@article{ref1,
title="Determinants of on-road driving in multiple sclerosis",
journal="Archives of physical medicine and rehabilitation",
year="2016",
author="Devos, Hannes and Ranchet, Maud and Backus, Deborah and Abisamra, Matt and Anschutz, John and Allison, C. Dan and Mathur, Sunil and Akinwuntan, Abiodun E.",
volume="98",
number="7",
pages="1332-1338.e2",
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). <br><br>DESIGN: Prospective cross-sectional study SETTING: MS Clinic and Driving Simulator Lab PARTICIPANTS: A total of 102 active drivers with various types of MS. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: 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 employed to determine the off-road functions influencing performance on the on-road test and each cluster. <br><br>RESULTS: Visuospatial function (p=0.002), inhibition (p=0.008), binocular acuity (p=0.04), vertical visual field (p=0.02), and stereopsis (p=0.03) best determined variance in total on-road score (unadjusted R(2)=0.37). Attentional shift (p=0.0004), stereopsis (p=0.007), glare recovery (p=0.047), and use of assistive devices (p=0.03) best predicted the operational cluster (unadjusted R(2)=0.28). Visuospatial function (p=0.002), inhibition (p=0.002), reasoning (p=0.003), binocular acuity (p=0.04), and stereopsis (p=0.005) best determined the tactical cluster (unadjusted R(2)=0.41). The visuo-integrative model (unadjusted R(2)=0.12) comprised binocular acuity (p=0.007) and stereopsis (p=0.045). Inhibition (p=0.0001) and binocular acuity (p=0.001) provided the best model of the mixed cluster (unadjusted R(2)=0.25). <br><br>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.<br><br>Copyright © 2016. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2016.10.008",
url="http://dx.doi.org/10.1016/j.apmr.2016.10.008"
}