Tremblay Marc-André, Corriveau Hélène, Boissy Patrick, Smeesters Cécile, Hamel Mathieu, Murray Jean-Christophe, Cabana François
Division of Orthopaedic Surgery, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
J Bone Joint Surg Am. 2009 Dec;91(12):2860-6. doi: 10.2106/JBJS.H.01633.
The effects of immobilization of the right lower limb on driving performance are unknown. Therefore, clinicians and legislators cannot put forth recommendations for road safety for patients requiring such immobilization. The objective of the present study was to evaluate the effect of two orthopaedic immobilization devices on the braking performances of healthy volunteers under simulated driving conditions.
The braking performances of forty-eight healthy volunteers were evaluated under three conditions: wearing a running shoe, wearing a walking cast, and wearing an Aircast Walker on the right lower limb. A computerized driving simulator was used to measure the maximum force applied on the brake pedal during braking as well as the braking reaction time and the total braking time during emergency braking with and without a distractor.
The mean braking forces applied with the shoe, the walking cast, and the Aircast Walker were 293.8, 275.4, and 287.2 lb (133.3, 124.9, and 130.3 kg), respectively. The value with the walking cast was significantly lower than that with the shoe or Aircast Walker (p < 0.0001); there was no difference between the shoe and the Aircast Walker. The adjusted mean braking reaction times during emergency braking without a distractor were 0.580 second (shoe), 0.609 second (cast), and 0.619 second (Aircast Walker). The value with the running shoe was significantly lower than that with either type of immobilization (p < or = 0.0001). With a distractor, the mean braking reaction time was shorter with the running shoe than it was with either form of immobilization (p < or = 0.0001); the mean time was also shorter with the walking cast than it was with the Aircast Walker (p = 0.003). During both emergency braking tasks (with and without a distractor), the mean total braking time was shorter with the shoe than it was with either type of immobilization (p < 0.0001). With a distractor, the adjusted mean total braking time was shorter with the walking cast than it was with the Aircast Walker (p = 0.035).
Immobilization of the right lower limb affects the braking force as well as the braking reaction time and total braking time during emergency braking by healthy volunteers. While these changes are significant, their impact on the ability to drive safely during emergency braking situations is questionable. Future research into the impact of such immobilization on the emergency braking performances of patients is warranted to confirm these observations.
右下肢固定对驾驶性能的影响尚不清楚。因此，临床医生和立法者无法为需要此类固定的患者提出道路安全方面的建议。本研究的目的是评估两种矫形固定装置在模拟驾驶条件下对健康志愿者制动性能的影响。
在三种情况下评估48名健康志愿者的制动性能：穿着跑鞋、穿着步行石膏以及右下肢穿着Aircast Walker。使用计算机化驾驶模拟器测量制动过程中施加在制动踏板上的最大力，以及在有和没有干扰因素的紧急制动过程中的制动反应时间和总制动时间。
穿着跑鞋、步行石膏和Aircast Walker时施加的平均制动力分别为293.8磅、275.4磅和287.2磅（133.3千克、124.9千克和130.3千克）。步行石膏时的值显著低于穿着跑鞋或Aircast Walker时的值（p<0.0001）；跑鞋和Aircast Walker之间没有差异。在没有干扰因素的紧急制动过程中，调整后的平均制动反应时间分别为0.580秒（跑鞋）、0.609秒（石膏）和0.619秒（Aircast Walker）。穿着跑鞋时的值显著低于任何一种固定方式时的值（p≤0.0001）。有干扰因素时，穿着跑鞋的平均制动反应时间比任何一种固定方式时都短（p≤0.0001）；穿着步行石膏时的平均时间也比穿着Aircast Walker时短（p = 0.003）。在两种紧急制动任务（有和没有干扰因素）中，穿着跑鞋时的平均总制动时间比任何一种固定方式时都短（p<0.0001）。有干扰因素时，调整后的平均总制动时间穿着步行石膏时比穿着Aircast Walker时短（p = 0.035）。
右下肢固定会影响健康志愿者在紧急制动过程中的制动力、制动反应时间和总制动时间。虽然这些变化很显著，但它们对紧急制动情况下安全驾驶能力的影响值得怀疑。有必要对这种固定对患者紧急制动性能的影响进行进一步研究以证实这些观察结果。
