Use of a driving simulator to improve on-road driving performance and cognition in persons with Parkinson's disease: A pilot study

Background/aim: The use of simulators as an assessment and intervention tool for driving is an emerging field in occupational therapy. We investigated the potential usefulness of a driving simulator to improve on-road skills and cognitive functions in drivers with Parkinson's disease (PD). Method: Fifteen participants with PD, and Hoehn and Yahr stages between 2 and 3 participated in this pre–post comparison study. Twelve of the 15 individuals (median age (Q1–Q3), 68 (63.5–72.5); 10 men) completed 10 hours of training in a high-fidelity driving simulator. A practical road test as well as off-road cognitive and simulator tests were administered at pre-training and post-training. Results: Nine participants, who passed the road test before training, passed at post-training. Furthermore, all three participants who initially failed the on-road test passed after training. Participants’ performance improved significantly from pre- to post-training on two cognitive tests: (i) the Montreal Cognitive Assessment and (ii) Dot Cancellation test. Conclusion: This pilot study demonstrates the potential usefulness of a simulator to improve on-road driving and driving-related cognitive skills in PD. Adequately powered randomized controlled trials are needed to further expand this field of study.