Mazer 2005

Methods	RCT
Participants	Recruited from a rehabilitation hospital in Quebec, 2 driving evaluation centres in Montreal and from a private driving evaluation clinic 39 participants: 20 intervention, 19 control Inclusion criteria (for stroke participants): people with a diagnosis of stroke that did not pass the driving tests at a recognised driving evaluation service. Had licence to drive and were driving prior to the stroke and desire to return to driving Exclusion criteria: medical condition precluding driving (for example, hemianopia, seizures), received their driving evaluation more than 2 years post diagnosis, unable to communicate in English or French, inadequate communication of basic verbal instructions or judged as dangerous by the therapist in the on‐road evaluation Mean (SD) age: intervention group 68 (14) years, control group 69 (9) years Stroke details: 31% right hemiparesis Timing post stroke: intervention group mean (SD) 1.4 (1) years, control group 1.7 (1) years
Interventions	Virtual reality intervention: driving simulator. Simulator is a car frame with 3 large screens providing a large field of view. Participants were progressed through 4 increasingly complex scenarios. In level 1, participants were familiarised with the simulator and controls; level 2 involved a simulated road circuit without traffic; level 3 focused on performing different driving manoeuvres and level 4 involved a variety of traffic conditions (for example, rain, wind, reduced visibility, pedestrians). Instant feedback was provided by the simulator when errors were made Control intervention: no intervention provided Sessions were 60 minutes, 2 times a week for 8 weeks (16 hours total)
Outcomes	Outcomes recorded at baseline and post‐intervention (or after 8 weeks for the control group) Activity limitation outcomes: DriveAble Testing Ltd Driver Evaluation
Notes	Note that this study also recruited 6 participants with traumatic brain injury. However, data for participants with stroke were able to be separated. This review reports on the stroke data only
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Used a computer program to generate
Allocation concealment (selection bias)	Low risk	Opaque, sealed envelopes
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Blind
Incomplete outcome data (attrition bias) All outcomes	Low risk	7 participants (5 control group, 2 simulator group) did not complete the outcome evaluation and were therefore considered to have dropped out from the study. Analysis was completed based on the actual number of participants contributing data. Intention‐to‐treat analyses were conducted
Selective reporting (reporting bias)	Low risk	No other outcomes were collected