Stefan Delmas, Prakruti Patel, Agostina Casamento-Moran, Evangelos A Christou, Neha Lodha
{"title":"脑卒中后认知障碍对踏板控制和碰撞风险的影响：一项初步研究。","authors":"Stefan Delmas, Prakruti Patel, Agostina Casamento-Moran, Evangelos A Christou, Neha Lodha","doi":"10.1177/09226028251379341","DOIUrl":null,"url":null,"abstract":"<p><p>Driving after stroke requires complex coordination of cognitive and motor systems, yet the influence of post-stroke cognitive impairment on lower limb motor control during driving remains poorly understood. This pilot study examined the association between cognitive function and lower limb motor control of gas/brake pedal control in stroke survivors. We hypothesized that compromised cognitive function would be associated with worse gas and brake pedal control. Twenty stroke survivors (65.89 ± 9.67 years; 6 females) participated. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Useful Field of View (UFOV) test scores for divided and selective attention. Participants performed a car-following task in a driving simulator requiring precise gas and brake control. Pedal control was quantified by gas pedal error, brake force error, and brake response time. Participants were categorized into cognitively normal and cognitively impaired groups (n=10 each). Driving behavior was assessed using the Driving Habits Questionnaire (DHQ), and crash risk was determined via UFOV classification. Increased gas pedal error was associated with poorer MoCA scores and selective attention deficits. Delayed brake response times correlated with lower MoCA scores and poorer divided and selective attention. Although self-reported driving behavior was comparable between groups, 60% of cognitively impaired participants demonstrated moderate to high crash risk compared to cognitively normal participants, who exhibited low crash risk. Cognitive impairment after stroke is significantly linked to impaired lower limb control during driving and elevated crash risk. These findings highlight an urgent need to integrate cognitive assessment along with motor assessments in post-stroke rehabilitation. Future advances in neuroengineering technologies, and personalized motor-cognitive interventions could play a critical role in restoring safe driving capabilities and mobility independence after stroke.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028251379341"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Impact of Cognitive Impairment on Pedal Control and Crash Risk Following Stroke: A Pilot Study.\",\"authors\":\"Stefan Delmas, Prakruti Patel, Agostina Casamento-Moran, Evangelos A Christou, Neha Lodha\",\"doi\":\"10.1177/09226028251379341\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Driving after stroke requires complex coordination of cognitive and motor systems, yet the influence of post-stroke cognitive impairment on lower limb motor control during driving remains poorly understood. This pilot study examined the association between cognitive function and lower limb motor control of gas/brake pedal control in stroke survivors. We hypothesized that compromised cognitive function would be associated with worse gas and brake pedal control. Twenty stroke survivors (65.89 ± 9.67 years; 6 females) participated. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Useful Field of View (UFOV) test scores for divided and selective attention. Participants performed a car-following task in a driving simulator requiring precise gas and brake control. Pedal control was quantified by gas pedal error, brake force error, and brake response time. Participants were categorized into cognitively normal and cognitively impaired groups (n=10 each). Driving behavior was assessed using the Driving Habits Questionnaire (DHQ), and crash risk was determined via UFOV classification. Increased gas pedal error was associated with poorer MoCA scores and selective attention deficits. Delayed brake response times correlated with lower MoCA scores and poorer divided and selective attention. Although self-reported driving behavior was comparable between groups, 60% of cognitively impaired participants demonstrated moderate to high crash risk compared to cognitively normal participants, who exhibited low crash risk. Cognitive impairment after stroke is significantly linked to impaired lower limb control during driving and elevated crash risk. These findings highlight an urgent need to integrate cognitive assessment along with motor assessments in post-stroke rehabilitation. 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The Impact of Cognitive Impairment on Pedal Control and Crash Risk Following Stroke: A Pilot Study.
Driving after stroke requires complex coordination of cognitive and motor systems, yet the influence of post-stroke cognitive impairment on lower limb motor control during driving remains poorly understood. This pilot study examined the association between cognitive function and lower limb motor control of gas/brake pedal control in stroke survivors. We hypothesized that compromised cognitive function would be associated with worse gas and brake pedal control. Twenty stroke survivors (65.89 ± 9.67 years; 6 females) participated. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Useful Field of View (UFOV) test scores for divided and selective attention. Participants performed a car-following task in a driving simulator requiring precise gas and brake control. Pedal control was quantified by gas pedal error, brake force error, and brake response time. Participants were categorized into cognitively normal and cognitively impaired groups (n=10 each). Driving behavior was assessed using the Driving Habits Questionnaire (DHQ), and crash risk was determined via UFOV classification. Increased gas pedal error was associated with poorer MoCA scores and selective attention deficits. Delayed brake response times correlated with lower MoCA scores and poorer divided and selective attention. Although self-reported driving behavior was comparable between groups, 60% of cognitively impaired participants demonstrated moderate to high crash risk compared to cognitively normal participants, who exhibited low crash risk. Cognitive impairment after stroke is significantly linked to impaired lower limb control during driving and elevated crash risk. These findings highlight an urgent need to integrate cognitive assessment along with motor assessments in post-stroke rehabilitation. Future advances in neuroengineering technologies, and personalized motor-cognitive interventions could play a critical role in restoring safe driving capabilities and mobility independence after stroke.
期刊介绍：
This interdisciplinary journal publishes papers relating to the plasticity and response of the nervous system to accidental or experimental injuries and their interventions, transplantation, neurodegenerative disorders and experimental strategies to improve regeneration or functional recovery and rehabilitation. Experimental and clinical research papers adopting fresh conceptual approaches are encouraged. The overriding criteria for publication are novelty, significant experimental or clinical relevance and interest to a multidisciplinary audience. Experiments on un-anesthetized animals should conform with the standards for the use of laboratory animals as established by the Institute of Laboratory Animal Resources, US National Academy of Sciences. Experiments in which paralytic agents are used must be justified. Patient identity should be concealed. All manuscripts are sent out for blind peer review to editorial board members or outside reviewers. Restorative Neurology and Neuroscience is a member of Neuroscience Peer Review Consortium.
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