Determinants of On-Road Driving in Multiple Sclerosis

Hannes Devos, Maud Ranchet, Deborah Backus, Matt Abisamra, John Anschutz, C. Dan Allison, Sunil Mathur, Abiodun E. Akinwuntan

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8 Scopus citations

Abstract

Objective To investigate the cognitive, visual, and motor deficits underlying poor performance on different dimensions of on-road driving in individuals with multiple sclerosis (MS). Design Prospective cross-sectional study. Setting MS clinic and driving simulator lab. Participants Active drivers (N=102) with various types of MS. Interventions Not applicable. Main Outcome Measures Off-road cognitive, visual, and motor functions, as well as 13 specific driving skills. These skills were categorized into hierarchic clusters of operational, tactical, visuo-integrative, and mixed driving. Stepwise regression analysis was used to determine the off-road functions influencing performance on the on-road test and each cluster. Results Visuospatial function (P=.002), inhibition (P=.008), binocular acuity (P=.04), vertical visual field (P=.02), and stereopsis (P=.03) best determined variance in total on-road score (unadjusted R2=.37). Attentional shift (P=.0004), stereopsis (P=.007), glare recovery (P=.047), and use of assistive devices (P=.03) best predicted the operational cluster (unadjusted R2=.28). Visuospatial function (P=.002), inhibition (P=.002), reasoning (P=.003), binocular acuity (P=.04), and stereopsis (P=.005) best determined the tactical cluster (unadjusted R2=.41). The visuo-integrative model (unadjusted R2=.12) comprised binocular acuity (P=.007) and stereopsis (P=.045). Inhibition (P=.0001) and binocular acuity (P=.001) provided the best model of the mixed cluster (unadjusted R2=.25). Conclusions Our results provide more insights into the specific impairments that influence different dimensions of on-road driving and may be used as a framework for targeted driving intervention programs in MS.

Original languageEnglish (US)
Pages (from-to)1332-1338.e2
JournalArchives of Physical Medicine and Rehabilitation
Volume98
Issue number7
DOIs
StatePublished - Jul 2017

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Keywords

  • Automobile driving
  • Multiple sclerosis
  • Neuropsychology
  • Rehabilitation
  • Vision, ocular

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Devos, H., Ranchet, M., Backus, D., Abisamra, M., Anschutz, J., Allison, C. D., Mathur, S., & Akinwuntan, A. E. (2017). Determinants of On-Road Driving in Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation, 98(7), 1332-1338.e2. https://doi.org/10.1016/j.apmr.2016.10.008