ABSTRACT

The decision to return to driving is both complex and difficult. It is often made with clinician support, perhaps on the basis of results from standardized paper and pencil tests, and less frequently an assessment of on-road driving. However, the resources required and inherent reliability and validity challenges suggest that greater use of computerization and driving simulation may play a useful role in the assessment process. In this study, thirty-six age-matched healthy and post-stroke drivers completed standard psychometric assessments (including NART, MMSE, BADS, IADL), computer delivered cognitive assessments (including SART, N-Back, Simple Reaction Time), as well as simulated and on-road assessments of driving. While significantly different in terms of psychometric and computer-based assessments, the healthy and post-stroke drivers who completed the on-road test did not differ. In contrast, driving in the portable simulator showed impaired driving, on some but not all driving manoeuvres, for those who failed the on-road test or had voluntarily ceased to drive. These results are discussed in terms of the implications they have for the multi-faceted nature of driving as a skill, and the need to involve simulation when assessing fitness to drive.

摘要

恢复驾驶的决定既复杂又困难。它通常是在临床医生的支持下进行的，也许是基于标准纸笔测试的结果，而很少是对道路行驶的评估。但是，所需的资源以及固有的可靠性和有效性挑战表明，更多地使用计算机化技术和驾驶模拟技术可能会在评估过程中发挥重要作用。在这项研究中，三十六名年龄匹配的健康和中风驾驶员完成了标准的心理测评（包括NART，MMSE，BADS，IADL），计算机交付的认知测评（包括SART，N-Back，简单反应时间），以及作为模拟和公路驾驶评估。尽管在心理测验和基于计算机的评估方面存在显着差异，完成道路测试的健康和中风后的驾驶员没有不同。相反，对于那些未通过道路测试或自愿停止驾驶的人，便携式模拟器中的驾驶在某些但并非全部驾驶行为上显示出驾驶障碍。讨论了这些结果，它们对驾驶技能的多方面性质具有影响，并且在评估驾驶适应性时需要涉及模拟。