Dynavision Normative Data for Reaction Time Principal Investigator: Lori Dryg, MA, CCC-SLP CBIS   Sub-Investigators: Cherie Blackwell, OTR/L, CHT; Sue Clemens, OTR/L, CBIS; Kristen Mandle, OTR/L; Kathy Cary, COTA/L; Jon Lemke, PhD

What is the Dynavision used for? Originally designed as a device to improve visual skills and eye hand coordination of athletes. Tiger Woods Professional Hockey and Football Players Rehabilitation Device provides the same training benefits to persons whose visual and motor function has been compromised by injury or disease Stroke TBI Spinal Cord Injury ADD

Benefits of Dynavision Improve visual and cognitive skills Hemi inattention Left neglect Processing speed Divided attention and concentration Improve Activities of Daily Living Driving Reading Managing finances School performance

Mallard Jersey Auction On March 17, 2013, the Quad City Mallard’s Jersey Auction contributed $19,745 toward purchase of the Dynavision equipment!

Dynavision Video

Research Purpose No established norms for Dynavision equipment. Establishing norms for visual reaction, physical response and motor response times will assist therapists in properly assessing and treating visual perceptual deficits.

Study Objectives To determine the visual reaction speed of adults in age categories 18 – 40, 41 – 59 and 60-80 years, using the Dynavision D2 Visuomotor Training System To determine the physical response speed of adults in age categories 18 – 40, 41 – 59 and 60-80 years, using the Dynavision D2 Visuomotor Training System To determine the motor response time of adults in age categories 18 – 40, 41 – 59 and 60-80 years, using the Dynavision D2 Visuomotor Training System  

Methodology Cross-sectional, descriptive 300 participants 100 in each of the three age categories Inclusion Criteria Exclusion Criteria The study will include up to 300 participants, 100 in each of the three age categories. The research team will begin recruitment with the 60-80 age group. Once the recruitment goal of 100 participants is reached in this age category, the research team will analyze the data. This will help to inform the recruitment goals and data analysis for the rest of the study groups.   Inclusion criteria: Adults ages 18-80 years old Exclusion criteria: Previous Neurological impairment History of seizures Partial to full blindness Cognitive Impairments (including but not limited to: moderate to severe dementia, inability to follow simple directives) Hand numbness Inability to reach the entire range of the Dynavision apparatus (as tested by the Bi-lateral Upper Extremity Range of Motion screening)

WE NEED YOU!!!! Recruitment Flyers Local newspaper articles Newsletters Word-of-mouth to families and patients in the Outpatient Physical Rehabilitation facility WE NEED YOU!!!! Flyers distributed throughout the community (e.g., churches, gyms, senior centers) Bettendorf Library, Palmer Hills Retirement Home, HYVEE, YMCA, Life Fitness Center Local newspaper articles Genesis Webpage/Facebook Newsletter sent out to Genesis staff members Letter sent via email?, Ambrose faculty and students Word-of-mouth to families and patients in the Outpatient Physical Rehabilitation facility

Data Collection Initial Intake Form Informed Consent Standard Screening Form (i.e., past medical history, ROM screen) Dynavision Reaction Speed Test Practice Recorded Results   Initial Intake Form Participants will be asked to complete a short intake form that collects the following information: name, age, gender, race, educational background, hand dominance and use of corrective lenses. Dynavision D2 Visuomotor Training System tests Use a written protocol to instruct the participant on how to complete each test. The participant will be asked to hold down a red button until a second red button lights up. The participant will be told to quickly strike the second button then return back to the original red button and hold it down firmly until a third button illuminates. This will continue for 5 repetitions. First, the sub-investigator will illustrate how to complete the test. Then the sub-investigator will allow the participant to complete a practice test. The participant will then complete six different portions of the test, 3 for the right hand and 3 for the left hand.

Data Analysis GHS Business Intelligence Center will analyze total reaction times across the 6 tasks for each age group to establish normal limits. Identifying the parametric distribution of the data allowed use of a 50 patient sample, opposed to 400 otherwise. Results to be announced upon completion of data collection. Data Analysis   Once data is transferred to the GHS Biostatistics Group, research team members will double enter the data and manage the databases, assign identification numbers to participants, perform edit diagnostics and prepare worksheets for analysis. Data analysis will focus on the total reaction times across the 6 tasks. The first sample will be 100 adult volunteers at least 60 years old that satisfy sufficient inclusion/exclusion criteria to represent normal functioning in this population. In order to minimize the required sample the biostatistics team reviewed the parametric distributions of reaction times and currently expect to use the reciprocal normal (Moscoso Del Prado Martin, et al. 2009) to establish our normal limits, that is the biostatistics team will take the reciprocals of the total reaction times and use the mean ± 1.96*(standard deviation). Then they will take the inverse of the reciprocal which is the reciprocal so that the estimated normal limits are: 2.5th Percentile: (1/(mean+1.96*standard deviation); and 97.5th Percentile: (1/(mean-1.96*standard deviation). Without identifying the parametric distribution of reaction times the study would require at least 400 participants. These estimates will serve as standards for stroke patients. Similar experiments will be run on younger subjects to establish normal limits for brain injury patients.

Initial Cohort 50 patients age 60+ Calculate time to complete all 6 tests Take reciprocal of these values Plot and test for normality Find 2.5 and 97.5 percentiles

Results of Analysis Lower limit (2.5th percentile) is 21.8 seconds Upper limit (97.5th percentile) is 43.5 seconds Recommend that patients age 60+ recovering from stroke complete all 6 tests in at most 43.5 seconds

Barriers to Data Collection Our equipment is not portable Conducted during regular business hours Men are more reluctant to participate Full time employees trying to manage caseload and research Convenience population fall in exclusion criteria

Volunteers Call 421-3460 to set up an appointment to volunteer! Data collection began Fall 2014. We have completed 1/3 of the study!!! Call 421-3460 to set up an appointment to volunteer!

Questions!!!