Return to Driving Following Moderate-to-Severe Traumatic Brain Injury: A TBI Model System Longitudinal Investigation.

J Head Trauma Rehabil

Author Affiliations: Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama (Dr Novack, Ms Marwitz, and Dr Brunner); Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine Integrative Center for Aging Research, University of Alabama at Birmingham, Birmingham, Alabama (Drs Zhang and Kennedy); Department of Psychology, Wayne State University, Detroit, Michigan (Dr Rapport); Department of Psychology and Neuropsychology, Tampa General Hospital, Tampa, Florida (Dr Mahoney); Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (Dr Bergquist); Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, Washington (Dr Bombardier); Research Department, Craig Hospital, Englewood, Colorado (Dr Tefertiller); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia (Dr Walker); and Department of Physical Medicine and Rehabilitation, Moss Rehabilitation at Elkins Park/Einstein Healthcare Network, Elkins Park, Pennsylvania (Dr Watanabe).

Published: July 2024

AI Article Synopsis

  • The study investigates how people with moderate-to-severe traumatic brain injuries (TBI) return to driving (RTD) and their driving habits over a two-year period following rehabilitation.
  • Results show that 65% of participants returned to driving one year post-injury, increasing to 70% by the second year, but driving frequency and distance were lower than before the injury.
  • Crash rates dropped from 14.9% before the injury to 9.9% in the first year and 6% in the second year, suggesting ongoing risks, but the study indicates that TBI patients may already be at a higher risk for crashes prior to their injuries.

Article Abstract

Objective: To examine longitudinal patterns of return to driving (RTD), driving habits, and crash rates associated with moderate-to-severe traumatic brain injury (TBI).

Setting: Eight TBI Model System sites.

Participants: Adults (N = 334) with TBI that required inpatient acute rehabilitation with follow-up of 197 and 218 at 1 and 2 years post-injury, respectively. Data collection at 2 years occurred almost exclusively during the pandemic, which may have affected results.

Design: Longitudinal and observational.

Main Measures: Driving survey completed during rehabilitation and at phone follow-up 1 and 2 years after injury.

Results: The rate of RTD was 65% at 1-year follow-up and 70% at 2-year follow-up. RTD at both follow-up time points was positively associated with family income. The frequency of driving and distance driven were diminished compared to before injury. Limitation of challenging driving situations (heavy traffic, bad weather, and at night) was reported at higher rates post-injury than before injury. Crash rates were 14.9% in the year prior to injury (excluding crashes that resulted in TBI), 9.9% in the first year post-injury, and 6% during the second year.

Conclusion: RTD is common after TBI, although driving may be limited in terms of frequency, distance driven, and avoiding challenging situations compared to before injury. Incidence of crashes is higher than population-based statistics; however, those who sustain TBI may be at higher risk even prior to injury. Future work is needed to better identify characteristics that influence the likelihood of crashes post-TBI.

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Source
http://dx.doi.org/10.1097/HTR.0000000000000983DOI Listing

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