Driving After Traumatic Brain Injury: Evaluation and Rehabilitation Interventions

Schultheis, Maria T.; Whipple, Elizabeth Kathryn

doi:10.1007/s40141-014-0055-0

Cited by 26 publications

(17 citation statements)

References 33 publications

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“…These include studies of measures of driving capacity [8,10,11], rates of traffic accidents [12][13][14], the predictive validity of neuropsychological [7,9] or functional tests for return to driving [4], and the impact of TBI-related cognitive impairment on driving outcomes [1][2][3]6,12]. This research has yielded complex and sometimes-contradictory findings, summarized in several literature reviews [1,6,7], but leaves little question that TBI-related deficits often affect driving adversely. Indeed, the association between TBI and driving problems commonly is assumed [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Self‐Reported Driving Difficulty in Veterans With Traumatic Brain Injury: Its Central Role in Psychological Well‐Being

Winter

Moriarty

Short

2017

PM&R

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Section: Introductionmentioning

confidence: 99%

Self‐Reported Driving Difficulty in Veterans With Traumatic Brain Injury: Its Central Role in Psychological Well‐Being

Winter

Moriarty

Short

2017

PM&R

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“…On-road Driving -The "Gold Standard" measure Whilst a variety of tests can be used to inform decisions about whether to revoke a driving licence Hird et al, 2014;Schultheis & Whipple, 2014), the primary decisionmaking tool remains in many cases the on-road driving test (Di Stefano & MacDonald, 2012;Dickerson, 2013;Ranchet et al, 2016;Ross et al, 2016). The advantages of real-world driving tests are fairly clear -the driver has to be able to demonstrate safe and appropriate behaviours when navigating real streets, interacting with other vehicles as well as vulnerable road users (Joanne M. Wood, Lacherez, & Tyrrell, 2014;Joanne M. Wood, Marszalek, Carberry, Lacherez, & Collins, 2015), and carry out a variety of tasks such as lane keeping and obeying traffic rules when driving at both fast (motorway) and slow (urban and parking) speeds.…”

Section: Testing Visual Function For Drivingmentioning

confidence: 99%

Looking to the future of visual assessment using driving simulation

Wilkie

Mole

2017

Scand J Optom Vis Sci

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Visual function is considered uniquely important for driving because it provides multiple critical sources of information that when combined ensures successful steering. There are, however, additional cognitive functions that are essential for the driver to be able to dynamically respond to the world and make predictions about the scene, as well as the behaviour of other road users. Given the complexity of driving through a busy urban environment it should be no surprise that simple tests of visual acuity seem to have weak explanatory power in terms of increased crash risk when driving. Despite this, fitness to drive still includes a formal assessment of visual acuity, with poor scores being used to revoke the driving licence. The "gold standard" measure of driving ability remains the on-road driving test but compared to visual tests they are fairly uncontrolled, susceptible to great variation depending on the road conditions, and are unable to reliably detect subtle visual deficits. To address some of the limitations of these existing tests we use examples from two simulator settings (steering control and hazard detection) that highlight the merits of using driving simulation in order to control the visual conditions and probe specific functional capabilities of drivers. When used in conjunction with visual tests these methods will not only determine whether the core functions of driving are intact but also be able to provide richer feedback to individuals about the nature of their deficits. There are many exciting possibilities using simulation techniques to establish predictive relationships between routine visual testing and driving performance, ultimately aiming for better, more reliable assessment of fitness to drive. SammendragSynsfunksjonen betraktes som enestående viktig for bilkjøring fordi den bidrar til flere kritiske informasjonskilder som sammen sikrer trygg kontroll av bilen. Men det finnes i tillegg andre kognitive funksjoner som er nødvendige for at en bilfører skal kunne reagere dynamisk og kunne forutse både hendelser i trafikkbildet og andre trafikanters handlinger. Tatt i betraktning kompleksiteten av å kjøre i trafikkerte, tettbygde strøk, er det ikke overraskende at en enkel test av synsstyrke sjelden kan forklare fullstendig risikoen for kollisjoner ved bilkjøring. Til tross for dette brukes fortsatt synsstyrke som et mål i den formelle undersøkelsen når man skal avgjøre om en person er egnet til å føre motorvogn, og dårlige resultater på synstesten fører til inndragelse av førerkortet. Kjøreevne måles fortsatt med praktisk prøve, men sammenlignet med tester av synsfunksjonen er disse prøvene vanskelige å kontrollere, sterkt varierende avhengig av veiforholdene, og ikke i stand til å avsløre små synsdefekter. For å studere noen av begrensningene ved disse eksisterende prøvene bruker vi eksempler fra to simulatorsettinger (styrekontroll og evne til å oppdage fare) som viser fordelene med å bruke kjøresimulator for å kontrollere synsforholdene og teste bestemte funkjonelle ferdighet...

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“…A recent survey of adult drivers found that those with a lifetime history of TBI have significantly higher odds of involvement in aggressive driving and serious MVAs within the previous 12 mo when compared to non-TBI drivers [9]. TBI can affect many areas of cognition necessary for safe driving, including planning, inhibition, attentional allocation, insight, memory, and information processing speed [10]. Moreover, TBI can result in physical symptoms (e.g., headaches, blurred vision, photophobia) that can challenge safe driving [11].…”

Section: Combat Veterans Of Iraq and Afghanistan (Operation Iraqi Frementioning

confidence: 99%

Preliminary findings of a novel measure of driving behaviors in Veterans with comorbid TBI and PTSD

2016

Self Cite

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Abstract-Veterans of the military operations in Iraq andAfghanistan are at an elevated risk of driving-related accidents and fatalities compared with civilians. Combat exposure, military driving training, risk-seeking, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) are all factors associated with driving-related risk. However, few empirical studies have observed driving patterns in this population, and the influence of these contributing factors remains unclear. This study utilized a novel self-report measure to assess driving behaviors, driving-related anxiety, and emotional experiences of military Veterans who have returned to civilian driving. This questionnaire was completed by 23 combat Veterans diagnosed with comorbid TBI and PTSD and 10 nondisabled combat Veterans. Drivers with TBI and PTSD reported more frequent high-risk driving behaviors and higher levels of anxiety while driving in certain situations than nondisabled combat Veterans. These preliminary findings highlight the importance of studying on-the-road situations and cues that produce anxiety in Veterans, particularly those with TBI and PTSD. A greater understanding of driving-related anxiety is needed to inform targeted and effective interventions for unsafe driving in Veterans.

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Driving After Traumatic Brain Injury: Evaluation and Rehabilitation Interventions

Cited by 26 publications

References 33 publications

Self‐Reported Driving Difficulty in Veterans With Traumatic Brain Injury: Its Central Role in Psychological Well‐Being

Self‐Reported Driving Difficulty in Veterans With Traumatic Brain Injury: Its Central Role in Psychological Well‐Being

Looking to the future of visual assessment using driving simulation

Preliminary findings of a novel measure of driving behaviors in Veterans with comorbid TBI and PTSD

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