TY - JOUR
T1 - Return to Driving After Moderate-to-Severe Traumatic Brain Injury
T2 - A Traumatic Brain Injury Model System Study
AU - Novack, Thomas A.
AU - Zhang, Yue
AU - Kennedy, Richard
AU - Rapport, Lisa J.
AU - Watanabe, Thomas K.
AU - Monden, Kimberley R.
AU - Dreer, Laura E.
AU - Bergquist, Thomas
AU - Bombardier, Charles
AU - Brunner, Robert
AU - Goldin, Yelena
AU - Marwitz, Jennifer
AU - Niemeier, Janet P.
N1 - Publisher Copyright:
© 2021 The American Congress of Rehabilitation Medicine
PY - 2021/8
Y1 - 2021/8
N2 - Objective: Describe who is able to return to driving (RTD) after moderate-to-severe traumatic brain injury (TBI), when this occurs, who maintains that activity, and the association with outcome. Design: Cross-sectional descriptive study. Setting: Eight follow-up sites of the TBI Model Systems (TBIMS) program. Participants: 618 participants enrolled in the TBIMS and 88 caregivers (N=706). Interventions: Not applicable. Main Outcome Measures: A survey was completed from 1-30 years postinjury focusing on RTD. Descriptors included demographic information, injury severity, and current employment status. Outcome was assessed at the time of the interview, including depression, quality of life, functional status, and community participation. Results: Of 706 respondents, 78% (N = 552) RTD, but 14% (N = 77) of these did not maintain that activity. Of those who RTD, 43% (N = 192) did so within 6 months of the injury and 92% did so within 24 months postinjury. The percentage of people driving after TBI did not differ significantly based on age at time of injury or follow-up. There were significant differences between drivers and nondrivers with respect to severity of injury, seizures, race, education, employment, rural vs urban setting, marital status, and family income. We performed a multivariate logistic regression to examine the association between driving status and demographic variables, adjusting for other variables in the model. The strongest associations were with current employment, family income, race, seizures, and severity of injury. Driving was associated with greater community participation, better functional outcomes, fewer symptoms of depression, and greater life satisfaction. Conclusions: Over a span of 30 years, three-quarters of people experiencing moderate-to-severe TBI return to driving a personal vehicle, although not everyone maintains this activity. Employment, race, family income, and seizures are strongly associated with RTD.
AB - Objective: Describe who is able to return to driving (RTD) after moderate-to-severe traumatic brain injury (TBI), when this occurs, who maintains that activity, and the association with outcome. Design: Cross-sectional descriptive study. Setting: Eight follow-up sites of the TBI Model Systems (TBIMS) program. Participants: 618 participants enrolled in the TBIMS and 88 caregivers (N=706). Interventions: Not applicable. Main Outcome Measures: A survey was completed from 1-30 years postinjury focusing on RTD. Descriptors included demographic information, injury severity, and current employment status. Outcome was assessed at the time of the interview, including depression, quality of life, functional status, and community participation. Results: Of 706 respondents, 78% (N = 552) RTD, but 14% (N = 77) of these did not maintain that activity. Of those who RTD, 43% (N = 192) did so within 6 months of the injury and 92% did so within 24 months postinjury. The percentage of people driving after TBI did not differ significantly based on age at time of injury or follow-up. There were significant differences between drivers and nondrivers with respect to severity of injury, seizures, race, education, employment, rural vs urban setting, marital status, and family income. We performed a multivariate logistic regression to examine the association between driving status and demographic variables, adjusting for other variables in the model. The strongest associations were with current employment, family income, race, seizures, and severity of injury. Driving was associated with greater community participation, better functional outcomes, fewer symptoms of depression, and greater life satisfaction. Conclusions: Over a span of 30 years, three-quarters of people experiencing moderate-to-severe TBI return to driving a personal vehicle, although not everyone maintains this activity. Employment, race, family income, and seizures are strongly associated with RTD.
KW - Automobile driving
KW - Brain injuries
KW - Brain injuries, traumatic
KW - Rehabilitation
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U2 - 10.1016/j.apmr.2021.02.006
DO - 10.1016/j.apmr.2021.02.006
M3 - Article
C2 - 33705772
AN - SCOPUS:85105462910
SN - 0003-9993
VL - 102
SP - 1568
EP - 1575
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 8
ER -
