User-friendliness of a Portable Driving Simulator to Retrain Impaired Driving Skills in Individuals with Parkinson’s Disease and Multiple Sclerosis – a Pilot Study

Research Objectives: (1) To determine the ease of use of the portable driving simulator (PDS.)
(2) To compare the benefits of retraining impaired driving skills of persons with MS and PD using the PDS and a high-fidelity simulator (HFS).
(3) To compare the prevalence of simulation sickness between PDS and HFS.

Design: Stratified randomized experimental design

Setting: Academic institution

Participants: Seventeen participants with MS or PD (PDS-8, HFS-9), age 56.3±17.3 years; 52.9% were women.

Interventions: Participants with MS and PD were stratified and randomly allocated into either the PDS or HFS training. The pre-training evaluation included driving-related physical, visual, and cognitive tests and a familiarization drive. Participants’ baseline driving performance was established on a standard 20.5 km simulated drive. Each participant received five hours of the assigned training in three sessions completed within 2 weeks that addressed specific driving skills such as lane positioning and divided attention The fifth session established the post-training driving performance.

Main Outcome Measures: 1. Ease of use of PDS on a self-reported user-friendliness questionnaire.
2. Driving parameters like collisions, traffic violation tickets, lane positioning, and brake reaction time.
3. Rate of occurrence of simulator sickness on self-reported Simulator Sickness Questionnaire (SSQ).

Results: At baseline, there was no difference in the user-friendliness between PDS and HFS groups, Mann Whitney U test; z= [-0.869], p = [0.42]. There was a difference in the user-friendliness at post-intervention, favoring the PDS; z= [-1.977], p = [0.046]. Within-group training effect on the Wilcoxon-signed rank test showed a significant reduction in traffic tickets; z= [-2.194], p= [0.02], and time out of lane; z= [-2.666], p= [0.01] in the HFS group. The PDS group showed a reduction in total run time; z= [-1.96], p= [0.05]. No differences were reported between PDS and HFS except for the number of speeding tickets, and average speed excursion favoring the HFS. Fisher’s exact test did not indicate significant association between SSQ and type of training at baseline; 0.373, p = [.263]) and post-intervention;1.134, p= [1.00] although both groups showed a reduction.

Conclusions: The low-fidelity PDS was similar to the high-fidelity simulator in user-friendliness and simulator sickness parameters. No difference was noted in most driving parameters between PDS and HFS. This pilot study warrants an adequately powered randomized controlled trial to determine the effectiveness of PDS.

Author(s) Disclosures: Drs. Hannes Devos and Abiodun Akinwuntan report a financial conflict of interest. They stand to profit from the sales of the PDS. They were not involved in the assessment, training, or analysis.