@article{ref1,
title="The relationship between MS symptom severity measures and performance on driving variability metrics in a virtual reality simulator",
journal="American journal of physical medicine and rehabilitation",
year="2019",
author="Raphail, Ann-Marie A. and Vickers, Kayci L. and Leist, Thomas P. and Schultheis, Maria T.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: Driving ability can be compromised in individuals with multiple sclerosis (MS); however, the progressive nature of MS makes it difficult for clinicians to assess when performance on functional tasks, such as driving, has started to decline. The objective of this study was to evaluate the relationship between two measures of MS severity, the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC), and minor driving errors in a virtual reality driving simulator (VRDS). <br><br>DESIGN: Symptom severity was measured in thirty-one active drivers with MS using the EDSS and MSFC. Driving performance was measured using a standardized VRDS route. Executive functioning, a cognitive function commonly related to driving, was evaluated using the Trail Making Test-B. <br><br>RESULTS: Greater impairment on the MSFC was related to increased difficulty maintaining lane positioning (r=-.49, p=.01) and poorer executive functioning (r=-.52, p<.01). In contrast, the EDSS was not related to either measure. <br><br>CONCLUSION: These findings suggest that poorer performance on the MSFC, and not the EDSS, may indicate vulnerability to minor driving errors as an early sign of driving compromise. The use of screening tools like the MSFC could help clinicians identify increased driving risk and consider comprehensive driving evaluations earlier, before a major driving violation or accident occurs.<p /> <p>Language: en</p>",
language="en",
issn="0894-9115",
doi="10.1097/PHM.0000000000001351",
url="http://dx.doi.org/10.1097/PHM.0000000000001351"
}