Objective: To investigate the feasibility and preliminary efficacy of a driving simulator intervention on driving outcomes following acquired brain injury.
Design: Pilot randomised controlled trial.
Setting: Occupational therapy driver assessment and rehabilitation service.
Subjects: Individuals post-acquired brain injury aiming to return to driving.
Intervention: Eight sessions of simulated driver training over four weeks, in addition to usual care. Control: Usual care only.
Main measures: Feasibility outcomes: Participant recruitment and retention; data completeness; therapy attendance and fidelity; adverse events. Performance outcomes: on-road driving performance; Simulator Sickness Questionnaire; Brain Injury Driving Self-Awareness Measure and Driving Comfort Scale - Daytime, assessed at baseline and five weeks post-randomisation.
Results: Out of 523 individuals screened, 22 (4%) were recruited and randomised, with 20 completing their allocated group (n = 12 Simulator, n = 8 Usual Care). For those who completed training, session attendance was 100% with simulator sickness rated, on average, as mild. Six individuals (50%) in the Simulator group failed the on-road assessment, versus two (25%) in the Usual Care group (P = 0.373). On average, the Simulator group reported a positive change in confidence ratings (M = 5.77, SD = 13.96) compared to the Usual Care group, who reported a negative change (M = -6.97, SD = 8.47), P = 0.034. The Simulator group (M = 0.67, SD = 3.34) demonstrated no significant change in self-awareness relative to the Usual Care group (M = -0.83, SD = 1.83, P = 0.325).
Conclusions: With adjustments to inclusion criteria and recruitment strategies, it may be feasible to deliver the intervention and conduct a larger trial. There is potential benefit of simulator training for improving driver confidence after acquired brain injury.
Keywords: Driving simulator; acquired brain injury; rehabilitation interventions; self-awareness; self-efficacy.