RCT protocol for driving performance in people with Parkinson's using autonomous in-vehicle technologies.

Introduction: Driving is an essential facilitator of independence, community participation, and quality of life. Drivers with Parkinson's Disease (PD) make more driving errors and fail on-road evaluations more than healthy controls. In-vehicle technologies may mitigate PD-related driving impairments and associated driving errors. Establishing a rigorous study protocol will increase the internal validity and the transparency of the scientific work. Methods: We present a protocol to assess the efficacy of autonomous in-vehicle technologies (Level 1) on the driving performance of drivers with PD via a randomized crossover design with random allocation. Drivers with a PD diagnosis based on established clinical criteria (N = 105), referred by neurologists, are exposed to two driving conditions (technology activated or not) on a standardized road course as they drove a 2019 Toyota Camry. The researchers collected demographic, clinical, on-road data observational and kinematic, and video data to understand several primary outcome variables, i.e., number of speeding, lane maintenance, signaling, and total driving errors. Discussion: The protocol may enhance participant adherence, decrease attrition, provide early and accurate identification of eligible participants, ensure data integrity, and improve the study flow. One limitation is that the protocol may change due to unforeseen circumstances and assumptions upon implementation. A strength is that the protocol ensures the study team executes the planned research in a systematic and consistent way.Following, adapting, and refining the protocol will enhance the scientific investigation to quantify the nuances of driving among those with PD in the era of automated in-vehicle technologies. Trial registration: ClinicalTrials.gov NCT04660500.

Feasibility of automated in-vehicle technologies on volunteers' driving performance.

BACKGROUND: Automated in-vehicle technologies, specifically in-vehicle information systems (IVIS) and advanced driver assistance systems (ADAS), are increasingly common in today's cars. Previous studies illustrate benefits of using IVIS and ADAS to improve safety, convenience, and comfort in healthy older drivers. However, research is sparse on the feasibility of such technologies for medically at-risk drivers, such as those with Parkinson's disease (PD). OBJECTIVE: This study enrolled healthy volunteer drivers to examine the feasibility of the procedures and measures for evaluating the effects of IVIS and ADAS on their driving performance. METHODS: During this feasibility study researchers compared drives completed with and without support of IVIS and ADAS, as participants drove a 2019 Toyota Camry XLE. The test vehicle was equipped with IVIS, ADAS, cameras, a telematics system, and sensors. Participants drove the road course supervised by a Driver Rehabilitation Specialist (DRS). RESULTS: Overall study procedures and vehicle equipment were feasible and provided sufficient data collection for measuring the impact of IVIS and ADAS on driving performance. Data observation by the DRS combined with data captured from cameras and telematics, facilitated comparisons to increase data reliability and validity. CONCLUSIONS: Feasibility study findings informed a randomized clinical trial, examining the use of IVIS and ADAS technologies as an intervention to support drivers with Parkinson's disease.

The team approach to transportation assessment.

Driving and/or transportation is an activity of daily living that should be considered in the rehabilitation plan of any individual. Safe and reliable transportation can be one of the most important factors to ensure the complete rehabilitation of an individual no matter the age or condition. Evaluation of a person's transportation needs can be complex and should be performed by a qualified professional with the necessary medical background and specialty experience to adequately address the exact needs. This paper describes the role of the transportation team and the vital activity performed by a driver rehabilitation specialist during a comprehensive transportation assessment.