Dammerer Dietmar, Waidmann Cornelia, Huber Dennis G, Krismer Martin, Haid Christian, Liebensteiner Michael C
Medical University of Innsbruck, Innsbruck, Austria.
Prosthet Orthot Int. 2017 Aug;41(4):373-378. doi: 10.1177/0309364616640925. Epub 2016 Apr 18.
The question whether or not a patient with a hip brace should drive a car is of obvious importance because the advice given to patients to resume driving is often anecdotal as few scientific data are available on this specific subject.
To assess driving ability (brake response time) with commonly used hip braces.
Repeated measures design.
Brake response time was assessed under six conditions: (1) without a brace (control), (2) with a typical postoperative hip brace with adjustable range of motion and the settings: unrestricted, (3) flexion limited to 70°, (4) extension blocked at 20° hip flexion, (5) both flexion and extension limited (20°/70°) and (6) an elastic hip bandage. Brake response time was assessed using a custom-made driving simulator as used in previous studies. The participants were a convenience sample of able-bodied participants.
A total of 70 participants (35 women and 35 men) participated in our study. Mean age was 31.1 (standard deviation: 10.6; range: 21.7-66.4) years. A significant within-subject effect for brake response time was found ( p = 0.009), but subsequent post hoc analyses revealed no significant differences between control and the other settings.
Based on our findings, it does not seem mandatory to recommend driving abstinence for patients wearing a hip orthosis. We suggest that our results be interpreted with caution, because (1) an underlying pathological hip condition needs to be considered, (2) the ability to drive a car safely is multifactorial and brake response time is only one component thereof and (3) brake response time measurements were performed only with healthy participants. Clinical relevance Hip braces are used in the context of joint-preserving and prosthetic surgery of the hip. Therefore, clinicians are confronted with the question whether to allow driving a car with the respective hip brace or not. Our data suggest that hip braces do not impair brake response time.
髋部支具佩戴者能否驾车这一问题显然至关重要,因为针对患者恢复驾车给出的建议往往多为轶事,关于这一特定主题的科学数据极少。
评估常用髋部支具的驾驶能力(制动反应时间)。
重复测量设计。
在六种情况下评估制动反应时间:(1)不佩戴支具(对照),(2)佩戴具有可调节活动范围且设置为无限制的典型术后髋部支具,(3)屈曲限制在70°,(4)在髋关节屈曲20°时伸展受阻,(5)屈曲和伸展均受限(20°/70°),以及(6)弹性髋部绷带。使用先前研究中使用的定制驾驶模拟器评估制动反应时间。参与者是健康参与者的便利样本。
共有70名参与者(35名女性和35名男性)参与了我们的研究。平均年龄为31.1岁(标准差:10.6;范围:21.7 - 66.4)。发现制动反应时间存在显著的受试者内效应(p = 0.009),但随后的事后分析显示对照与其他设置之间无显著差异。
基于我们的研究结果,对于佩戴髋部矫形器的患者,似乎没有必要强制建议禁止驾车。我们建议谨慎解读我们的结果,因为(1)需要考虑潜在的髋部病理状况,(2)安全驾驶汽车的能力是多因素的,制动反应时间只是其中一个组成部分,以及(3)制动反应时间测量仅在健康参与者中进行。临床相关性髋部支具用于髋关节保关节手术和假体手术。因此,临床医生面临是否允许佩戴相应髋部支具驾车的问题。我们的数据表明髋部支具不会损害制动反应时间。