Investigating on-road lane maintenance and speed regulation in post-stroke driving: a pilot case-control study

Abstract

The post-stroke population is expected to rise and the cohort of post-stroke individuals who wish to return to driving is likely to rapidly increase too. Stroke can adversely affect coordination and judgement of drivers due to the executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate driving performance of post-stroke drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups using spatial and statistical techniques. The results showed that the mean Standard Deviation of Lane Deviation (SDLD) in post-stroke participants was higher than those of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight-line sections). No statistically significant differences were found in the speed maintenance between the post-stroke drivers and the normal adults. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults' driving behaviour at more challenging driving scenarios, or design driving intervention program to improve their executive function in driving.