Je. Korteling et Na. Kaptein, NEUROPSYCHOLOGICAL DRIVING FITNESS TESTS FOR BRAIN-DAMAGED SUBJECTS, Archives of physical medicine and rehabilitation, 77(2), 1996, pp. 138-146
Objective: The study was carried out to evaluate and develop simple to
ols to assess the driving fitness of brain-damaged patients. Design: F
our neuropsychological tests (predictors) were validated against an op
en-road driving test (criterion standard), which is used by the Depart
ment of Adaptations of the Dutch Driving Licensing Agency for assessin
g disabled drivers. Setting: The predictor tests were conducted in the
involved scientific institute; the criterion standard involved partic
ipation in normal traffic. Patients: The subject group consisted of 33
men and 5 women who had recovered to a stabilized level from traumati
c brain injuries. All had valid driving licenses when they were injure
d and they were considered to be potentially able to recommence drivin
g. The subjects had a mean reported driving experience of 109.200km (S
D = 86.300km). All subjects were recovered from a brain trauma with an
average coma duration of 33 days (SD = 51 days). They were tested at
least 1 year after the accident. All subjects had normal or corrected-
to-normal vision and none used medications that, according to existing
medical criteria, interfere with normal psychomotor or cognitive func
tioning. Ages at the time of the injury were between 17 and 55 years (
mean, 29.8; SD, 10.9). Main Outcome Measures: Pearson product moment c
orrelations (and explained variances) were calculated between the four
predictor tests (a Perceptual Speed test, the WAIS Symbol-Digit Subst
itution subtest, a Tracking-Reaction dual task, and a Time Estimation
task) and the open-road criterion standard. Results: The results indic
ated that performance on both the Perceptual Speed task and the Time E
stimation task were significantly correlated with driving performance
(p < .05). When combined with coma duration and driving experience, th
e Perceptual Speed and Tracking-Reaction tests together explained 35.3
% (r = .59) of the variance in on-road driving performance. Conclusion
: The amount of variance in open-road driving performance that could b
e accounted for by these tests was insufficient to completely replace
an open-road driving fitness assessment. Also, based on other experime
ntal documentation, it is concluded that more integral, domain-specifi
c tests leg, based on driving simulation) need to be developed. (C) 19
96 by the American Congress of Rehabilitation Medicine and the America
n Academy of Physical Medicine and Rehabilitation.