title: Return to driving after lower-extremity amputation.
abstract: OBJECTIVE
  To study driving behaviors after major lower-extremity amputations and to determine which factors influence return to driving after amputation.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Data were collected from patients attending an outpatient amputee and prosthetics clinic between February 2001 and September 2001.
  
  
  METHODS
  A convenience sample (N=123). Inclusion criteria were: age greater than 18 years, unilateral or bilateral major lower-extremity amputation, minimum 1 year since prosthetic fitting, and active automobile driver within 6 months prior to amputation. Subjects had an average age of 63.4+/-12.1 years and were on average 6.8+/-8.3 years since amputation. Common causes for amputation were peripheral vascular disease (73.2%), trauma (13.8%), and tumor (12.2%).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Driving habits after lower-extremity amputation.
  
  
  RESULTS
  Overall, 80.5% of participants were able to return to driving an average of 3.8 months after amputation, although the majority reported a decreased driving frequency. Female sex (odds ratio [OR]=.08; 95% confidence interval [CI], .02-.34), age of 60 years or greater (OR=.16; 95% CI, .03-.74), right-sided amputation (OR=.13; 95% CI, .03-.52), and preamputation driving frequency of less than every day (OR=.18; 95% CI, .05-.69) were all significantly related to a reduced likelihood of return to driving postamputation. Items that did not have a statistically significant association with return to driving included level of amputation, reason for amputation, preamputation automobile transmission, and accessibility to public transit. Subjects with left-sided amputation had significantly fewer concerns about driving, while those with a right amputation frequently required vehicle modifications (40.6%) or switch to a left-foot driving style for braking (81.3%) and accelerating (65.6%). Common barriers to return to driving included preference not to drive, fear and/or lack of confidence, and related medical conditions.
  
  
  CONCLUSIONS
  The majority of subjects with major lower-extremity amputation were able to return to driving after major lower-extremity amputation. Major automobile modifications are commonly performed by right-sided amputees. Several predictors of return to driving and barriers preventing return to driving were identified.
authors.affiliation: Division of Physiatry, Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Boulias
authors.forename: Ben
authors.initials: B
authors.lastname: Meikle
authors.forename: Tim
authors.initials: T
authors.lastname: Pauley
authors.forename: Michael
authors.initials: M
authors.lastname: Devlin
mesh_terms: D000368:Aged; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D001334:Automobile Driving / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013997:Time Factors