Does Immobilization Affect Braking Time?

Abstract

Background: Despite the importance to patients of driving, no well-established guideline exists to help either the patient or the physician determine when it is safe for the patient to return to driving. Previous studies have recommended 6 weeks postoperatively before patients can return to driving safely. Several scientific studies have found the nationally recommended safe brake time standard to be 1.25 sec (1,250 msec), looking at brake reaction time (BRT) in all types of patients, surgical and nonsurgical. Methods: This is a prospective study assessing BRT after individuals are placed in various forms of immobilization (controlled action motion [CAM] boot, surgical shoe). The study also tested whether BRT is different when using the left foot to brake, with immobilization of the right foot. Results: All 29 male and 71 female participants in this study (mean age, 35.49 years) were capable of driving and were not currently being treated for any foot or ankle conditions. No differences were found regarding age, sex, and use of assistive devices. The mean BRT while wearing a CAM boot was 713 msec, while using the left foot to brake (CAM boot on the right foot) was 593.86 msec, and while wearing a surgical shoe was 626.32 msec. Conclusions: Although most of the study participants were below the nationally recommended safe brake time standard, it was found that not all of the participants fell within these parameters.

Return to driving post upper or lower extremity orthopaedic surgical procedures: a scoping review of current published literature

“…In total, 68 studies were identified meeting our study aims and inclusion criteria for both upper and lower extremity procedures ( Fig. 1 , Table 1 , Supplementary Tables 1 and 2) ( 1 , 14 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ). There was a wide variation in procedures performed and sample size, the study methodology, and measurements obtained.…”

“…There were 36 lower extremity studies included in the review ( 4 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ) A total of 1021 patients were assessed, with 1006 having right-sided procedures and 15 left-sided procedures. The summary of these data is presented in Supplementary Table 1.…”

“…Two articles assessed BRT, RT, BT, and TBT while patients wore a controlled ankle motion (CAM) brace, and both advised patients should not drive while wearing this device ( 39 , 40 ). Orr et al demonstrated a mean TBRT of 571 ms ( s.d.…”

“…136) for the CAM brace group, with a significantly slower TBRT in the CAM group ( P < 0.05) ( 39 ). Schick et al demonstrated a mean BRT of 713 ms for CAM boot usage and 593.86 ms while using the left foot to brake while wearing the CAM boot ( 40 ). CAM groups were significantly slower than the control of 1250 ms ( P = 0.0001–0.0011).…”

“…Two articles assessed driving while wearing a stiff surgical shoe utilising BRT as the primary outcome measure ( 40 , 47 ). They advised slower braking times were found in this device, no specific recommendations were given by Sansosti et al ; however, Schick et al advised that patients in any form of immobilisation device should not drive as they may fall outside of nationally recognised safe parameters ( 40 , 47 ).…”