Ross Pamela E, Ponsford Jennie L, Di Stefano Marilyn, Spitz Gershon
Occupational Therapy Department, Epworth HealthCare, Melbourne, Australia.
School of Psychology and Psychiatry, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Melbourne, Victoria, Australia.
Arch Phys Med Rehabil. 2015 Mar;96(3):440-6. doi: 10.1016/j.apmr.2014.09.027. Epub 2014 Oct 12.
To examine assessment outcomes and factors associated with passing an occupational therapy (OT) on-road driver assessment after traumatic brain injury (TBI).
Retrospective analysis of outcomes of on-road driver assessment completed by persons with TBI over an 8-year period.
Inpatient and outpatient rehabilitation hospital.
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.
Not applicable.
Outcome of on-road driver assessment.
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.
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.
研究创伤性脑损伤（TBI）后通过职业治疗（OT）道路驾驶评估的评估结果及相关因素。
对TBI患者在8年期间完成的道路驾驶评估结果进行回顾性分析。
住院和门诊康复医院。
连续抽取207例轻度至重度TBI患者，这些患者完成了道路驾驶评估且在受伤后至少3个月接受了评估。
不适用。
道路驾驶评估结果。
在TBI驾驶员中，66%（n = 137）通过了初次道路驾驶评估（通过组），而34%（n = 70）需要道路驾驶康复和/或≥1次道路评估（康复组）。在驾驶员康复后，该组中只有3名参与者没有恢复驾驶。男性、创伤后遗忘（PTA）持续时间较短、无身体和/或视力障碍且反应时间较快的参与者更有可能属于通过组。综合起来，这些变量正确分类了87.6%的通过组和71.2%的康复组。
事实证明，PTA持续时间比格拉斯哥昏迷量表评分更能预测驾驶员评估结果。结合身体/视力障碍的存在和反应时间减慢，PTA可以帮助临床医生确定OT驾驶员评估的转诊标准。道路驾驶康复后进行道路重新评估与TBI后恢复驾驶的高概率相关。
