Driver Training After Stroke

NCT ID: NCT06672107

Last Updated: 2025-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-11-17

Study Completion Date

2029-09-30

Brief Summary

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One hundred Veteran stroke survivors will participate in both an Active Driver Training intervention and a Control intervention in a fully interactive driving simulator. In addition, all participants will complete pre- and post-intervention driving assessments in the driving simulator to measure driving performance and types of driving errors committed. Half the participants will receive the Active Driver Training first, whereas the other half will receive the Control intervention first. Each Active Driver Training session will provide targeted practice and feedback on each of four unique driving skills including: speed management, collision avoidance, lane positioning, and dashboard attention. The Control intervention will be matched for total time but will only provide extra familiarization with the operation of the driving simulator, with no skill-specific practice. It is predicted that the Active Driver Training Intervention will result in improved driving performance, relative to the Control condition. In addition, after a delay period of at least 6 months, all participants will be re-assessed in the driving simulator and will complete a survey to capture changes in driving status.

Detailed Description

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In this study, 100 Veteran stroke survivors (half with left hemisphere stroke and half with right hemisphere stroke) will engage in both an Active and a Control simulated driving intervention. The order of interventions (Active first vs. Control first) will be randomly assigned.

Each driving intervention will include weekly training for 3 consecutive weeks, followed by a post-intervention driving assessment. After a 1-week delay, participants will complete the other intervention type (for 3 consecutive weeks) followed by another post-intervention driving assessment. Last, all participants will be re-assessed 6 months later to measure stability of post-intervention driving performance and to complete a questionnaire on current driving status. The driving intervention condition (Active vs. Control) will serve as the main predictor variable in the study.

The Active Driver Training intervention sessions include targeted practice on four critical driving skills, namely, lane positioning, speed management, collision/obstacle avoidance, and dashboard attention. In each driver training session, participants complete all 4 modules sequentially, take a short break, and then repeat the sequence. In other words, participants receive targeted training on each skill six times over the 3-week training period.

In the Control sessions, participants will participate in familiarization drives, for a total duration comparable to the Active Driver Training sessions. The familiarization drive is a pre-programmed feature of the driving simulator that is designed to introduce/familiarize participants with the interactive features of the driving simulator (steering wheel, turn signals, rear-view mirror, etc.) but does not include any complex challenges or situations that require decision-making, and no performance feedback is given.

Simulated driving assessments will be re-administered upon completion of each intervention condition (Active Driver Training vs. Control), and again after a 6-month delay period. The driving assessments involve a challenging drive with multiple speed changes and obstacles and provides an overall score, as well as the number of driving errors committed. Post-intervention Driving Assessment scores will provide an indication of driving improvement due to intervention type, thus serving as the primary outcome variable.

Conditions

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Stroke

Study Design

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Observational Model Type

CASE_CROSSOVER

Study Time Perspective

PROSPECTIVE

Study Groups

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Right hemisphere stroke

Participants with a history of a unilateral stroke affecting the right cerebral hemisphere.

Active Driver Training Intervention

Intervention Type BEHAVIORAL

simulated driver training focusing on practice of 4 specific driving skills including lane positioning, speed management, collision avoidance, and dashboard attention

Control Intervention

Intervention Type BEHAVIORAL

pre-scripted familiarization with driving simulator controls in the absence of any complex driving scenarios, decision making requirements, or feedback pertaining to driving skills

Left hemisphere stroke

Participants with a history of a unilateral stroke affecting the left cerebral hemisphere.

Active Driver Training Intervention

Intervention Type BEHAVIORAL

simulated driver training focusing on practice of 4 specific driving skills including lane positioning, speed management, collision avoidance, and dashboard attention

Control Intervention

Intervention Type BEHAVIORAL

pre-scripted familiarization with driving simulator controls in the absence of any complex driving scenarios, decision making requirements, or feedback pertaining to driving skills

Interventions

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Active Driver Training Intervention

simulated driver training focusing on practice of 4 specific driving skills including lane positioning, speed management, collision avoidance, and dashboard attention

Intervention Type BEHAVIORAL

Control Intervention

pre-scripted familiarization with driving simulator controls in the absence of any complex driving scenarios, decision making requirements, or feedback pertaining to driving skills

Intervention Type BEHAVIORAL

Other Intervention Names

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Active Training Intervention

Eligibility Criteria

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Inclusion Criteria

* U.S. Veterans
* History of a unilateral stroke (at least 3 months post-onset)
* Ages 40-80
* pre-morbidly right hand dominant
* prior driving experience/U.S. driver's license

Exclusion Criteria

* History of other neurologic illness (e.g., TBI, dementia, epilepsy, Parkinson's, etc.)
* History of severe psychiatric illness (e.g., schizophrenia or other psychotic disorders)
* Recent substance abuse/dependence disorder (\< 1 year)
* Non-Veteran status
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Krista Schendel Parker, PhD BA

Role: PRINCIPAL_INVESTIGATOR

VA Northern California Health Care System, Mather, CA

Locations

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VA Northern California Health Care System, Mather, CA

Sacramento, California, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jefferson Lee

Role: CONTACT

(916) 843-2769

Jeanette M Cope

Role: CONTACT

(916) 843-7512

Facility Contacts

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Jerry L Nadler, MD

Role: primary

(916) 843-2776

Juliana V Baldo, PhD

Role: backup

(925) 372-4649

References

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Akinwuntan AE, Wachtel J, Rosen PN. Driving simulation for evaluation and rehabilitation of driving after stroke. J Stroke Cerebrovasc Dis. 2012 Aug;21(6):478-86. doi: 10.1016/j.jstrokecerebrovasdis.2010.12.001. Epub 2011 Jan 14.

Reference Type BACKGROUND
PMID: 21236698 (View on PubMed)

Devos H, Akinwuntan AE, Nieuwboer A, Truijen S, Tant M, De Weerdt W. Screening for fitness to drive after stroke: a systematic review and meta-analysis. Neurology. 2011 Feb 22;76(8):747-56. doi: 10.1212/WNL.0b013e31820d6300.

Reference Type BACKGROUND
PMID: 21339502 (View on PubMed)

Akinwuntan AE, Devos H, Verheyden G, Baten G, Kiekens C, Feys H, De Weerdt W. Retraining moderately impaired stroke survivors in driving-related visual attention skills. Top Stroke Rehabil. 2010 Sep-Oct;17(5):328-36. doi: 10.1310/tsr1705-328.

Reference Type BACKGROUND
PMID: 21131257 (View on PubMed)

Perrier MJ, Korner-Bitensky N, Petzold A, Mayo N. The risk of motor vehicle crashes and traffic citations post stroke: a structured review. Top Stroke Rehabil. 2010 May-Jun;17(3):191-6. doi: 10.1310/tsr1703-191.

Reference Type BACKGROUND
PMID: 20797963 (View on PubMed)

Other Identifiers

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N5300-R

Identifier Type: -

Identifier Source: org_study_id

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