Determinants of On-Road Driving in Multiple Sclerosis

Hannes Devos, Maud Ranchet, Deborah Backus, Matt Abisamra, John Anschutz, C. Dan Allison, Sunil Mathur, Abiodun E. Akinwuntan

    Research output: Contribution to journalArticlepeer-review

    22 Scopus citations

    Abstract

    Objective To investigate the cognitive, visual, and motor deficits underlying poor performance on different dimensions of on-road driving in individuals with multiple sclerosis (MS). Design Prospective cross-sectional study. Setting MS clinic and driving simulator lab. Participants Active drivers (N=102) with various types of MS. Interventions Not applicable. Main Outcome Measures Off-road cognitive, visual, and motor functions, as well as 13 specific driving skills. These skills were categorized into hierarchic clusters of operational, tactical, visuo-integrative, and mixed driving. Stepwise regression analysis was used to determine the off-road functions influencing performance on the on-road test and each cluster. Results Visuospatial function (P=.002), inhibition (P=.008), binocular acuity (P=.04), vertical visual field (P=.02), and stereopsis (P=.03) best determined variance in total on-road score (unadjusted R2=.37). Attentional shift (P=.0004), stereopsis (P=.007), glare recovery (P=.047), and use of assistive devices (P=.03) best predicted the operational cluster (unadjusted R2=.28). Visuospatial function (P=.002), inhibition (P=.002), reasoning (P=.003), binocular acuity (P=.04), and stereopsis (P=.005) best determined the tactical cluster (unadjusted R2=.41). The visuo-integrative model (unadjusted R2=.12) comprised binocular acuity (P=.007) and stereopsis (P=.045). Inhibition (P=.0001) and binocular acuity (P=.001) provided the best model of the mixed cluster (unadjusted R2=.25). Conclusions Our results provide more insights into the specific impairments that influence different dimensions of on-road driving and may be used as a framework for targeted driving intervention programs in MS.

    Original languageEnglish (US)
    Pages (from-to)1332-1338.e2
    JournalArchives of Physical Medicine and Rehabilitation
    Volume98
    Issue number7
    DOIs
    StatePublished - Jul 2017

    Keywords

    • Automobile driving
    • Multiple sclerosis
    • Neuropsychology
    • Rehabilitation
    • Vision, ocular

    ASJC Scopus subject areas

    • Physical Therapy, Sports Therapy and Rehabilitation
    • Rehabilitation

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