Sherrilene Classen, Babette Brumback, Miriam Monahan, Irene I. Malaty, Ramon L. Rodriguez, Michael S. Okun, Nikolaus R. McFarland; Driving Errors in Parkinson’s Disease: Moving Closer to Predicting On-Road Outcomes. Am J Occup Ther 2014;68(1):77-85. doi: 10.5014/ajot.2014.008698.
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© 2019 American Occupational Therapy Association
Age-related medical conditions such as Parkinson’s disease (PD) compromise driver fitness. Results from studies are unclear on the specific driving errors that underlie passing or failing an on-road assessment. In this study, we determined the between-group differences and quantified the on-road driving errors that predicted pass or fail on-road outcomes in 101 drivers with PD (mean age = 69.38 ± 7.43) and 138 healthy control (HC) drivers (mean age = 71.76 ± 5.08). Participants with PD had minor differences in demographics and driving habits and history but made more and different driving errors than HC participants. Drivers with PD failed the on-road test to a greater extent than HC drivers (41% vs. 9%), χ2(1) = 35.54, HC N = 138, PD N = 99, p < .001. The driving errors predicting on-road pass or fail outcomes (95% confidence interval, Nagelkerke R2 =.771) were made in visual scanning, signaling, vehicle positioning, speeding (mainly underspeeding, t(61) = 7.004, p < .001, and total errors. Although it is difficult to predict on-road outcomes, this study provides a foundation for doing so.
Vehicle positioning (i.e., posterior or anterior position of the vehicle in relation to other vehicles, objects, or pavement markings)
Speed regulation (i.e., maintaining speed limit as well as controlled acceleration and braking); includes underspeeding (>10 mph under the posted speed limit), overspeeding (>10 mph over the posted speed limit), and other types of speeding errors (e.g., making a rolling stop instead of a complete stop).
Lane maintenance (i.e., lateral positioning of the vehicle in the lane during driving or while stopped); can include encroachment errors (steering toward the left oncoming traffic), wide errors (steering toward the shoulder of the road), and other lane errors (touching or crossing roadway lines while making turns to the right or left side).
Yielding (i.e., giving right of way to other vehicles as appropriate)
Signaling (i.e., proper use and timing of turn signals)
Visual scanning (i.e., checking blind spots and intersections)
Adjustment to stimuli (i.e., responding to driving situations such as road sign information, vehicle movements, pedestrian movements, or potential hazards)
Gap acceptance (i.e., demonstrating safe timing and spacing distance when crossing in front of oncoming traffic).
Drivers with Parkinson's disease are more likely than healthy drivers to have impaired fitness to drive.
The driving errors predicting on-road pass–fail outcomes in PD are visual scanning, signaling, vehicle positioning, speed regulation (mainly underspeeding), and total errors.
By understanding the types of driving errors made by drivers with PD and the client and contextual factors underlying those errors, occupational therapy practitioners have the opportunity to provide tailored intervention strategies.
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