Predictors of Track Test Performance in Drivers with Stroke.
OBJECTIVE
To identify in-house assessment criteria to predict outcomes of driving tests in patients with stroke who wish to resume driving.


METHODS
A total of 181 patients with stroke who attended Fukui General Hospital (as outpatients or inpatients) between 2003 and 2015 and who had no obvious motor impairment were included in the study. All subjects underwent a neuropsychological examination, a driving simulator test, and a track test at a driving school. Based on their performance in the track test, the subjects were divided into capable drivers (CD group) and incapable drivers (ID group). Intergroup differences in test results were evaluated. Logistic regression analysis was performed using age and outcomes of Trail-Making Tests A and B, and Symbol Digit Modalities Test (SDMT) as independent variables and track test performance as the dependent variable.


RESULTS
The ID group performed worse than the CD group in most aspects of the neuropsychological examination. There was no significant difference between the two groups with respect to any component of the driving simulator test. SDMT values were extracted from the logistic regression analysis, with an Odds Ratio of 1.05 (p=0.028). On receiver operating characteristic curve analysis (with the area under the curve of 0.76), at the SDMT achievement rate < 37.3%, there was a sensitivity of 65% and specificity of 79% for the identification of driving inability.


CONCLUSIONS
Neuropsychological tests are useful for evaluating the ability of patients with stroke to resume driving. In particular, SDMT is the most suitable test for predicting driving test outcomes.
Fukui General Hospital, Department of Rehabilitation Medicine, Fukui, Japan.
Yasutaka
Y
Kobayashi
Yutaro
Y
Omokute
Akiyo
A
Mitsuyama
Yuka
Y
Takaoka
Chiaki
C
Takama
Yoko
Y
Watanabe
D001334:Automobile Driving / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D020521:Stroke / Q000523:psychology*