Objectives Guidelines in several countries recommend against driving soon after a stroke; however, some patients resume driving within one month after onset. This study aimed to examine the relationship between neurological and social background factors at intensive care unit (ICU) admission and resumption of motor vehicle driving within 30 days of the first acute stroke/cerebral hemorrhage. Materials and methods Data were extracted from medical records of a single center linked to the National Cerebral and Cardiovascular Center Administration Office for Stroke Data Bank in Japan. The data included age, sex, Japan Coma Scale (JCS), National Institutes of Health Stroke Scale (NIHSS), employment status, family situation, and outcomes of driving resumption in patients with a valid driving license transported to the ICU within 24 hours of stroke onset. Time-to-event analysis was used to explore the associations between these factors and driving resumption, with data censored 30 days from onset. Results In total, 239 patients had complete medical records, of whom 66 resumed driving. A multivariate Cox proportional hazards analysis showed that fewer patients aged ≥65 years resumed driving than those aged <65 years (hazard ratio 0.46; 95% confidence interval: 0.25-0.84; p=0.009). Patients with NIHSS scores ≥5 and JCS scores ≥1 were also less likely to resume driving compared with those with scores <5 (0.22; 0.08-0.56; p=0.008) and 0 (0.13; 0.04-0.37; p<0.001), respectively. Conclusions Age, NIHSS score, and JCS score at ICU admission are independently associated with the likelihood of resuming driving within 30 days of stroke onset. These findings may aid with the provision of support and education to facilitate the efficient resumption of driving after an acute event.

Mobility is crucial for independent living in old age. Older people with reduced physical ability (frailty) begin to limit their personal range of activities to their immediate living environment and ultimately to their immediate home. Diseases of the musculoskeletal system as well as neurological, psychological, cognitive, sensory, and circulatory disorders can limit functional competence (ability to live independently).In the Longitudinal Urban Cohort Ageing Study (LUCAS), from which selected results are reported in this article, participants were categorized into different functional classes (Robust, postRobust, preFrail, Frail) using the LUCAS functional index. The results show that losses in functional competence were associated with impaired mobility and reduced car driving. Impaired mobility led to restricted radius of action.The aim of healthcare in old age is to preserve independence and quality of life as long as possible. Car driving is an important part of older peoples\' activities of daily living. Therefore, primary care physicians should address car driving regularly because preventive measures to strengthen functional health also strengthen car driving ability in older persons.
UNASSIGNED: Mobilität ist auch im höheren Alter maßgeblich für die selbstständige Lebensführung. Ältere Menschen beginnen bei geringerer körperlicher Leistungsfähigkeit (Gebrechlichkeit, engl. Frailty) ihren persönlichen Aktionsradius auf das nähere Wohnumfeld und schließlich die unmittelbare Häuslichkeit zu begrenzen. Erkrankungen des Bewegungsapparates, neurologische, psychische, kognitive, Sinnes- oder Kreislaufstörungen können die funktionale Kompetenz (Fähigkeit, unabhängig zu leben) einschränken.In einer Längsschnittstudie zur Alterung urbaner Kohorten (LUCAS), aus der in diesem Artikel ausgewählte Ergebnisse berichtet werden, wurden die Teilnehmenden mittels des LUCAS-Funktions-Index unterschiedlichen Funktionsklassen zugeordnet (Robust, postRobust, preFrail und Frail). Die Ergebnisse zeigen, dass zunehmende Verluste funktionaler Kompetenz mit abnehmender Mobilität und weniger häufigem selbstständigen Autofahren verknüpft waren. Beeinträchtigungen der Mobilität engten den Aktionsradius ein.Das Ziel der gesundheitlichen Versorgung im Alter ist es, Unabhängigkeit und Lebensqualität der Menschen lange zu erhalten. Autofahren ist ein wichtiger Teil der Alltagsaktivitäten älterer Menschen. Deshalb sollte insbesondere hausärztlich auch regelmäßig wiederholt die Frage nach dem Autofahren gestellt werden, denn präventive Maßnahmen zum Erhalt funktionaler Gesundheit dienen auch dem Erhalt der Fahreignung älterer Menschen.

