Authors (including presenting author) :
So, YNL (1), Chow, HWJ (1), Chu, WHC (1), Ma, WLE (1)
Affiliation :
1. Community Rehabilitation Service Support Centre, Hospital Authority
Introduction :
Community Rehabilitation Service Support Centre (CRSSC) received a drastic increase of referrals for comprehensive driver assessment between 2016 to 2022. Among the 772 referrals between April, 2021 to March, 2022, 34% of clients were referred after an episode of stroke. With the growing demands, there is a need for Occupational Therapist Driver Assessor (OTDA) to have a more efficient pathway in determining clients’ fitness to resume driving.
Objectives :
Objective: To investigate the contributing factors in determining fitness to drive for people after Cerebrovascular Accident (CVA) on a driving simulator using Performance Analysis of driving Ability (P-Drive).
Methodology :
Participants were clients who came to CRSSC for driver assessments after an episode of stroke between April 2021 to July 2022. Participants who were regular drivers and did not require vehicle modification were included. Participants who reported motion sickness and/or did not have a full set of cognitive assessments results were excluded. All participants were randomly selected, a total of 47 were identified with 26 participants were recruited and 21 participants were excluded. The average age of recruited was 59 (SD 6.9).
Participants’ demographics were collected through initial assessment and were assessed in HK-MoCA, Trail Making B, Stroke Drivers’ Screening Assessment (SDSA), DriveSafe DriveAware (DSDA), P-Drive and on-road assessment.
P-Drive was evident to be a valid tool for assessing simulation driving.
Result & Outcome :
Chi-Square Goodness-of-Fit Test showed there was statistically significant association between P-Drive simulator score, on-road result, side of brain lesion, SDSA total score, and SDSA score in direction and compass subtests.
From clinical observation, among the 2 participants who failed the simulator driving, the average age was 63. One failed both the on-road assessment and SDSA. From the 4 participants who scored marginally on the simulator driving, the average age was 65.8. One participant failed the on-road assessment and another failed SDSA.
The findings in this pilot study implied there were a few associated factors which may contribute in determining the fitness to drive after CVA. The statistical association concluded in this study showed consistency with previous researches that the side of brain lesion, simulator driving result and on-road result were factors that predicted driving performance. In clinical practice, OTDA could make reference to multiple predictive factors to conclude an accurate clinical judgement on fitness to drive efficiently.
Further study to recruit more samples to find out stronger correlation factors in predicting driving performance is essential.
