Objective
To evaluate safely the driving ability of the handicapped with developed driving simulator in the virtual environment and to investigate clinical usefulness.

Method
A real car was remodeled for realism and equipped it with hand control device for driving of the handicapped. The subjects were 10 normal people with driving license and 15 patients with thoracic or lumbar spinal cord injury who had driving experience. 5 driving skills were measured (average speed, steering stability, centerline violation, traffic signal violation, and time taken in driving) in various road conditions. The normal participants manipulated the gas pedal and the brake by their foot while the patients did with their hands. After they finished to drive the whole course, they answered the questions ("How realistic the driving simulator seems to you" and "How much your fear reduced")

Results
1) Four driving skills measured between two groups (normal vs. handicapped) were not significantly different (p＞0.05). 2) In 4 kinds (start road, speed limit road, sharp curve road and left turn) of the road conditions, the average speed of the patients group was significantly different from the normal group (p＜0.05). 3) Eleven patients (73%) reported that their driving fear was reduced and the score of "how realistic" question was 51.5% in average.

Conclusion
This developed driving simulator will be able to be used for one of the programs for evaluating and training the driving skill of the handicapped and need to enhance the reality of driving simulator. (J Korean Acad Rehab Med 2002; 26: 311-315)