Investigating on-road lane maintenance and speed regulation in post-stroke driving: a pilot case-control study

Zhou, Heng; Sun, Qian (Chayn); Blane, Alison; Hughes, Brett; Falkmer, Torbjörn; Xia, Jianhong (Cecilia) · 2019 · Crossref

DOI: 10.1101/549410

archive: archived pipeline: cataloged verified

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Summary

This pilot case-control study investigates on-road driving performance in post-stroke adults compared to neurotypical older drivers, addressing the growing need to assess driving safety as the post-stroke population increases. Stroke often causes executive dysfunction and coordination issues that may impair driving, yet traditional on-road assessments rely on subjective observation and fail to detect subtle variations in vehicle control. The study aims to determine whether specific quantitative indicators, such as lane keeping and speed regulation, can differentiate post-stroke drivers from controls using advanced tracking technology. The researchers employed a case-control design with 14 post-stroke adults (mean age 71.1 years) and 14 age-matched controls (mean age 72.9 years). All participants held valid licenses and were medically cleared to drive. Data were collected during a 9-kilometer on-road driving task in Western Australia, featuring straight sections, left turns, and U-turns. Vehicle trajectories were recorded using a Trimble R10 Multi-GNSS receiver at 10 Hz, with Real-Time Kinematic (RTK) corrections applied to achieve centimeter-level accuracy. Lane keeping performance was measured by the Standard Deviation of Lane Deviation (SDLD), while speed control was assessed via mean speed and speed standard deviation. Statistical analyses, including one-way ANOVA, compared performance across simple (straight-line) and complex (turns) driving tasks. The results revealed distinct differences in lane maintenance depending on task complexity. In complex maneuvers, specifically the exit section of a U-turn, post-stroke drivers exhibited significantly higher lane deviation (mean 1.38 m vs. 0.62 m; p=0.043) and higher SDLD (0.48 m vs. 0.19 m; p=0.026) than controls. In contrast, during simple straight-line driving, post-stroke drivers showed significantly lower lane deviation (0.30 m vs. 0.60 m; p=0.015) in one section, indicating more consistent lane positioning. No statistically significant differences were found between the groups in speed maintenance or speed variability across any task. The study concludes that multi-GNSS RTK technology is an effective tool for detecting subtle driving deficits in post-stroke individuals that traditional methods miss. While post-stroke drivers performed comparably to controls in simple tasks and speed regulation, they demonstrated poorer lane control in complex scenarios like U-turn exits. This suggests that cognitive workload and executive function demands in complex environments disproportionately affect post-stroke drivers. The findings imply that while medically cleared post-stroke drivers may be safe in routine conditions, they require further assessment or intervention for complex driving scenarios. The authors note limitations including small sample size and gender imbalance, recommending larger studies to validate these indicators for clinical driving assessments.

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Topics

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• lane positioning
• steering pattern
• post concussion
• cognitive capacity variation

Information type

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• Empirical Findings: behavioral performance data
• Methodological Resource: validation psychometrics
• Theoretical Contribution: computational model