Junpei Kubota, a second-year doctoral student in the Doctoral Program of Occupational Therapy at Yamagata Prefectural University of Health Sciences (Supervisor: Professor Tasuku Sotokawa), and colleagues have published their research findings in the international academic journal Brain Injury. This study is a scoping review that systematically synthesized existing research on driving behavior after brain injury and stroke, based on simulator-based and on-road driving assessments.

It is well known that cognitive and motor functions required for driving may be impaired following brain injury or stroke; however, the characteristics of driving behavior captured through assessment have not been sufficiently organized. In this study, 38 articles were analyzed in accordance with the PRISMA extension for scoping reviews. Driving behaviors were classified into operational, tactical, and strategic levels. The results showed that individuals with brain injury who failed driving assessments consistently demonstrated more tactical-level errors, such as lane deviations and insufficient visual scanning.

This research was conducted as an international collaborative study with the laboratory of Dr. Neha Lodha in the Department of Rehabilitation Science, College of Health and Human Sciences at Colorado State University. The laboratory conducts research aimed at improving the quality of rehabilitation by scientifically evaluating motor control, cognitive function, and performance in daily activities among individuals with brain injury and neurological disorders. The lab specializes in functional assessment and behavioral analysis using both real-world and simulated environments, and provided important contributions to the theoretical framework and interpretation of driving behavior in this study. The research was also carried out with the cooperation of Mr. Takao Kaneko, an occupational therapist at Yamagata Prefectural Central Hospital. These findings highlight the importance of evaluating tactical-level abilities when determining readiness to resume driving after brain injury or stroke, and are expected to contribute to the advancement of clinical assessment methods.

Publication Information
Kubota, J., Tiwari, A., Kaneko, T., Lodha, N., & Sotokawa, T. (2026). Driving behavior in simulator and on-road assessments in brain injury and stroke: a scoping review. Brain Injury, 1–36. https://doi.org/10.1080/02699052.2026.2617467