Driving Simulator Assessment of Fitness-to-Drive Following Traumatic Brain Injury

Abstract

Returning to driving is a major goal for individuals recovering from a traumatic brain injury (TBI). Clinicians have a variety of tools to assess the ability to return to driving for TBI patients, including cognitive assessments, but on-road instrumented vehicle driving assessments have been considered the gold standard. However, these on-road assessments are limited in the ability to ethically expose drivers to certain driving situations or environments. The purpose of this study was to examine the ability of a high-fidelity driving simulator to assess driving performance in individuals who have sustained a moderate-to-severe TBI, as well as associate cognitive measures commonly used in this population with simulated driving outcomes. Fourteen participants from a TBI clinic were recruited to drive in a simulator through a series of increasingly complex diving modules: 1) basic vehicle operation; 2) secondary task engagement while driving; 3) car following; 4) divided attention; and 5) navigating left hand turns across oncoming traffic. Half (n = 7) had been released to return to drive and half (n = 7) were considered to never be able to return to driving. Although general trends suggest non-drivers exhibit slower driving and increased lane position variation, group differences driving were not shown likely due to small sample sizes. Differences in patterns of cognitive correlates with driving were found, with higher order cognitive processes, like working memory, being more associated with driving outcomes in active drivers. Suggestions for driving scenario development in this population are discussed.

Severity and correlates of brain fog in people with traumatic brain injury

“…All procedures were ethically approved by our Institutional Review Board. Further details about these studies have been published elsewhere (McManus et al, 2015; McManus et al, 2019; Newton et al, 2018; Stavrinos et al, 2019).…”

Severity and Correlates of Mental Fog in People with Traumatic Brain Injury

“…All procedures were ethically approved by our Institutional Review Board. Further details about these studies have been published elsewhere (McManus, Bell, & Stavrinos, 2019; McManus, Cox, Vance, & Stavrinos, 2015; Newton et al, 2018; Stavrinos et al, 2019).…”