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Clinical Determinants of Fitness to Drive in Persons With Multiple Sclerosis: Systematic Review

Published:January 25, 2019DOI:https://doi.org/10.1016/j.apmr.2018.12.029

      Abstract

      Objective

      To critically appraise the evidence for the clinical determinants of fitness to drive in adults with multiple sclerosis (MS).

      Data Sources

      The research librarian and lead author searched 7 databases for driving simulator and on-road studies for adults with MS published in the English language from 1991 to 2018.

      Study Selection

      Three reviewers independently screened titles, abstracts, and full-texts for studies with: cohort, case-control, or cross-sectional designs; participants, 18 years or older, with relapsing or progressive MS; visual, cognitive, or motor clinical assessments as predictors; and driving performance through simulator or fitness to drive through on-road assessment as outcomes.

      Data Extraction

      Using the 2017 American Academy of Neurology guidelines, reviewers independently classified each study from class I to class IV, or highest to lowest amount of rigor. For each clinical assessment, reviewers independently rated the level of confidence for predicting driving performance or fitness to drive from level A, highly probable; B, probable; C, possible; to level U, insufficient conclusions.

      Data Synthesis

      Through qualitative synthesis, 2 class III and 4 class IV driving simulator studies employed 24 clinical assessments with level C (n=4) or level U (n=20) confidence for predicting driving performance. Six class II and 3 class IV on-road studies employed 35 clinical assessments with level B (n=9), level C (n=22), or level U (n=4) confidence for predicting fitness to drive.

      Conclusions

      This systematic review identified mostly insufficient conclusions for predicting driving performance in driving simulator studies, and possible conclusions for predicting fitness to drive in on-road studies. The best available evidence suggests that the Stroke Driver Screening Assessment and Useful Field of View test probably predict fitness to drive in adults with MS (level B). Class I studies that compare predictors of fitness to drive with large prospective samples of adults with and without MS are necessary for highly probable conclusions.

      Keywords

      List of abbreviations:

      AAN (American Academy of Neurology), EDSS (Expanded Disability Status Scale), MS (multiple sclerosis), 9HPT (Nine-Hole Peg Test), PASAT (Paced Auditory Serial Addition Test), SDSA (Stroke Driver Screening Assessment), SPIDER (Systematic Process for Investigating and Describing Evidence-Based Research tool), T25W (Timed 25-Foot Walk Test), UFOV (Useful Field of View test)
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      References

        • Compston A.
        • Coles A.
        Multiple sclerosis.
        Lancet. 2008; 372: 1502-1517
        • Brouwer W.H.
        • Ponds R.W.
        Driving competence in older persons.
        Disabil Rehabil. 1994; 16: 149-161
        • Transportation Research Board
        Taxonomy and terms for stakeholders in senior mobility.
        (Available at:)
        • Di Stefano M.
        • MacDonald W.
        On-the-road evaluation of driving performance.
        in: Pellerito J.M. Driver rehabilitation and community principles and practice. Elsevier Mosby, St. Louis2005: 255-274
        • Lincoln N.
        • Radford K.
        Cognitive abilities as predictors of safety to drive in people with multiple sclerosis.
        Mult Scler. 2008; 14: 123-128
        • Akinwuntan A.E.
        • O’Connor C.
        • McGonegal E.
        • et al.
        Prediction of driving ability in people with relapsing-remitting multiple sclerosis using the stroke driver screening assessment.
        Int J MS Care. 2012; 14: 65-70
        • Akinwuntan A.E.
        • Devos H.
        • Stepleman L.
        • et al.
        Predictors of driving in individuals with relapsing-remitting multiple sclerosis.
        Mult Scler. 2012; 19: 344-350
        • Classen S.
        • Krasniuk S.
        • Morrow S.A.
        • et al.
        Visual correlates of fitness to drive in adults with multiple sclerosis.
        OTJR (Thorofare N J). 2018; 38: 15-27
        • Krasniuk S.
        • Classen S.
        • Morrow S.A.
        • et al.
        Driving errors that predict on-road outcomes in adults with multiple sclerosis.
        OTJR (Thorofare N J). 2017; 37: 115-124
        • Morrow S.A.
        • Classen S.
        • Monahan M.
        • et al.
        On-road assessment of fitness-to-drive in persons with MS with cognitive impairment: a prospective study.
        Mult Scler. 2018; 24: 1499-1506
        • Schultheis M.T.
        • Weisser V.
        • Ang J.
        • et al.
        Examining the relationship between cognition and driving performance in multiple sclerosis.
        Arch Phys Med Rehabil. 2010; 91: 465-473
        • Schultheis M.T.
        • Weisser V.
        • Manning K.
        • Blasco A.
        • Ang J.
        Driving behaviors among community-dwelling persons with multiple sclerosis.
        Arch Phys Med Rehabil. 2009; 90: 975-981
        • Devos H.
        • Ranchet M.
        • Backus D.
        • et al.
        Determinants of on-road driving in multiple sclerosis.
        Arch Phys Med Rehabil. 2017; 98: 1332-1338
        • Fragoso Y.D.
        • Rocha F.B.
        • Beloni T.M.
        • et al.
        Driving ability in patients with multiple sclerosis: can legislation be provided on the matter?.
        Crit Rev Phys Rehabil Med. 2016; 28: 215-224
        • Gronseth G.S.
        • Cox J.
        • Gloss D.
        • et al.
        2017 Edition clinical practice guideline process manual.
        American Academy of Neurology, Minneapolis2017
        • Kay L.G.
        • Bundy A.C.
        • Clemson L.
        • Cheal B.
        • Glendenning T.
        Contribution of off-road tests to predicting on-road performance: a critical review of tests.
        Aust Occup Ther J. 2012; 59: 89-97
        • Shinar D.
        Traffic safety and human behavior.
        2nd ed. Emerald Publishing Limited, Bingley,United Kingdom2017: 25-33
        • Campos J.L.
        • Bédard M.
        • Classen S.
        • et al.
        Guiding framework for driver assessment using driving simulators.
        Front Psychol. 2017; 8: 1428
        • Classen S.
        • Akinwuntan A.
        Validity and reliability in driving simulation.
        in: Classen S. Driving simulation for assessment, intervention, and training: a guide for occupational therapy and health care professionals. American Occupational Therapy Association Inc, Bethesda, MD2017: 95-104
        • Archer C.
        • Morris L.
        • George S.
        Assessment and rehabilitation of driver skills: subjective experiences of people with MS and health professionals.
        Disabil Rehabil. 2014; 36: 1875-1882
        • Portney L.G.
        • Watkins M.P.
        Foundations of clinical research: applications to practice.
        3rd ed. Pearson Education, Upper Saddle River, NJ2009
        • Kalmar J.H.
        • DeLuca J.
        Driving and other neurological and psychiatric disorders.
        in: Schultheis M.T. DeLuca J. Chute D.L. Handbook for the assessment of driving capacity. Elsevier, San Diego2009: 131-154
        • Lublin F.D.
        • Reingold S.C.
        • Cohen J.A.
        • et al.
        Defining the clinical course of multiple sclerosis: the 2013 revisions.
        Neurology. 2014; 83: 278-286
        • Classen S.
        • Winter S.
        • Awadzi K.D.
        • Garvan C.W.
        • Lopez E.D.
        • Sundaram S.
        Psychometric testing of SPIDER: data capture tool for systematic literature reviews.
        Am J Occup Ther. 2008; 62: 335-348
        • Eden J.
        • Levis L.
        • Berg A.
        • et al.
        Finding what works in health care: standards for systematic reviews.
        (Available at:)
        https://www.nap.edu/read/13059/chapter/1
        Date accessed: February 25, 2019
        • Weaver B.
        • Bédard M.
        Assessing fitness-to-drive: practical tips on choosing the right screening tools for your practice.
        Can Geriatr Soc J CME. 2012; 2: 5-9
        • Kotterba S.
        • Orth M.
        • Eren E.
        • Fangerau T.
        • Sindern E.
        Assessment of driving performance in patients with relapsing-remitting multiple sclerosis by a driving simulator.
        Eur Neurol. 2003; 50: 160-164
        • Devos H.
        • Brijs T.
        • Alders G.
        • Wets G.
        • Feys P.
        Driving performance in persons with mild to moderate symptoms of multiple sclerosis.
        Disabil Rehabil. 2013; 35: 1387-1393
        • Badenes D.
        • Garolera M.
        • Casas L.
        • et al.
        Driving competences and neuropsychological factors associated to driving counseling in multiple sclerosis.
        J Int Neuropsychol Soc. 2014; 20: 555-565
        • Schultheis M.T.
        • Garay E.
        • Deluca J.
        The influence of cognitive impairment on driving performance in multiple sclerosis.
        Neurology. 2001; 56: 1089-1094
        • Shawaryn M.A.
        • Schultheis M.T.
        • Garay E.
        • Deluca J.
        Assessing functional status: exploring the relationship between the Multiple Sclerosis Functional Composite and driving.
        Arch Phys Med Rehabil. 2002; 83: 1123-1129
        • Marcotte T.D.
        • Rosenthal T.J.
        • Roberts E.
        • et al.
        The contribution of cognition and spasticity to driving performance in multiple sclerosis.
        Arch Phys Med Rehabil. 2008; 89: 1753-1759
        • Michon J.A.
        A critical view of driver behavior models: what do we know, what should we do?.
        in: Evans L. Schwing R. Human behavior and traffic safety. Springer, Boston1985: 485-520
        • De Raedt R.
        • Ponjaert-Kristoffersen I.
        Can strategic and tactical compensation reduce crash risk in older drivers?.
        Age Ageing. 2000; 29: 517-521
        • Canadian Council of Motor Transport Administrators
        Determining Driver Fitness in Canada.
        (Available at:)
        • National Highway Traffic Safety Administration and American Association of Motor Vehicle Administrators
        Driver fitness medical guidelines.
        National Highway Traffic Safety Administration, Washington (DC)2009
        • Driver and Vehicle Licensing Agency
        Assessing fitness to drive—a guide for medical professionals.
        (Available at:)
        • Austroads
        Assessing fitness to drive for commercial and private vehicle drivers.
        (Available at:)
        • Lundberg C.
        • Caneman G.
        • Samuelsson S.M.
        • Hakamies-Blomgvist L.
        • Almkvist O.
        The assessment of fitness to drive after a stroke: the Nordic Stroke Driver Screening Assessment.
        Scand J Psychol. 2003; 44: 23-30
        • Akinwuntan A.E.
        • Gantt D.
        • Gibson G.
        • et al.
        United States version of the Stroke Driver Screening Assessment: a pilot study.
        Top Stroke Rehabil. 2013; 20: 87-92
        • Lincoln N.B.
        • Radford K.A.
        • Nouri F.M.
        Stroke Drivers’ Screening Assessment European version 2012.
        (Available at:)
        • Visual Awareness Research Group
        UFOV user’s guide. 2009.
        (Available at:)
        • Wood J.M.
        • Owsley C.
        Useful Field of View Test.
        Gerontology. 2014; 60: 315-318
        • Ball K.
        • Owsley C.
        The Useful Field of View Test: a new technique for evaluating age-related declines in visual function.
        J Am Optom Assoc. 1993; 64: 71-79
        • Bobholz J.A.
        • Rao S.M.
        Cognitive dysfunction in multiple sclerosis: a review of recent developments.
        Curr Opin Neurol. 2003; 16: 283-288
        • Benedict R.H.B.
        • Cookfair D.
        • Gavett R.
        • et al.
        Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS).
        J Int Neuropsychol Soc. 2006; 12: 549-558
        • Dehning M.
        • Kim J.
        • Nguyen C.M.
        • Shivapour E.
        • Denburg N.L.
        Neuropsychological performance, brain imaging, and driving violations in multiple sclerosis.
        Arch Phys Med Rehabil. 2014; 95: 1818-1823
        • Krasniuk S.
        • Classen S.
        • Tippett M.
        • Knott M.
        • Morrow S.A.
        • Akinwuntan A.
        Clinical determinants of fitness to drive in persons with multiple sclerosis: systematic review.
        (Available at:)
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        • PRISMA Group
        Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement.
        J Clin Epidemiol. 2009; 62: 1006-1012
        • Crizzle A.M.
        • Classen S.
        • Uc E.Y.
        Parkinson disease and driving: an evidence-based review.
        Neurology. 2012; 13: 2067-2074
        • Devos H.
        • Akinwuntan A.E.
        • Nieuwboer A.
        • Truijen S.
        • Tant M.
        • De Weerdt W.
        Screening for fitness to drive after stroke: a systematic review.
        Neurology. 2011; 76: 747-756