Accident analyses repeatedly reported the considerable contribution of run-off-road incidents to fatalities in road traffic, and despite considerable advances in assistive technologies to mitigate devastating consequences, little insight into the drivers\' brain response during such accident scenarios has been gained. While various literature documents neural correlates to steering motion, the driver\'s mental state, and the impact of distraction and fatigue on driving performance, the cortical substrate of continuous deviations of a car from the road - i.e., how the brain represents a varying discrepancy between the intended and observed car position and subsequently assigns customized levels of corrective measures - remains unclear. Furthermore, the superposition of multiple subprocesses, such as visual and erroneous feedback processing, performance monitoring, or motor control, complicates a clear interpretation of engaged brain regions within car driving tasks. In the present study, we thus attempted to disentangle these subprocesses, employing passive and active steering conditions within both error-free and error-prone vehicle operation conditions. We recorded EEG signals of 26 participants in 13 sessions, simultaneously measuring pairs of Executors (actively steering) and Observers (strictly observing) during a car driving task. We observed common brain patterns in the Executors regardless of error-free or error-prone vehicle operation, albeit with a shift in spectral activity from motor beta to occipital alpha oscillations within erroneous conditions. Further, significant frontocentral differences between Observers and Executors, tracing back to the caudal anterior cingulate cortex, arose during active steering conditions, indicating increased levels of motor-behavioral cognitive control. Finally, we present regression results of both the steering signal and the car position, indicating that a regression of continuous deviations from the road utilizing the EEG might be feasible.

UNASSIGNED: Prolonged sitting during driving is linked to neck pain, uncomfortable body positions, and repetitive motions. Recognizing these challenges, this study aimed to investigate Cervical Health Parameters in Car Drivers.
UNASSIGNED: The sample consisted of 160 car drivers between 25 and 45 years. This subject was then divided into two groups based on neck pain. Participants met the required criteria, such as being between 25-45 years of age, maintaining a BMI of 18-24, and driving for at least 2 hours each day for at least 3-5 years. To evaluate the results, we employed a clinometer and compass app on a smartphone to measure the Cervical Range of Motion (CROM). We used Surgimap software to estimate the Craniovertebral Angle (CVA), and a (Cervical range of motion) CROM device was used for proprioception assessment.
UNASSIGNED: The result shows the participants in neck pain group displayed lower Cervical Range of Motion (CROM) values than without neck Pain Group. Similarly, the Craniovertebral Angle (CVA) was smaller in the neck Pain Group (mean difference of -6.3°), indicating a more forward head posture. Neck pain resulted in a mean difference of -4.5° in proprioception accuracy. This indicates that neck pain affects CROM, CVA, and proprioception in car drivers.
UNASSIGNED: Car driving significantly impacts cervical parameters in individuals with neck pain, reducing cervical range of motion, altered craniovertebral angle, and diminished proprioceptive accuracy. These findings emphasize the need for ergonomic interventions and proprioceptive training tailored for drivers. Future research should broaden demographic parameters and consider potential confounders to provide a holistic understanding of the relationship between car driving and neck health.

To investigate the impact of environmental noise on the cognitive abilities of drivers, this study, using in-vehicle voice interaction as an example, conducted laboratory experiments to assess the effects of road traffic noise, entertainment noise, and white noise stimuli on drivers\' attention and short-term memory. The noise levels simulated to mimic acoustic conditions during car driving ranged from 35 dB(A) to 65 dB(A). The conclusions drawn were as follows: (1) Noise levels directly influenced subjective annoyance levels, with annoyance linearly increasing as noise levels escalated; (2) Both attention and short-term memory task reaction times of drivers were significantly influenced by noise types. Compared to traffic noise and white noise, drivers\' cognitive efficiency was lower under entertainment noise. (3) Performance in complex cognitive tasks was more susceptible to noise levels compared to simple cognitive tasks; (4) Experimentally, it was found that drivers exhibited the highest cognitive efficiency in cognitive tasks when the environmental noise level was 55 dB(A), as opposed to noise levels of 35 dB(A), 45 dB(A), and 65 dB(A).

Forward collision warning systems (FCWSs) monitor the road ahead and warn drivers when the time to collision reaches a certain threshold. Using a driving simulator, this study compared the effects of FCWSs between novice drivers (unlicensed drivers) and experienced drivers (holding a driving license for at least four years) on near-collision events, as well as visual and driving behaviors. The experimental drives lasted about six hours spread over six consecutive weeks. Visual behaviors (e.g., mean number of fixations) and driving behaviors (e.g., braking reaction times) were collected during unprovoked near-collision events occurring during a car-following task, with (FCWS group) or without FCWS (No Automation group). FCWS presence reduced the number of near-collision events drastically and enhanced visual behaviors during those events. Unexpectedly, brake reaction times were observed to be significantly longer with FCWS, suggesting a cognitive cost associated with the warning process. Still, the FCWS showed a slight safety benefit for novice drivers attributed to the assistance provided for the situation analysis. Outside the warning events, FCWS presence also impacted car-following behaviors. Drivers took an extra safety margin, possibly to prevent incidental triggering of warnings. The data enlighten the nature of the cognitive processes associated with FCWSs. Altogether, the findings support the general efficiency of FCWSs observed through a massive reduction in the number of near-collision events and point toward the need for further investigations.

