title: Improvement of driving skills in persons with relapsing-remitting multiple sclerosis: a pilot study.
abstract: OBJECTIVE
  To determine the potential to improve driving-related skills using a simulator-based program in persons with relapsing-remitting multiple sclerosis (RRMS).
  
  
  METHODS
  Pre-post intervention.
  
  
  METHODS
  A university driving simulator laboratory.
  
  
  METHODS
  Participants (N=50) with RRMS and Expanded Disability Status Scale (EDSS) scores between 1 and 7 were enrolled. Pre- and posttraining data from 36 participants (mean age ± SD, 46±11y; 30 women) who received training and 6 participants (mean age ± SD, 48±13y; 5 women) who did not receive training (control group) were compared.
  
  
  METHODS
  Five hours of driving training in a simulator.
  
  
  METHODS
  Performance on a road test at pre- and posttraining. Secondary outcome measures were performance on visual, physical, and cognitive tests.
  
  
  RESULTS
  Overall, no significant differences were observed between the training and control groups before and after training. However, 4 of the 7 participants in the training group who failed the road test at pretraining passed posttraining, while the only participant in the control group who failed at pretraining still failed at posttraining. The training group also improved on perception of red and colored numbers, the Paced Auditory Serial Addition Test, and the dot cancellation test of the Stroke Driver Screening Assessment battery and reported less fatigue. These improvements were most pronounced among those with an EDSS score between 3 and 7.
  
  
  CONCLUSIONS
  This pilot study demonstrates the potential of using a simulator to improve driving-related visual, cognitive, and on-road skills in individuals with RRMS, particularly those with an EDSS score >3. Future randomized controlled trials with adequate power are needed to expand this field of study.
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA; Department of Neurology, Georgia Regents University, Augusta, GA. Electronic address: aakinwuntan@gru.edu.
authors.forename: Abiodun Emmanuel
authors.initials: AE
authors.lastname: Akinwuntan
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA.
authors.forename: Hannes
authors.initials: H
authors.lastname: Devos
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Baker
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA.
authors.forename: Kendra
authors.initials: K
authors.lastname: Phillips
authors.affiliation: Department of Health Informatics, Georgia Regents University, Augusta, GA.
authors.forename: Vibha
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Neurology, Georgia Regents University, Augusta, GA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Smith
authors.affiliation: Multiple Sclerosis Center of Atlanta, Atlanta GA.
authors.forename: Mitzi Joi
authors.initials: MJ
authors.lastname: Williams
mesh_terms: D000328:Adult; D001333:Automobile Driver Examination; D001334:Automobile Driving; D003071:Cognition; D003198:Computer Simulation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000503:physiopathology*; D010865:Pilot Projects; D014787:Vision Tests
keywords: Automobile driving; Cognition; Multiple sclerosis; Rehabilitation; Vision