TY - JOUR
T1 - Effect of simulator training on fitness-to-drive after stroke
T2 - A 5-year follow-up of a randomized controlled trial
AU - Devos, Hannes
AU - Akinwuntan, Abiodun Emmanuel
AU - Nieuwboer, Alice
AU - Ringoot, Isabelle
AU - Van Berghen, Karen
AU - Tant, Mark
AU - Kiekens, Carlotte
AU - De Weerdt, Willy
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2010/11
Y1 - 2010/11
N2 - Background. No long-term studies have been reported on the effect of training programs on driving after stroke. Objectives. The authorsg' primary aim was to determine the effect of simulator versus cognitive rehabilitation therapy on fitness-to-drive at 5 years poststroke. A second aim was to investigate differences in clinical characteristics between stroke survivors who resumed and stopped driving. Methods. In a previously reported randomized controlled trial, 83 stroke survivors received 15 hours of simulator training (n = 42) or cognitive therapy (n = 41). In this 5-year follow-up study, 61 participants were reassessed. Fitness-to-drive decisions were obtained from medical, visual, neuropsychological, and on-road tests; 44 participants (simulator group, n = 21; cognitive group, n = 23) completed all assessments. The primary outcome measures were fitness-to-drive decision and current driving status. Results. The authors found that 5 years after stroke, 18 of 30 participants (60%) in the simulator group were considered fit to drive, compared with 15 of 31 (48%) in the cognitive group (P =.36); 34 of 61 (56%) participants were driving. Current drivers were younger (P =.04), had higher Barthel scores (P =.008), had less comorbidity (P =.01), and were less severely depressed (P =.02) than those who gave up driving. Conclusions. The advantage of simulator-based driving training over cognitive rehabilitation therapy, evident at 6 months poststroke, had faded 5 years later. Poststroke drivers were younger and less severely affected and depressed than nondrivers.
AB - Background. No long-term studies have been reported on the effect of training programs on driving after stroke. Objectives. The authorsg' primary aim was to determine the effect of simulator versus cognitive rehabilitation therapy on fitness-to-drive at 5 years poststroke. A second aim was to investigate differences in clinical characteristics between stroke survivors who resumed and stopped driving. Methods. In a previously reported randomized controlled trial, 83 stroke survivors received 15 hours of simulator training (n = 42) or cognitive therapy (n = 41). In this 5-year follow-up study, 61 participants were reassessed. Fitness-to-drive decisions were obtained from medical, visual, neuropsychological, and on-road tests; 44 participants (simulator group, n = 21; cognitive group, n = 23) completed all assessments. The primary outcome measures were fitness-to-drive decision and current driving status. Results. The authors found that 5 years after stroke, 18 of 30 participants (60%) in the simulator group were considered fit to drive, compared with 15 of 31 (48%) in the cognitive group (P =.36); 34 of 61 (56%) participants were driving. Current drivers were younger (P =.04), had higher Barthel scores (P =.008), had less comorbidity (P =.01), and were less severely depressed (P =.02) than those who gave up driving. Conclusions. The advantage of simulator-based driving training over cognitive rehabilitation therapy, evident at 6 months poststroke, had faded 5 years later. Poststroke drivers were younger and less severely affected and depressed than nondrivers.
KW - automobile driving
KW - randomized controlled trial
KW - stroke
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U2 - 10.1177/1545968310368687
DO - 10.1177/1545968310368687
M3 - Article
C2 - 20656965
AN - SCOPUS:78649254048
SN - 1545-9683
VL - 24
SP - 843
EP - 850
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 9
ER -