) learned to negotiate stairs independently. The time from admission to achievement of independent function and the time from onset of stroke to achievement of independent function was modeled in relation to explanatory variables: age, sex, side of lesion, comorbidity, the presence of depression and the extent of impairment in perception, cognition, auditory comprehension and verbal expression. Four variables were found to influence recovery time: age influenced the rate of recovery of walking and stair climbing; perceptual impairment influenced the rate of achieving independent sitting and stair climbing; and depression and comprehension influenced walking.

Activities of Daily Living↗

PubMed1989

Determining medical fitness to drive: physicians' responsibilities in Canada.

Current legislation indicates that physicians in Canada have a legal responsibility to know which medical conditions may impede driving ability, to detect these conditions in their patients and to discuss with their patients the implications of these conditions. The requirements to report unfit drivers vary among the provinces, and the interpretations of the law vary among the courts; therefore, physicians' risks of liability are unclear. Physicians may be sued by their patients if they fail to counsel the patients on the dangers of driving associated with certain medications or medical conditions. Physicians may also face legal action by victims of motor vehicle accidents caused by their patients if the court decides that the physicians could have foreseen the danger of their patients' continuing to drive. Physicians' legal responsibilities to report patients with certain medical conditions override their ethical responsibilities to keep patients' medical histories confidential.

Accidents, Traffic↗

PubMedDate not supplied

Visual testing for readiness to drive after stroke: a multicenter study.

OBJECTIVE: The purpose of this study was to determine the ability of a visual-perception assessment tool, the Motor-Free Visual Perception Test, to predict on-road driving outcome in subjects with stroke. DESIGN: This was a retrospective study of 269 individuals with stroke who completed visual-perception testing and an on-road driving evaluation. Driving evaluators from six evaluation sites in Canada and the United States participated. Visual-perception was assessed using the Motor-Free Visual Perception Test. Scores range from 0 to 36, with a higher score indicating better visual perception. A structured on-road driving evaluation was performed to determine fitness to drive. Based on driving behaviors, a pass or fail outcome was determined by the examiner. RESULTS: The results indicated that, using a score on the Motor-Free Visual Perception Test of < or =30 to indicate poor visual-perception and >30 to indicate good visual perception, the positive predictive value of the Motor-Free Visual Perception Test in identifying those who would fail the on-road test was 60.9% (n = 67/110). The corresponding negative predictive value was 64.2% (n = 102/159). Univariate logistic regression analyses revealed that older age, low Motor-Free Visual Perception Test scores and a right hemisphere lesion contributed significantly to identifying those who failed the on-road test. CONCLUSIONS: The predictive validity of the Motor-Free Visual Perception Test is not sufficiently high to warrant its use as the sole screening tool in identifying those who are unfit to undergo an on-road evaluation.

Aged↗