Sansosti Laura E, Rocha Zinnia M, Lawrence Matthew W, Meyr Andrew J
Resident, Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.
Student, Temple University School of Podiatric Medicine, Philadelphia, PA.
J Foot Ankle Surg. 2016 Sep-Oct;55(5):999-1002. doi: 10.1053/j.jfas.2016.05.010. Epub 2016 Jul 18.
The effect of lower extremity pathologic features and surgical intervention on automobile driving function has been a topic of contemporary interest in the orthopedic medical literature. The objective of the present case-control investigation was to assess 3 driving outcomes (i.e., mean emergency brake response time, frequency of abnormally delayed brake responses, and frequency of inaccurate brake responses) in a group of participants with 3 variable footwear conditions (i.e., regular shoe gear, surgical shoe, and walking boot). The driving performances of 25 participants without active right-sided lower extremity pathology were evaluated using a computerized driving simulator. Both the surgical shoe (0.611 versus 0.575 second; p < .001) and the walking boot (0.736 versus 0.575 second; p < .001) demonstrated slower mean brake response times compared with the control shoe gear. Both the surgical shoe (18.5% versus 2.5%; p < .001) and the walking boot (55.5% versus 2.5%; p < .001) demonstrated more frequent abnormally delayed brake responses compared with the control shoe gear. The walking boot (18.0% versus 2.0%; p < .001) demonstrated more frequent inaccurate brake responses compared with the control shoe gear. However, the surgical shoe (4.0% versus 2.0%; p = .3808) did not demonstrate a difference compared with the control shoe gear. The results of the present investigation provide physicians working with the lower extremity with a better understanding on how to assess the risk and appropriately advise their patients who have been prescribed lower extremity immobilization devices with respect to the safe operation of an automobile.
下肢病理特征和手术干预对汽车驾驶功能的影响一直是骨科医学文献中当下关注的话题。本病例对照研究的目的是评估一组参与者在三种不同鞋类条件（即常规鞋具、手术鞋和步行靴）下的三种驾驶结果（即平均紧急制动反应时间、异常延迟制动反应的频率和不准确制动反应的频率）。使用计算机驾驶模拟器对25名无右侧下肢活动性病变的参与者的驾驶性能进行了评估。与对照鞋具相比，手术鞋（0.611秒对0.575秒；p <.001）和步行靴（0.736秒对0.575秒；p <.001）的平均制动反应时间均较慢。与对照鞋具相比，手术鞋（18.5%对2.5%；p <.001）和步行靴（55.5%对2.5%；p <.001）的异常延迟制动反应频率更高。与对照鞋具相比，步行靴（18.0%对2.0%；p <.001）的不准确制动反应频率更高。然而，手术鞋（4.0%对2.0%；p = 0.3808）与对照鞋具相比未显示出差异。本研究结果为从事下肢治疗的医生提供了更好的理解，以便他们评估风险，并就下肢固定装置使用者安全驾驶汽车的问题向患者提供适当建议。
