a Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences , Monash University , Clayton , Victoria , Australia.
b Monash-Epworth Rehabilitation Research Centre , Richmond , Victoria , Australia.
Disabil Rehabil. 2019 Jun;41(11):1313-1320. doi: 10.1080/09638288.2018.1424955. Epub 2018 Jan 15.
To characterise on-road driving performance in individuals with traumatic brain injury who fail on-road driving assessment, compared with both those who pass assessment and healthy controls, and the injury and cognitive factors associated with driving performance.
Cross-sectional.
Forty eight participants with traumatic brain injury (Age M = 40.50 SD = 14.62, 77% male, post-traumatic amnesia days M = 28.74 SD =27.68) and 48 healthy matched controls completed a standardised on-road driving assessment in addition to cognitive measures.
Individuals with traumatic brain injury who passed on-road driving assessment performed no differently from controls while individuals with traumatic brain injury who failed the assessment demonstrated significantly worse driving performance relative to controls across a range of driving manoeuvres and error types including observation of on-road environment, speed control, gap selection, lane position, following distance and basic car control. Longer time post-injury and reduced visual perception were both significantly correlated with reduced driving skills.
This exploratory study indicated that drivers with traumatic brain injury who failed on-road assessment demonstrated a heterogeneous pattern of impaired driving manoeuvres, characterised by skill deficits across both operational (e.g., basic car control and lane position) and tactical domains (e.g., following distance, gap selection, and observation) of driving. These preliminary findings can be used for implementation of future driving assessments and rehabilitation programs. Implications for rehabilitation Clinicians should be aware that the majority of individuals with traumatic brain injury were deemed fit to resume driving following formal on-road assessment, despite having moderate to very severe traumatic brain injuries. Drivers with traumatic brain injury who failed an on-road assessment demonstrated a heterogeneous pattern of impaired skills including errors with observation, speed regulation, gap selection, and vehicle control and accordingly had difficulty executing a diverse range of common driving manoeuvres. Comprehensive, formal on-road assessments, incorporating a range of skills, and manoeuvres, are needed to evaluate readiness to return to driving following traumatic brain injury. Individually tailored driver rehabilitation programs need to address these heterogeneous skill deficits to best support individuals to make a successful return to driving post-traumatic brain injury.
与通过评估的人和健康对照组相比，描述在道路评估中失败的创伤性脑损伤患者的道路驾驶表现，并确定与驾驶表现相关的损伤和认知因素。
横断面研究。
48 名创伤性脑损伤患者（年龄 M = 40.50，标准差= 14.62，77%为男性，创伤后遗忘症天数 M = 28.74，标准差= 27.68）和 48 名健康匹配的对照者除了认知测试外，还完成了标准化的道路驾驶评估。
通过道路驾驶评估的创伤性脑损伤患者的表现与对照组没有不同，而未能通过评估的创伤性脑损伤患者在观察道路环境、速度控制、间隙选择、车道位置、跟车距离和基本车辆控制等一系列驾驶操作和错误类型方面表现出明显更差的驾驶表现，与对照组相比。受伤后时间较长和视觉感知能力下降与驾驶技能下降显著相关。
这项探索性研究表明，在道路评估中失败的创伤性脑损伤患者的驾驶操作存在异质性受损模式，表现为驾驶操作和战术领域（例如，跟车距离、间隙选择和观察）的基本车辆控制和车道位置）。这些初步发现可用于实施未来的驾驶评估和康复计划。康复的影响 临床医生应该意识到，尽管大多数创伤性脑损伤患者在经过正式的道路评估后被认为适合恢复驾驶，但他们都有中度至非常严重的创伤性脑损伤。在道路评估中失败的创伤性脑损伤患者表现出各种受损技能模式，包括观察、速度调节、间隙选择和车辆控制方面的错误，因此难以执行各种常见的驾驶操作。需要进行全面、正式的道路评估，包括一系列技能和操作，以评估创伤性脑损伤后重返驾驶的准备情况。需要制定个性化的驾驶员康复计划，以解决这些异质技能缺陷，以最好地支持个人在创伤性脑损伤后成功重返驾驶。
