Driving is a complex activity that requires intact cognitive, behavioral, and motor function. Stroke is one of the most prevalent neurologic impairments and can affect all of these functions. However, diagnosis of stroke is not a definitive indicator of driving impairment. Determining fitness to drive after stroke is a very complex process and is typically based on cognitive assessments, on-road performance, simulator-based assessment, or a combination of the three. The aim of this review was to provide (1) a systematic review of the literature on cognitive, on-road, and simulator assessment after stroke, and (2) address the existing limitations and inconsistencies in stroke and driving research. Our results indicated that of 1413 total stroke patients, 748 definitively passed and 367 definitely failed an on-road assessment, with minimal information provided about clinical presentation. In addition, although the Stroke Driver Screening Assessment, the Useful Field of View Test, and the Rey-O Complex Figure test may have some utility in predicting driving performance, most cognitive measures have been inconsistently and minimally explored. Several limitations were observed across studies such as procedural inconsistencies, including outcome variables used (eg, driving cessation and pass/fail classification) and the heterogeneity of patient samples (eg, time since stroke and stroke location). Due, in part, to the larger variability in results of cognitive, on-road, and simulator-based assessment, there is no consensus regarding a valid and reliable driving assessment for physicians. Future studies should assess poststroke driving fitness by differentiating different stages, severities, and locations of stroke.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.06.010 | DOI Listing |
Cureus
December 2024
Department of Rehabilitation, Tokyo University of Technology, Tokyo, JPN.
Introduction: On-road tests are considered the gold standard for evaluating real-world driving skills. However, their reliability and validity remain inadequately established, particularly under varying legal and road conditions across countries.
Aim: This study investigates the discriminant validity of the closed-course version of the Standardized On-Road Assessment for Drivers (SOAD) in Japan.
J Forensic Leg Med
December 2024
Major Collision Team, ACT Policing, Australian Capital Territory, Australia. Electronic address:
Introduction: Medical conditions may cause driving impairment and preventable motor vehicle collisions. Australian Capital Territory (ACT) Police detect potentially medically impaired drivers as part of their duties. ACT Police and medical fitness to drive reviewers sought to determine the accuracy of police suspicion of medically impaired drivers for quality assurance and legislative purposes.
View Article and Find Full Text PDFBehav Sci (Basel)
November 2024
Department of Molecular Medicine, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 00185 Roma, Italy.
Attentional deficits have tragic consequences on road safety. These deficits are not solely caused by distraction, since they can also arise from other mental impairments such as, most frequently, mental fatigue. Fatigue is among the most prevalent impairing conditions while driving, degrading drivers' cognitive and physical abilities.
View Article and Find Full Text PDFAppl Neuropsychol Adult
October 2024
Southern Cross University - Coffs Harbour Campus, Coffs Harbour, NSW, Australia.
Mental processes responsible for goal-oriented behavior - executive functioning (EF) - include working memory, flexible thinking, and cognitive control. A reliable and valid assessment of EF can inform appropriate interventions and decisions to drive. We investigated the feasibility and validity of a short, iPad-administered EF screening tool in a non-clinical sample: the Coffs Harbour Executive Functioning Screen (CHEFS).
View Article and Find Full Text PDFAim: Driving cessation is strongly associated with adverse health outcomes in older adults. Although numerous studies have focused on driving skill interventions for safe driving, the effects of interventions on car accidents remain unclear. We designed a randomized controlled trial to examine the effects of driving skill training on the prevention of car accidents among community-dwelling older adults using on-road training.
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