Evaluating fitness to drive after cerebral injury: basic issues and recommendations for medical and legal communities.

Specialists in rehabilitation are typically called upon to evaluate and render an opinion about whether or not a person can be entrusted to resume driving. And, because driving is an individual privilege to be balanced against the public's right to safety and protection from the dangers of a driver whose residual deficits may impede ability to drive safely, these specialists have developed a number of methods to assess fitness to drive. Unfortunately, many evaluators remain unfamiliar with research used as basis for evaluations or lack understanding of the strengths and weaknesses of tests in use.

Effects of opioids on driving ability.

Driving has been regarded as an activity of daily living that is important in maintaining a person's independence in the community, access to employment, and social activities. Many patients, however, using opioid medications on a regular basis (Chronic Opioid Analgesic Therapy: COAT) to ameliorate their intractable pain have been restricted from driving out of concern that skills would be impaired and driving safety compromised by these medications. Yet there are no driving studies which have explored the effects of using opioid analgesics for an extended period of time.

Nurses' assessment of patients' cognitive orientation in a rehabilitation setting.

Orientation is a critical determinant of a patient's neurological status and an indicator of change in condition during hospitalization. The ways rehabilitation nurses assess orientation and the manner in which findings are interpreted and reported can have significant implications for the care of neurologically compromised patients. This study used a questionnaire to examine how 52 nurses appraised and reported the results of orientation evaluations.

Competence in discourse as a measure of social integration and quality of life in persons with traumatic brain injury.

Persisting difficulties in communication are a serious handicap faced by many after traumatic brain injury (TBI) and a major barrier to community reintegration. Conventional approaches to the study of communication problems after TBI have focused on the form of language production and expression, usually in terms of phonological, semantic, and syntactical features. Most TBI patients, however, perform overall within normal ranges on these conventional indicators.

Low back pain in college athletes. A prospective study correlating lower extremity overuse or acquired ligamentous laxity with low back pain.

Study Design: A prospective evaluation of the incidence of low back pain in college athletes was undertaken.

Objectives: To evaluate prospectively leg length discrepancy, hip flexor tightness, and lower extremity acquired laxity or overuse as predictive factors for low back pain in college athletes.

Summary Of Background Data: A pilot study found an association between low back pain and the factors to be studied.