Article

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 R(2)=.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 R(2)=.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 R(2)=.41). The visuo-integrative
model (unadjusted R(2)=.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 R(2)=.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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS