Training Of Driving In Individuals With Relapsing-Remitting Multiple Sclerosis

Background: Impairments of driving-related physical, visual, and cognitive skills are common sequelae of Multiple Sclerosis (MS). Many studies have been reported on the evaluation of the ability to drive in individuals with MS. We found a few studies in which cognitive skills were retrained in individuals with MS to improve performance on other activities of daily living, but none on retraining of impaired skills necessary to improve their driving performance.

Objectives: In this study, we investigated the effect of a simulator-based training program on the driving performance of individuals with MS. We hypothesized that there will be significant improvements in some off-road tests and on a standardized on road test after five hours of training.

Methods: Thirty-six participants with relapsing-remitting MS (age = 46±11 years, 30 females) and Expanded Disability Status Scale values between 1 and 7 each received five hours of training in a high-fidelity simulator. Performance on selected physical, visual, and cognitive tests, and on a standardized road test was evaluated immediately before and after training. Post-training performance was compared to pre-training data. 

Results: Participants improved on red and green color perception, on the Paced Auditory Serial Addition Test, reported less fatigue, and spent less time on the dot cancellation test of the Stroke Driver Screening Assessment battery after training. Participants, most of whom passed the on-road test pre-training, did not show significant improvement on the test post-training. Further analysis revealed better improvements on the road test in more severely impaired participants.

Conclusions: To our knowledge, this is the first study to show that a simulator-based program is potentially useful to retrain individuals with MS on some off-road visual and cognitive tests. However, future studies are needed to confirm our findings.