To restore the ability to drive is one aim of the rehabilitation of patients with neurological disabilities. In some instances, an evaluation is required to judge a patient's fitness to drive in today's traffic. Forty-three patients of the neurorehabilitation unit of the Valens Clinic were assessed by a standard traffic psychological test protocol and a control drive. In 88%, there was agreement between the judgments based on each procedure. Four patients had failed either the psychological tests or the control drive but not both. Six patients had failed the psychological test and the control drive. Two drove nevertheless, and three patients stopped driving. Nineteen of 32 patients cleared to drive were followed up. Eleven drove without accidents or traffic fines. The traffic psychological tests and control drive yield complementary information on the fitness to drive. However, the assessments need to be improved. New generations of interactive driving simulators may refine the fitness to drive evaluation and become useful tools in driving rehabilitation.
References
1.
1. Galski T, Bruno RL, Ehle HT. Driving after cerebral damage: a model with implications for evaluation . Am J Occup Ther1992;46(4): 324-332 .
2.
2. Hauri-Bionda R, Friederich-Koch A. Verkehrsmedizinische Fragestellung in Spital- und Praxisalltag: Fahrfähig? Therapeutische Umschau1997;54(5): 255-262 .
3.
3. Seeger R. Probleme bei der Beurteilung der Fahreignung in der hausärztlichen Praxis . Therapeutische Umschau1997;54(5): 242-254 .
4.
4. Hawie R. Hamburg-Wechsler-Intelligenztest für Erwachene. Rev. ed. Bern, Switzerland: Verlag Hans Huber ; 1991.
5.
5. Prosiegel M, Böttger S, Schenk T, et al. Der Erweiterte Barthel-Index (EBI)—eine neue Skala zur Erfassung von Fähigkeitsstörungen bei neurologischen Patienten . Neurol Rehabil1996;1: 7-13 .
6.
6. Galski T, Ehle HAT, Mc Donald MA, et al. Evaluating fitness to drive after cerebral injury: basic issues and recommendations for medical and legal communities . J Head Trauma Rehabil2000;15(3): 895-908 .
7.
7. Galski T, Ehle HT, Bruno RL. An assessment of measures to predict the outcome of driving evaluations in patients with cerebral damage . Am J Occup Ther1990;44: 709-713 .
8.
8. van Zomeren AH, Brouwer WH, Rothengatter JA, et al. Fitness to drive a car after recovery from severe head injury . Arch Phys Med Rehabil1988;69: 90-96 .
9.
9. Croft D, Jones RD. The value of off-road tests in the assessment of driving potential of unlicensed disable people . Br J Occup Ther1987;50: 357-361 .
11. Brouwer WH, Withaar FK, Tant ML, van Zomeren AH. Attention and driving in traumatic brain injury: a question of coping with time-pressure . J Head Trauma Rehabil2002;17(1): 1-15 .
12.
12. Katz RT, Golden RS, Butter J, et al. Driving safety after brain damage: follow-up of twenty-two patients with matched controls . Arch Phys Med Rehabil1990;71: 133-137 .
13.
13. Priddy DA, Johnson P, Lam CS. Driving after a severe head Injury . Brain Injury1990;4(3): 267-272 .
14.
14. Haselkorn JK, Mueller BA, Rivera FH. Characteristics of drivers and driving record after traumatic and nontraumatic brain injury . Arch Phys Med Rehabil1998;79: 738-742 .
15.
15. Kakaiy R, Tisovec R, Fulkerson P. Evaluation of fitness to drive: the physician's role in assessing elderly or demented patients . Postgraduate Medicine2000;107(3): 229-236 .
16.
16. Zazzo R. Le test des deux barrages. Manuel pour l'examen psychologique de l'enfant. Neuchâtel, Switzerland: Delachaux & Nestlé ;; 1959.
17.
17. Rey A. Test de copie et de reproduction de mémoire de figures géometriques complex. Paris: Centre de psychologie appliquée ; 1959.
18.
18. Regard M, Strauss E, Knapp P. Children's production on verbal and nonverbal fluency tasks . Perc Mot Skills1982;55: 839-844 .
19.
19. Gerhard U, Annen B, Betschart R, Hobi V. Erneuerung, Normierung und Validierung der Schweizerischen Verkehrspsychologischen Normaluntersuchung SVN'96. Bundesamt für Unfallverhütung BfU. Switzerland: Impressum Schoch, Ostermundigen ; 1998.
20.
20. Berg M. Benutzerhandbuch zum Determinationsgerät. Version 2.2. Wiener Determinationsgerät. Dr. G. Schuhfried Ges. Mbh. 14 January 1992.
21.
21. Sacco RL. Ischemic stroke. In: Gerlic PB, Alter M, editors. Handbook of neuroepidemiology. New York: Marcel Dekker ; 1974. p. 77-121.
22.
22. Brouwer WH, Zomeren AH, van Wolffelaar PC. Traffic behaviour after severe traumatic brain injury. In: Deelman BG, Saan RJ, van Zomeren AH, editors. Traumatic brain injury: clinical social and rehabilitation aspects. Amsterdam, the Netherlands: Swets & Zeitlinger ; 1990. p. 89-100.
23.
23. van Zomeren AH, Brouwer WH, Rothengatter JA, Snoek JW. Fitness to drive a car after recovery from severe head injury . Arch Phys Med Rehabil1988;69: 90-96 .
24.
24. Hannen P, Hartje W, Skreczek W. Evaluating driving ability after brain damage: neuropsychological diagnosis and driving test . Nervenarzt1998;69(10): 864-872 .
25.
25. Fox GK, Bowden SC, Smithz DS. On-road assessment of driving competence after brain impairment: review of current practice and recommendations for a standardized examination . Arch Phys Med Rehabil1998;79: 1288-1296 .
26.
26. Hartje W, Pach R, Willmes K, Hannen P, Weber E. Fahreignung hinrgeschädigter Patienten . Zeitschrift für Neuropsychologie1991;2(2): 100-114 .
27.
27. Johnson HM. Detection and treatment of accident prone drivers . Psychol Bull1946;43: 489-532 .
28.
28. Wallace JE, Crancer A. Licensing exams and their relation to subsequent driving record . Behav Res Highway Safety1971;2: 53-65 .
29.
29. Sundet K, Goffeng L, Hofft E. To drive or not to drive: neuropsychological assessment for driver's licence among stroke patients . Scand J Psychol1995;36(1): 47-58 .
30.
30. Netz J. Evaluationsstudie Fahrsimulator . Neuro-Reha 2000, ZNS-Symposium `Neurologie und Verkehrssicherheit.'; (Abstract)