Car driving is more and more automated, to such an extent that driving without active steering control is becoming a reality. Although active driving requires the use of visual information to guide actions (i.e., steering the vehicle), passive driving only requires looking at the driving scene without any need to act (i.e., the human is passively driven).
After a careful search of the scientific literature, 11 different studies, providing 17 contrasts, were used to run a comprehensive meta-analysis contrasting active driving with passive driving.
Two brain regions were recruited more consistently for active driving compared to passive driving, the left precentral gyrus (BA3 and BA4) and the left postcentral gyrus (BA4 and BA3/40), whereas a set of brain regions was recruited more consistently in passive driving compared to active driving: the left middle frontal gyrus (BA6), the right anterior lobe and the left posterior lobe of the cerebellum, the right sub-lobar thalamus, the right anterior prefrontal cortex (BA10), the right inferior occipital gyrus (BA17/18/19), the right inferior temporal gyrus (BA37), and the left cuneus (BA17).
From a theoretical perspective, these findings support the idea that the output requirement of the visual scanning process engaged for the same activity can trigger different cerebral pathways, associated with different cognitive processes. A dorsal stream dominance was found during active driving, whereas a ventral stream dominance was obtained during passive driving. From a practical perspective, and contrary to the dominant position in the Human Factors community, our findings support the idea that a transition from passive to active driving would remain challenging as passive and active driving engage distinct neural networks.

Lane Departure Warning Systems (LDWS) are automation that warn drivers in case of immediate lane departure. While LDWS are associated with increased road safety, little is known about the neural aspects of the cooperation between an LDWS and the driver behind the wheel. The present study addresses this issue by combining fMRI and driving simulation for experienced and novice drivers. The results reveal brain areas activated immediately after warning: it involves areas linked to the alertness network (midbrain, thalamus, anterior cingulate cortex), to motor actions and planning (motor and premotor cortexes; BA4/6 -cerebellum) and to attentional redirection (superior frontal cortex; BA10). There were no differences between experienced and novice drivers in this network of cerebral areas. However, prior driving experience mediates the number of lane departures. The results allow for refining a model of cooperation proposed earlier in the literature, by adding a cerebral dimension.

UNASSIGNED: Few studies have examined motor function in determining the suitability of patients with stroke to resume driving a car. Patients with hemiplegia usually control car pedals with the unaffected lower limb. However, motor control on the unaffected side is also impaired in patients with stroke. This study aimed to clarify the neurophysiological characteristics of pedal switching control during emergency braking in patients with hemiplegia.
UNASSIGNED: The study participants consisted of 10 drivers with left hemiplegia and 10 age-matched healthy drivers. An experimental pedal was used to measure muscle activity and kinematic data during braking, triggered by the light from a light-emitting diode placed in front of the drivers.
UNASSIGNED: The patient group took the same reaction time as the healthy group. However, from the visual stimulus to the release of the accelerator pedal, the patient group had higher muscle activity in the tibialis anterior and rectus femoris and had faster angular velocities of hip and knee flexion than the healthy group. In addition, the patient group had higher co-contraction activities between flexors and extensors. From the accelerator pedal release to brake contact, the patient group had slower angular velocities of hip adduction, internal rotation, ankle dorsiflexion, internal return, and internal rotation than the healthy group.
UNASSIGNED: Patients with hemiplegia exhibited poor control of pedal switching using their unaffected side throughout the pedal-switching task. These results indicate that the safety related to car-pedal control should be carefully evaluated while deciding whether a patient can resume driving a car after a stroke.

Lane Departure Warning Systems (LDWS) generate a warning in case of imminent lane departure. LDWS have proven to be effective and associated human-machine cooperation modelled. In this study, LDWS acceptance and its impact on visual and steering behaviour have been investigated over 6 weeks for novice and experienced drivers. Unprovoked lane departures were analysed along three driving tasks gradually more demanding. These observations were compared to a baseline condition without automation. The number of lane departures and their duration were dramatically reduced by LDWS, and a narrower visual spread of search during lane departure events was recorded. The findings confirmed LDWS effectiveness and suggested that these benefits are supported by visuo-attentional guidance. No specific influence of driving experience on LDWS was found, suggesting that similar cognitive processes are engaged with or without driving experience. Drivers\' acceptance of LDWS lowered after automation use, but LDWS effectiveness remained stable during prolonged use.Practitioner summary: Lane Departure Warning Systems (LDWS) have been designed to prevent lane departure crashes. Here, LDWS assessment over a 6-week period showed a major drop in the number of lane departure events increasing over time. LDWS effectiveness is supported by the guidance of drivers\' visual attention during lane departure events.