Oral Communication

Simulator-based driving assessment after stroke : interest as a complement to cognitive evaluation.

Ms Claire PALAYERa, Dr Jérome FROGERb, Dr Huei Yune BONNIN KOANGb, Mr Stephane PROIAb, Prof Isabelle LAFFONTa

a CHU Lapeyronie, b Centre Hospitalier du Grau du Roi

Introduction. Driving is a complex activity that requires motor, visuo-perceptual, behavioral and cognitive abilities, which all could be affected after stroke. There is no correlation between cognitive assessment and on-road test, which is the gold standard for driving assessment [1]. Few studies have so far been conducted on simulator-based assessment interest in the specific context of stroke [2].

Purpose. The main aim of our study is to evaluate the contribution of driving simulator, in addition to cognitive assessment.

Material and Method. It is a retrospective study, involving patients with supratentorial stroke, for global assessment before driving again, including : cognitive assessment (Trail Making Test, Rey-O Complex Figure, WAIS IV figure weights, Stroop test, BEC 96, the Bells test), simulator-based assessment after commands adjustment (reaction time, driving control [speed, path], driving behavior) and medical assessment. Statistical analysis between cognitive assessment and driving simulator results are performed using a multiple linear regression model.

Results. 43 patients, admitted in our ward between 2010 and 2013 for driving assessment were included: 33 with ischemic stroke, 8 with hemorrhagic stroke (right hemisphere for 23 patients, left for 18). Statistical analysis are currently in progress.

Discussion. Driving simulator allows, compared to on-road test, a safe assessment with possible standardization procedures. Characterizing cognitive elements useful to predict inability to drive, in particular those giving a false sense of security and which should encourage to further exploration on simulator driving or on-road test, is important to optimize the management.

1. Fattal C et al. Sélection des patients cérébrolésés en vue de la reprise de ce la conduite automobile. Ann Réadaptation Med Phys 1998; 41:77-83

2.Hird MA,Vetivelu A1,Saposnik G,Schweizer TA. Cognitive, on-road, and simulator-based driving assessment after stroke.J Stroke Cerebrovasc Dis.2014; 23:2654-70.

Keywords : Driving ability, stroke, driving simulator