Support for stroke patients in resumption of driving: patient survey and driving simulator trial

Hitosugi; Takehara; Watanabe; Tokudome · 2011 · OpenAlex-citations

DOI: 10.2147/ijgm.s17475

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Summary

This study addresses the lack of structured support for stroke patients wishing to resume driving, a critical factor for social reintegration. In Japan, the absence of objective guidelines and specific rehabilitation protocols has led to low driving resumption rates, despite many patients retaining the physical capacity to drive. The authors aimed to establish an effective support program by first assessing patient needs through a survey and then evaluating the efficacy of a driving simulator training intervention. The research comprised two phases. First, a questionnaire was distributed to 525 stroke patients admitted to the Tokyo Metropolitan Rehabilitation Hospital; data from 118 patients who drove prior to their stroke were analyzed. Second, a driving simulator trial involved 24 stroke patients and 20 healthy controls. Participants underwent training on a modified Honda driving simulator equipped with adaptive aids for hemiplegia. The primary assessment involved a braking task where participants had to avoid a collision with a truck appearing 21.6 meters ahead while traveling at 40 km/h. Reaction time (time from hazard appearance to 10% braking) and braking time (duration to stop) were measured across up to three attempts. The survey revealed that only 35.6% of patients resumed driving post-stroke, while 33.9% still wished to drive. Crucially, 62.7% reported receiving insufficient information about driving resumption during hospitalization, and 38.1% expressed a desire for simulator-based training. In the simulator trial, stroke patients initially performed worse than controls, with only 33.3% successfully avoiding collision on the first attempt compared to 65.0% of controls. Patient reaction times were also significantly longer (0.8 seconds vs. 0.7 seconds). However, repeat training yielded significant improvements: the success rate for patients increased to 72.7% on the second attempt and 86.4% on the third. Reaction times decreased significantly to 0.7 and 0.6 seconds, respectively. Braking times remained consistent and comparable to controls throughout the trials, indicating adequate motor control. The findings demonstrate that comprehensive support, including adequate information and simulator-based training, significantly enhances driving skills and confidence in stroke patients. The simulator serves as a safe, realistic tool for assessing and improving reaction times and hazard avoidance. The authors conclude that integrating such programs into rehabilitation can help more patients safely resume driving, thereby promoting better social reintegration, while also assisting those who must abandon driving to understand their limitations.

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• simulator training transfer