Utilizing driving simulators for persons with multiple sclerosis: A scoping review

ObjectiveThis scoping review synopsized and mapped the evidence on the utility of driving simulators for drivers with Multiple Sclerosis (MS) including participant characteristics (e.g., demographic, clinical) suited to simulator use; and driving scenario environments, maneuvers, and outcomes reflective of driving performance.Data SourcesThe research team searched six databases for English studies on driving simulator performance in drivers with MS.Study SelectionFour reviewers independently screened 976 unique titles, 148 abstracts, and 18 full-text sources for study inclusion or exclusion. Inclusion criteria ensured that studies utilized measures of driving simulator performance in adults 18 years or older with MS.Data ExtractionReviewers independently charted, verified, and achieved consensus on 100% of the data in the extraction table.Data SynthesisThe scoping review included thirteen studies (twelve assessment, one intervention), published between 2001 and 2021. Studies included small samples (N = 11–50) of adults (M age = 36–50 years; 40–91% female), mostly with a relapsing-remitting (53–100%) diagnosis and low to moderate physical disability (Expanded Disability Status Scale score < 6.0). The assessment studies utilized driving scenarios to assess pre-driving (n = 1) or driving abilities (n = 2), responses to hazardous events in suburban (n = 1) or urban environments (n = 4), or the ability to maintain speed or lateral lane positioning during monotonous highway drives (n = 7), with four scenarios also including responses to secondary divided attention tasks. The intervention study utilized driving simulation as a training program to improve driving-related skills.ConclusionsThe evidence on the utility of driving simulators for adults with MS is limited to assessment of driving performance, mostly during monotonous highway drives. Further research should consider exploring how driving simulators can be utilized to assess driving performance in other environments or for intervention. Gender should be examined to support gender diverse populations.