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Original article| Volume 96, ISSUE 3, P440-446, March 2015

Predictors of On-Road Driver Performance Following Traumatic Brain Injury

Published:October 11, 2014DOI:https://doi.org/10.1016/j.apmr.2014.09.027

      Abstract

      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.

      Keywords

      List of abbreviations:

      AIC (Akaike information criterion), GCS (Glasgow Coma Scale), PTA (posttraumatic amnesia), TBI (traumatic brain injury)
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