Model System:

TBI

Reference Type:

Journal

Accession No.:

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

, Epub, ,

Abstract:

Objective: Describe who returns to driving (RTD) after moderate-to-severe traumatic brain injury (TBI), when this occurs, who maintains that activity, and association with outcome.

Design: Cross-sectional descriptive.

Setting: Eight follow-up sites of the TBI Model System (TBI MS) program.

Participants: 618 participants enrolled in the TBI MS and 88 caregivers.

Intervention: None.

Measurements: A survey was completed from 1 to 30 years post injury focusing on RTD. Descriptors included demographic information, injury severity, and current employment status. Outcome was assessed at the time of the interview, including depression, quality of life, functional status, and community participation.

Results: Of 706 respondents, 78% RTD, but 14% of these did not maintain that activity. Of those who RTD, 42% did so within 6 months of the injury, and 90% did so within 24 months post-injury. The percentage of people driving after TBI did not differ significantly based on age at time of injury or follow-up. There were significant differences between drivers and non-drivers with respect to severity of injury, seizures, race, education, employment, rural versus urban setting, marital status, and family income. A multivariable logistic regression analysis was performed to examine the association between driving status and demographic variable, adjusting for other variable in the model. The strongest associations were with current employment, family income, race, seizures, and severity of injury. Driving was associated with greater in community participation , better functional outcomes, fewer symptoms of depression, and greater life satisfaction.

Conclusion: Over a span of 30 years, three-quarters of people experiencing moderate-to-severe TBI return to driving a personal vehicle, although not everyone maintains this activity. Employment, race, family income, and seizures are strongly associated with RTD.

Author(s):

Thomas A Novack, Yue Zhang, Richard Kennedy, Lisa J Rapport, Thomas K Watanabe, Kimberley R Monden, Laura E Dreer, Thomas Bergquist, Charles Bombardier, Robert Brunner, Yelena Goldin, Jennifer Marwitz, Janet P Niemeier