Research Reports - Predictors of on-road driver performance following traumatic brain injury

Arch Phys Med Rehabil. 2015 Mar;96(3):440-6

Ross PE(1), Ponsford JL(2), Di Stefano M(3), Spitz G(2)

OBJECTIVE: To examine assessment outcomes and factors associated with passing an
occupational therapy (OT) on-road driver assessment after traumatic brain injury
(TBI).
DESIGN: Retrospective analysis of outcomes of on-road driver assessment completed
by persons with TBI over an 8-year period.
SETTING: Inpatient and outpatient rehabilitation hospital.
PARTICIPANTS: A consecutive sample of individuals (N=207) with mild to severe TBI
who completed an on-road driver assessment and were assessed at least 3 months
postinjury.
INTERVENTION: Not applicable.
MAIN OUTCOME MEASURE: Outcome of on-road driver assessment.
RESULTS: Of the drivers with TBI, 66% (n=137) passed the initial on-road driver
assessment (pass group), whereas 34% (n=70) required on-road driver
rehabilitation and/or ≥1 on-road assessment (rehabilitation group). After driver
rehabilitation, only 3 participants of the group did not resume driving.
Participants who were men, had shorter posttraumatic amnesia (PTA) duration, had
no physical and/or visual impairment, and had faster reaction times were
significantly more likely to be in the pass group. In combination, these
variables correctly classified 87.6% of the pass group and 71.2% of the
rehabilitation group.
CONCLUSIONS: PTA duration proved to be a better predictor of driver assessment
outcome than Glasgow Coma Scale score. In combination with the presence of
physical/visual impairment and slowed reaction times, PTA could assist clinicians
to determine referral criteria for OT driver assessment. On-road driver
rehabilitation followed by on-road reassessment were associated with a high
probability of return to driving after TBI.

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