The Planning Strategies for Driving on a Map test (COMAP): Initial validation in stroke patients

Abstract

Objective

To validate a novel off-road assessment tool—the Planning Strategies for Driving on a Map (COMAP)—designed to evaluate strategic predriving planning in individuals with stroke.

Design

Cross-sectional observational study following COSMIN and STROBE guidelines.

Setting

Research conducted at a university-affiliated research facility.

Participants

A total of 41 stroke survivors (≥6 months poststroke) and 42 age- and gender-matched healthy controls. Participants with significant language or cognitive impairments (Mini-Mental State Examination < 24) were excluded.

Main measures

Participants completed the COMAP and a battery of cognitive tests including tests of attention, executive functions, working memory, and visuospatial organization.

Results

The COMAP total performance showed good internal consistency (α = .885) and significant correlations with cognitive measures of executive function and memory. A cutoff score of 59 demonstrated strong diagnostic utility (area under the curve = .829; sensitivity = 78%; specificity = 87%) in identifying stroke-related cognitive impairments. Strategy use and planning time were associated with better task performance. The COMAP was more sensitive to within-group variability among stroke participants than between-group differences with healthy controls.

Conclusions

The COMAP is a valid and reliable tool for assessing strategic predriving planning after stroke. It offers clinically relevant insights into executive functioning and compensatory strategies, with potential applications in rehabilitation and driving-related decision-making.

Keywords

Fitness to drive neuropsychological assessment strategic planning occupational therapy

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