title: Driving simulator sickness: an evidence-based review of the literature.
abstract: OBJECTIVE
  Guided by the Occupational Therapy Practice Framework: Domain and Process (2nd edition; American Occupational Therapy Association, 2008), we conducted an evidence-based review on simulator sickness (SS).
  
  
  METHODS
  We searched Web of Science, PubMed, SafetyLit, Google Scholar, and recently published literature. We used the American Academy of Neurology's classification criteria to extract data from 10 studies and assign each a level of 1-4, with "1" indicating the highest level of evidence. We grouped studies that addressed SS into client factors, context and environment factors, and activity demands.
  
  
  RESULTS
  Client factors (i.e., older clients [>70 yr; Level B], women [Level B]) and context/environment factors (e.g., refresh rates, scenario design and duration, simulator configuration, and calibration; Level B) probably increase the rates of SS, whereas activity demands (vection, speed of driving, and postural instability; Level C) possibly contribute to SS.
  
  
  CONCLUSIONS
  We classified factors contributing to SS and identified the need for randomized trials to identify causes of SS.
authors.affiliation: Department of Occupational Therapy, Institute for Mobility, Activity, and Participation, University of Florida, P.O. Box 100164, Gainesville, FL 32610-0164, USA. sclassen@phhp.ufl.edu
authors.forename: Sherrilene
authors.initials: S
authors.lastname: Classen
authors.forename: Megan
authors.initials: M
authors.lastname: Bewernitz
authors.forename: Orit
authors.initials: O
authors.lastname: Shechtman
mesh_terms: D001334:Automobile Driving; D003198:Computer Simulation; D019317:Evidence-Based Medicine; D009788:Occupational Therapy; D011597:Psychomotor Performance; D016032:Randomized Controlled Trials as Topic