title: Fitness-to-drive after mild traumatic brain injury: mapping the time trajectory of recovery in the acute stages post injury.
abstract: BACKGROUND
  Little is known about the trajectory of recovery in fitness-to-drive after mild traumatic brain injury (mTBI). This means that health-care professionals have limited evidence on which to base recommendations to this cohort about driving.
  
  
  OBJECTIVE
  To determine fitness-to-drive status of patients with a mTBI at 24h and two weeks post injury, and to summarise issues reported by this cohort about return to driving.
  
  
  METHODS
  Quasi-experimental case-control design. Two groups of participants were recruited: patients with a mTBI (n=60) and a control group with orthopaedic injuries (n=60). Both groups were assessed at 24h post injury on assessments of fitness-to-drive. Follow-up occurred at two weeks post injury to establish driver status.
  
  
  METHODS
  Mini mental state examination, occupational therapy-drive home maze test (OT-DHMT), Road Law Road Craft Test, University of Queensland-Hazard Perception Test, and demographic/interview form collected at 24h and at two weeks.
  
  
  RESULTS
  At the 24h assessment, only the OT-DHMT showed a difference in scores between the two groups, with mTBI participants being significantly slower to complete the test (p=0.01). At the two week follow-up, only 26 of the 60 mTBI participants had returned to driving. Injury severity combined with scores from the 24h assessment predicted 31% of the variance in time taken to return to driving. Delayed return to driving was reported due to: "not feeling 100% right" (n=14, 23%), headaches and pain (n=12, 20%), and dizziness (n=5, 8%).
  
  
  CONCLUSIONS
  This research supports existing guidelines which suggest that patients with a mTBI should not to drive for 24h; however, further research is required to map factors which facilitate timely return to driving.
authors: Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia.
authors: Anne
authors: A
authors: Baker
authors: Faculty of Health Sciences, La Trobe University, Victoria, Australia; Department of Occupational Therapy, Central Queensland University, Victoria, Australia; Department of Rehabilitation, School of Health Sciences, Jönköping University, Sweden; Department of Occupational Therapy, Curtin University, Perth, Australia.
authors: Carolyn A
authors: CA
authors: Unsworth
authors: Faculty of Health Sciences, La Trobe University, Victoria, Australia; Department of Occupational Therapy, Alfred Health, Victoria, Australia; Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Australia. Electronic address: anne.baker@monash.edu.
authors: Natasha A
authors: NA
authors: Lannin
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D001334:Automobile Driving / Q000523:psychology*; D001924:Brain Concussion / Q000503:physiopathology* / Q000534:rehabilitation*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010809:Physical Fitness / Q000523:psychology*; D020127:Recovery of Function; D013997:Time Factors; D055815:Young Adult
keywords: Acute care; Fitness-to-drive; Mild traumatic brain injury