Deans' stroke musings: Prediction of on-road driving ability after traumatic brain injury and stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, April 9, 2013

Prediction of on-road driving ability after traumatic brain injury and stroke

I think I would have tried again and again until I passed.

Prediction of on-road driving ability after traumatic brain injury and stroke

Background and purpose

The aim of the study was to examine the predictive value of widely used standardized neuropsychological tests in a clinical setting for on-road driving performance in patients with cerebral stroke or traumatic brain injury (TBI), and to provide cut-off values for neuropsychological test results under which driving should not be recommended.

Methods

Data from 78 patients who had undergone comprehensive driving assessment after stroke or TBI were retrospectively included in the analysis. Patients underwent medical examination, neuropsychological testing and on-road assessment. Medical data, demographic variables and neuropsychological performance were used as predictors in a stepwise logistic regression analysis with pass/fail after the on-road test as the dependent variable. Receiver operating characteristic curve analysis was employed to select cut-off values for the tests that were significant predictors for on-road performance.

Results

Forty-three patients passed and 35 failed the on-road driving task. Logistic regression analysis revealed three significant neuropsychological tests (CalCap simple reaction time, Trail Making Test A, Grooved Pegboard) as predictors for on-road performance explaining 46% of the variance with an overall classification accuracy of 82.1%. Receiver operating characteristic curve analysis showed the following cut-off values: CalCap, 395 ms; Trail Making Test A, 46 s; Grooved Pegboard, 97.5 s.

Conclusion

The results suggest that driving ability after brain damage and cerebral disease with no severe neurological deficits can be measured with a few distinctive neuropsychological tests together with medical examination and on-road assessment. Cut-off scores are a useful supplement to normative data/scaled scores.