title: Use of a driving simulator to improve on-road driving performance and cognition in persons with Parkinson's disease: A pilot study.
abstract: OBJECTIVE
  The use of simulators as an assessment and intervention tool for driving is an emerging field in occupational therapy. We investigated the potential usefulness of a driving simulator to improve on-road skills and cognitive functions in drivers with Parkinson's disease (PD).
  
  
  METHODS
  Fifteen participants with PD, and Hoehn and Yahr stages between 2 and 3 participated in this pre-post comparison study. Twelve of the 15 individuals (median age (Q1-Q3), 68 (63.5-72.5); 10 men) completed 10 hours of training in a high-fidelity driving simulator. A practical road test as well as off-road cognitive and simulator tests were administered at pre-training and post-training.
  
  
  RESULTS
  Nine participants, who passed the road test before training, passed at post-training. Furthermore, all three participants who initially failed the on-road test passed after training. Participants' performance improved significantly from pre- to post-training on two cognitive tests: (i) the Montreal Cognitive Assessment and (ii) Dot Cancellation test.
  
  
  CONCLUSIONS
  This pilot study demonstrates the potential usefulness of a simulator to improve on-road driving and driving-related cognitive skills in PD. Adequately powered randomized controlled trials are needed to further expand this field of study.
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA, USA.|Department of Neurology, Georgia Regents University, Augusta, GA, USA.
authors.forename: Hannes
authors.identifier: http://orcid.org/0000-0002-8853-6840
authors.initials: H
authors.lastname: Devos
authors.affiliation: Department of Neurology, Georgia Regents University, Augusta, GA, USA.|Charlie Norwood Veterans Affairs Medical Center, Augusta, GA, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Morgan
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA, USA.
authors.forename: Arinze
authors.initials: A
authors.lastname: Onyeamaechi
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA, USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Bogle
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Holton
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA, USA.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Kruse
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA, USA.
authors.forename: Sierra
authors.initials: S
authors.lastname: Sasser
authors.affiliation: Department of Physical Therapy, Georgia Regents University, Augusta, GA, USA.|Department of Neurology, Georgia Regents University, Augusta, GA, USA.
authors.forename: Abiodun E
authors.initials: AE
authors.lastname: Akinwuntan
mesh_terms: D000368:Aged; D001334:Automobile Driving; D003071:Cognition; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010300:Parkinson Disease / Q000534:rehabilitation*; D010865:Pilot Projects; D011597:Psychomotor Performance
keywords: Parkinson's disease; cognition; driving; rehabilitation