A retrospective review of the potential relationship between the TMT B and on-road driving performance within a community rehabilitation setting

Aims: Occupational therapy (OT) driving assessments provide the gold standard approach to determine fitness to drive post-injury, medical event, and aging. However, these assessments are time intensive, costly and are associated with lengthy waitlists. As such, there is interest to investigate innovative approaches, including the use of the Trails Making Test B (TMT B), to assist clinicians with their decisions around returning to driving. The aim of this research was to explore potential correlations between TMT B scores and driving assessment outcomes. Methods: Trails Making Test B data were collected between 2010 and 2019 within a publicly funded community-based driving service in Brisbane, which serviced a wide range of client diagnostic groups and age ranges (17–94 years). A retrospective analysis was completed to compare with the on-road OT driving assessment outcome. Results: Results indicate a statistically significant relationship between TMT B score with on-road driving performance, with a higher confidence of predictability in the younger age groups (defined as 63 years or younger). Age is also related to on-road performance, with older clients more likely to fail. A 120 second time cut off may be a clinically relevant marker in predicting on-road performance, particularly for the younger clients. Conclusion: The TMT B is useful tool to assist in the decision making around returning to driving to aid in the timing and need of on-road driving assessment and to potentially assist with decision making in situations where these assessments are not practically available. Clinicians can consider the risk versus the benefits of the test as a predictive tool given their specific contextual environment and access to on-road driving assessments.