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Visual Testing for Readiness to Drive After Stroke: A Multicenter Study

Korner-Bitensky, Nicol A. PhD; Mazer, Barbara L. MSc; Sofer, Susan BSc, CDRS; Gelina, Isabelle PhD; Meyer, Mary Beth OTR; Morrison, Carol BSc, OT(C), CDRS; Tritch, Linda OTR; Roelke, Mary Ann BSc, OTR, BCN; White, Marie BSc, OT

American Journal of Physical Medicine & Rehabilitation: May-June 2000 - Volume 79 - Issue 3 - p 253-259
CME Article: Stroke

Objective: The purpose of this study was to determine the ability of a visual-perception assessment tool, the Motor-Free Visual Perception Test, to predict on-road driving outcome in subjects with stroke.

Design: This was a retrospective study of 269 individuals with stroke who completed visual-perception testing and an on-road driving evaluation. Driving evaluators from six evaluation sites in Canada and the United States participated. Visual-perception was assessed using the Motor-Free Visual Perception Test. Scores range from 0 to 36, with a higher score indicating better visual perception. A structured on-road driving evaluation was performed to determine fitness to drive. Based on driving behaviors, a pass or fail outcome was determined by the examiner.

Results: The results indicated that, using a score on the Motor-Free Visual Perception Test of ≤30 to indicate poor visual-perception and >30 to indicate good visual perception, the positive predictive value of the Motor-Free Visual Perception Test in identifying those who would fail the on-road test was 60.9% (n = 67/110). The corresponding negative predictive value was 64.2% (n = 102/159). Univariate logistic regression analyses revealed that older age, low Motor-Free Visual Perception Test scores and a right hemisphere lesion contributed significantly to identifying those who failed the on-road test.

Conclusions: The predictive validity of the Motor-Free Visual Perception Test is not sufficiently high to warrant its use as the sole screening tool in identifying those who are unfit to undergo an on-road evaluation.

From the Jewish Rehabilitation Hospital Research Center (NAK-B, BLM, SS, IG), Laval, Quebec, Canada; School of Physical and Occupational Therapy, McGill University (NAK-B, BLM, SS, IG), Montreal, Quebec, Canada; Saint Francis Hospital (MBM), Poughkeepsie, New York; Centre de Réadaptation Stan Cassidy (CM), Frédéricton, New Brunswick, Canada; Parkview Memorial Hospital, Parkview Neuro Rehab Services, Fort Wayne Neurological Center (LT), Fort Wayne, Indiana; Meriter Hospital, Inc. (MAR), Madison, Wisconsin; and Private Driving Service (MW), Hull, Quebec, Canada.

Reprints: All correspondence and requests for reprints should be addressed to Nicol A. Korner-Bitensky, PhD, Jewish Rehabilitation Hospital Research Center, 3205 Place Alton Goldbloom, Laval, Quebec, Canada H7V 1R2.

Disclosure: Supported by the Jewish Rehabilitation Hospital Foundation.

2000 Series · Number 7

© 2000 Lippincott Williams & Wilkins, Inc.