Karen Hookstadt, OTR

Spalding Rehabilitation Hospital

Discuss the use of technology and how it can improve an individual’s visual and motor skills

Define the role of our visual system and how deficits affect performance in daily activities

Identify commonly used terminology in relation to visual skills

Originally designed as a device to improve visual motor skills of athletes

Then adapted to provide the same benefits to individuals with visual motor deficits resulting from an injury or disease

Mary Warren PhD, OTR/L, SCLV, FAOTA (highly respected in OT and vision) recognized the device and the training programs as being useful within the rehabilitation field

Large, height adjustable board (4 x 4 feet)

64 contoured LED switches Five concentric rings/Four quadrants Choice of Red or Green LED lights Central Focal LCD screen Audible feedback with correct responses Game-like presentation, challenging

levels Computer Netbook: Patient database

(history storage)

Stroke TBI (acquired or non-traumatic) MS Vestibular and Balance Disorders

Presentation of the following deficits: unilateral inattention, neglect, visual field loss, hemianopsia, or suppression.

Additional uses: sustained attention, divided attention, eye-hand coordination, reaction time, balance, endurance, UE AROM

Contraindicated for clients with photo sensitive seizure disorders.

Fixation: ability to direct and maintain steady eye gaze on a target

Scanning: visual search that requires attention and combines smooth and quick movements of the eyes to locate objects or targets in the surrounding environment

Smooth pursuits: eye movements that maintain continued fixation on moving targets

Saccades: quick, discontinuous but simultaneous movements of both eyes in the same direction (visual search and then fixate onto an target)

Accommodation: ability to adjust visual focus at varying distances (convergence/divergence)

Exhibit difficulty localizing or orienting visual stimuli or objects

Orientation of their body in space (ability to orient to midline)

Significant eye gaze or preference to uninvolved side OR reluctant to move their head past midline

Frequently bump into objects Have difficulty initiating or coordinating

movements

Difficulty with self care, mobility and transfers

Depth perception (judging distances between objects, curb height, etc)

Anxiety moving in busy environments Display limited functional cognitive skills

(attention, memory, processing, multi-tasking)

Complain of disorientation (especially when moving, such as riding in a car)

Primary method of gathering and processing environmental information

Postural alignment and control (vision leads our movement patterns)

Social interaction: visual system allows us to interpret body language, maintain eye contact

Vision assists in our ability to engage in any cognitive activity and allows us to make decisions upon what we are interpreting (reading, writing, safety awareness, navigating in the environment, driving, etc)

When our vision is compromised our overall ability to process information slows significantly

Mode A: self pacing program (light only turns off when the client touches it); facilitate visual scanning

Mode B: automatic presentation of stimulus

(machine timed stimulus); facilitates reaction time

Mode B with Flash Option: challenging higher functioning individuals, incorporates divided attention (visual, physical and cognitive component)

Reaction time: able to assess visual and physical reaction times

Endurance Test: sustained attention- program continues for 4 minutes

Lets see it in action

Because of the relatively recent introduction of the Dynavision into rehabilitation centers, the published literature surrounding the use of this device in rehabilitation is limited

Over 600 rehabilitation centers are currently utilizing the Dynavision in treatment

Websites: Dynavisiond2.com visABILITIES.com