Longitudinal Assessment of Post-Concussion Driving (LAPD)
Upwards of 3.8 million concussions occur annually in the United States. Concussed individuals are slower to identify hazards and present poorer vehicle control throughout full symptom recovery. There is a critical need to determine when concussed individuals should return to driving and to identify the key concussion assessment predictors of readiness to return to driving.
These results will have a broad and positive impact that will improve the safety of both concussed individuals and the general population, guide the practices of health professionals, inform the future work of researchers, and substantiate the work of policy-makers by providing evidence-based recommendations for managing post-concussion driving.
- Sponsor
National Institutes of Health to Emory University Georgia Clinical and Translational Science Alliance
$58,048 - Principal investigator
Julianne D. Schmidt
Associate Professor, Kinesiology - Co-principal investigators
Hannes Devos
Assistant Professor, University of Kansas Medical Center
Russell Gore )
Medical Director, Vestibular Neurology at Shepherd Center & SHARE Military Initiative; Adjunct Associate Professor, Wallace H. Coulter Department of Biomedical Engineering; Director, Complex Concussion Clinic Georgia Tech and Emory University
Robert C. Lynall
Assistant Professor, Kinesiology L. Stephen Miller
Professor and Department Head, University of Georgia - Active since
July 2020
Abstract
Despite emergent concerns over post-concussion driving safety, documented driving impairment, and reports of feeling unsafe driving after a concussion, only 44% of concussed individuals reduce their driving at any point. Those that do reduce their driving only do so for 24-48 hours following the injury. Driving is a highly complicated activity that requires the timely interaction of visual, motor, and cognitive skills to adequately respond to a dynamic, constantly changing environment. Concussed individuals are slower to identify hazards and present poorer vehicle control throughout the full symptom recovery. There is a critical need to determine when concussed individuals should return to driving and to identify the key concussion assessment predictors of readiness to return to driving.
In the absence of formal recommendations, impaired concussed drivers are a risk to themselves and others on the road. Therefore, the first specific aim is to compare simulated driving between concussed individuals and non-concussed yoked matched controls throughout concussion recovery (within 48 hours, asymptomatic, and unrestricted medical clearance) and daily naturalistic driving during the subacute period (asymptomatic to unrestricted medical clearance). Though post-concussion impairments may negatively influence driving performance, it is also important to consider the psychosocial implications of driving restrictions.
Driving restrictions must be appropriate and necessitated by concussion impairments since excessive restrictions wrongfully strip concussed patients of their independence and may dissuade individuals from seeking medical care, as evidenced by our prior work. Therefore, the second specific aim of this study is to identify concussion assessment outcomes that predict simulated driving performance among concussed individuals throughout concussion recovery.
To address these aims, concussed and yoked matched control collegiate athletes will complete a simulated driving assessment and a robust concussion assessment battery within 48 hours, at asymptomatic and at unrestricted medical clearance. Naturalistic driving (measured with global positioning systems) will be captured from asymptomatic to unrestricted medical clearance. This study will determine the acute and subacute time course of post-concussion driving impairment and determine key predictors of post-concussion driving performance. These results will have a broad and positive impact that will improve the safety of both concussed individuals and the general population, guide the practices of health professionals, inform the future work of researchers, and substantiate the work of policy-makers by providing evidence-based recommendations for managing post-concussion driving.