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) · 2021 · Crossref

DOI: 10.3390/geriatrics6010016

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Summary

This pilot case–control study investigates on-road driving performance in post-stroke older adults, specifically focusing on lane maintenance and speed regulation. The research addresses a critical gap in understanding how stroke-induced executive dysfunction affects vehicle control, as traditional subjective assessments often fail to detect subtle deficits in drivers who do not commit overt errors. With the post-stroke population projected to rise significantly, quantifying specific driving risks is essential for ensuring safe return-to-driving practices. The study aims to determine whether indicators such as lane keeping and speed control can differentiate post-stroke drivers from neurotypical older drivers. The study employed a case–control design involving 14 post-stroke adults and 14 age-matched control drivers, all aged 60 or older. Participants completed a 9 km on-road driving task in Western Australia, featuring complex scenarios such as U-turns, left turns, roundabouts, and straight-line sections. Data were collected using a Trimble R10 Multi-GNSS receiver with Real-Time Kinematic (RTK) technology, recording vehicle positions at 10 Hz to achieve millimeter-to-centimeter accuracy. This high-precision data allowed for the calculation of the standard deviation of lane deviation (SDLD) and speed control metrics using Geographic Information System (GIS) software. The study specifically analyzed performance during demanding maneuvers versus simple straight-line driving to assess the impact of cognitive workload. The results indicated that post-stroke participants exhibited a higher mean SDLD than control participants during complex driving tasks, including U-turns and left turns. This suggests greater difficulty in maintaining lane position when executive function demands are high. However, no statistically significant differences were found in SDLD during simple straight-line sections, nor were there significant differences in speed control performance between the two groups. These findings imply that while post-stroke drivers may maintain adequate speed regulation and perform well in low-complexity scenarios, their lane keeping deteriorates under cognitively demanding conditions. The study concludes that although post-stroke older drivers can often continue driving, the decline in cognitive abilities imposes a higher cognitive workload, particularly during complex maneuvers. The use of advanced multi-GNSS RTK technology proved effective in detecting these subtle variations in vehicle control that traditional assessments might miss. The authors suggest that future research should investigate driving behavior in more challenging scenarios and develop targeted intervention programs to improve executive function and driving safety for this population.

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Topics

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• lane positioning
• steering pattern
• post concussion
• speed choice

Information type

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