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Trial registered on ANZCTR
Registration number
ACTRN12617000386336
Ethics application status
Approved
Date submitted
6/03/2017
Date registered
15/03/2017
Date last updated
15/03/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
What is the most effective type of driver rehabilitation for individuals post stroke or traumatic brain injury? A comparison of driving instructor lessons and driving simulator interventions.
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Scientific title
A randomised controlled trial comparing the effectiveness of two forms of driving remediation: driving lessons and driving simulation; on improving driving behaviours for individuals with stroke or traumatic brain injury.
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Secondary ID [1]
291338
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Nil known
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Universal Trial Number (UTN)
U1111-1193-8864
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
traumatic brain injury
302354
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stroke
302355
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Condition category
Condition code
Neurological
301940
301940
0
0
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Other neurological disorders
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Physical Medicine / Rehabilitation
301941
301941
0
0
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Occupational therapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention group will be undertaking 6 x 1 hour simulator sessions (held two times per week for 3 weeks). The intervention involves being seated in the simulator and completing training protocols focussing on areas identified as requiring driver rehabilitation including physical control of the vehicle, observation skills, vehicle positioning, speed control and planning and judgement based on the errors from the On Road assessment conducted with the occupational therapists. A protocol will be used during the training sessions; training involves following a set route that is graded in terms of performance demands and driving tasks. These tasks and scenarios encountered on the simulator will be graded in terms of environmental complexity from no or low traffic areas to increased density and visually complex environments. Each route will be directed by an occupational therapist experienced in using the simulator and this therapist will also provide teaching, instruction and feedback about performance. Cueing (such as keep to the left) and feedback provided to participants will be reduced as performance on simulator tasks of participants improve. Intervention adherence will be assessed by the occupational therapist, and strategies will include information provided regarding the direct relevance of training to deficits identified on the on road assessment.
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Intervention code [1]
297395
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Rehabilitation
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Intervention code [2]
297503
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Treatment: Devices
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Intervention code [3]
297504
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Treatment: Other
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Comparator / control treatment
The control group will participate in a series of driving lessons which is currently the "usual" driving rehabilitation approach. Six times 1 hour driving lessons will be completed 2 times per week over 3 weeks with a driving instructor. The driving instructor will be experienced in working with people with neurological conditions and will be provided with the same handover as the simulator group about the driving errors and areas for driving rehabilitation.
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Control group
Active
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Outcomes
Primary outcome [1]
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On Road Assessment completed by an Occupational Therapist
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Assessment method [1]
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Timepoint [1]
301364
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Prior to randomisation (week 1) and and on conclusion of intervention (week 4)
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Secondary outcome [1]
332429
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Useful Field of View Assessment
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Assessment method [1]
332429
0
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Timepoint [1]
332429
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Prior to randomisation (week 1) and and on conclusion of intervention (week 4)
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Secondary outcome [2]
332431
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Stroke Drivers Screening Assessment
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Assessment method [2]
332431
0
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Timepoint [2]
332431
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Prior to randomisation (week 1) and and on conclusion of intervention (week 4)
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Secondary outcome [3]
332432
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Adelaide Driving Self Efficacy Scale
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Assessment method [3]
332432
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Timepoint [3]
332432
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Prior to randomisation (week 1) and and on conclusion of intervention (week 4)
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Secondary outcome [4]
332433
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Trailmaking Test B
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Assessment method [4]
332433
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Timepoint [4]
332433
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Prior to randomisation (week 1) and and on conclusion of intervention (week 4)
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Secondary outcome [5]
332434
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Reaction Time test
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Assessment method [5]
332434
0
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Timepoint [5]
332434
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Prior to randomisation (week 1) and and on conclusion of intervention (week 4)
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Eligibility
Key inclusion criteria
Diagnoses of stroke or traumatic brain injury;
Meets medical guidelines to return to driving, i.e. more than one month post stroke (or equivalent duration for brain injury), binocular vision of 6/12 and appropriate visual fileds on confrontation testin,
Recommended to undertake a practical driving assessment with an Occupational Therapist
Have held a full driver's licence and driving prior to stroke/traumatic brain injury
Undertaken Occupational Therapy assessment that indicates that they would likely fail an on road assessment and require driving rehabilitation to successfully return to driving.
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Minimum age
17
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Does not meet medical guidelines for driving (including visual fields of less than 120 degress with 10 degrees above and below the midline)
Experiences language difficulties that mean they cannot independently follow instructions (e.g. of driving instructor or therapist during intervention)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
central randomisation via a computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A minimum of 16 participants (8 per group) is required to achieve 80% power (with an alpha of 0.05) to detect change in on-road scores; based on previously collected data about on road assessment scores for individuals requiring lessons and those who successfully regained their drivers license.
Using an alpha of 0.05, multiple t-tests will be completed to determine signficant differences between each group's outcome measures at follow up assessment s. Fisher's Exact analysis will be used to determine significant differences in the pass rate and On Road Assessment scores between the groups.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
27/03/2017
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Actual
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Date of last participant enrolment
Anticipated
13/11/2017
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Actual
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Date of last data collection
Anticipated
18/12/2017
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Actual
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Sample size
Target
16
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
7606
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Repatriation Hospital - Daw Park
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Recruitment postcode(s) [1]
15507
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5041 - Daw Park
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Funding & Sponsors
Funding source category [1]
295810
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University
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Name [1]
295810
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Flinders University Seeding Grant
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Address [1]
295810
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GPO Box 2100
Adelaide South Australia 5001
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Country [1]
295810
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Australia
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Primary sponsor type
University
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Name
Flinders University
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Address
GPO Box 2100
Adelaide South Australia 5001
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Country
Australia
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Secondary sponsor category [1]
294696
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None
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Name [1]
294696
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Address [1]
294696
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Country [1]
294696
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297097
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Southern Adelaide clinical Human Research Ethics committee
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Ethics committee address [1]
297097
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Flinders Medical Centre Flinders Drive Bedford Park South Australia 5042
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Ethics committee country [1]
297097
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Australia
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Date submitted for ethics approval [1]
297097
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Approval date [1]
297097
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25/01/2017
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Ethics approval number [1]
297097
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312.16
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Summary
Brief summary
The study will compare the intervention of driving instructor lessons with the use of a driving simulator to undertake driving tasks in order to identify the most effective rehabilitation approach for returning to driving post stroke or traumatic brain injury. This study will identify the most effective rehabilitation approach for returning to driving in order to inform clinical practice.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
72966
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A/Prof Stacey George
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Address
72966
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Rehabilitation Aged and Extended Care
Flinders University
Daws Road
Daw Park
South Australia
5041
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Country
72966
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Australia
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Phone
72966
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+61 8 8275 1103
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Fax
72966
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Email
72966
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[email protected]
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Contact person for public queries
Name
72967
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Stacey George
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Address
72967
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Rehabilitation Aged and Extended Care
Flinders University
Daws Road
Daw Park
South Australia
5041
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Country
72967
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Australia
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Phone
72967
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+61 8 275 1103
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Fax
72967
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Email
72967
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[email protected]
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Contact person for scientific queries
Name
72968
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Stacey George
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Address
72968
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Rehabilitation Aged and Extended Care
Flinders University
Daws Road
Daw Park
South Australia
5041
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Country
72968
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Australia
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Phone
72968
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+61 8 8275 1103
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Fax
72968
0
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Email
72968
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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