Driving Rehabilitation as Delivered by Driving Simulation

The ability to drive safely constitutes an important aspect of individual freedom in today’s society. Partial or complete loss of driving ability can seriously impair an individual’s daily functioning, well-being, and quality of life. Assessment of driving abilities and delivering driving rehabilitation are complex procedures, especially when dealing with clinical populations (e.g., patients who have suffered a traumatic brain injury). Traditional measures such as neuropsychological tests and computerized tests may offer information on specific cognitive, motor, and perceptual skills that facilitate driving; however, they fall considerably short of providing a comprehensive picture in terms of real-life, complex, and demanding driving situations. Virtual reality driving simulation (VRDS) offers tremendous advantages over traditional assessment tools in that it has the potential to evaluate both specific driving behaviors and general driving skills objectively, reliably, and safely in an assimilated real-life experience using a variety of challenging, but standardized and monitored, settings. Use of VRDS in driving rehabilitation, although still an emerging field, shows a lot of promise. It offers an opportunity to incorporate real-life driving situations (without compromising safety of participants) that can be manipulated to train people in a systematic manner. The literature strongly supports the use of VRDS as a sensitive and an effective tool for driving assessment and it can be hoped that researchers, in the near future, can work towards standardization of driving evaluations (in terms of simulators and the software used) across various clinical and non-clinical conditions. The use of VRDS in driving rehabilitation is, however, surprisingly limited. The few studies that have been published in this area offer compelling evidence highlighting their potential effectiveness in providing driving retraining to those who have suffered a neurological and/or physical compromise. In the face of encouraging evidence indicating the value of driving simulators in driving rehabilitation, it is important to appreciate that this is a relatively new field of application for driving simulators. Therefore, a few practical and technological concerns (e.g., standardization, simulation adaptation syndrome) will need to be addressed before driving simulators are accepted as the tool of choice to deliver and assess driving rehabilitation.