title: Effect of Variable Lower Extremity Immobilization Devices on Emergency Brake Response Driving Outcomes.
abstract: The effect of lower extremity pathologic features and surgical intervention on automobile driving function has been a topic of contemporary interest in the orthopedic medical literature. The objective of the present case-control investigation was to assess 3 driving outcomes (i.e., mean emergency brake response time, frequency of abnormally delayed brake responses, and frequency of inaccurate brake responses) in a group of participants with 3 variable footwear conditions (i.e., regular shoe gear, surgical shoe, and walking boot). The driving performances of 25 participants without active right-sided lower extremity pathology were evaluated using a computerized driving simulator. Both the surgical shoe (0.611 versus 0.575 second; p < .001) and the walking boot (0.736 versus 0.575 second; p < .001) demonstrated slower mean brake response times compared with the control shoe gear. Both the surgical shoe (18.5% versus 2.5%; p < .001) and the walking boot (55.5% versus 2.5%; p < .001) demonstrated more frequent abnormally delayed brake responses compared with the control shoe gear. The walking boot (18.0% versus 2.0%; p < .001) demonstrated more frequent inaccurate brake responses compared with the control shoe gear. However, the surgical shoe (4.0% versus 2.0%; p = .3808) did not demonstrate a difference compared with the control shoe gear. The results of the present investigation provide physicians working with the lower extremity with a better understanding on how to assess the risk and appropriately advise their patients who have been prescribed lower extremity immobilization devices with respect to the safe operation of an automobile.
authors.affiliation: Resident, Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Sansosti
authors.affiliation: Student, Temple University School of Podiatric Medicine, Philadelphia, PA.
authors.forename: Zinnia M
authors.initials: ZM
authors.lastname: Rocha
authors.affiliation: Student, Temple University School of Podiatric Medicine, Philadelphia, PA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Lawrence
authors.affiliation: Clinical Associate Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA. Electronic address: ajmeyr@gmail.com.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Meyr
mesh_terms: D000328:Adult; D001334:Automobile Driving; D016022:Case-Control Studies; D004630:Emergencies; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation*; D007869:Leg Injuries / Q000534:rehabilitation; D035002:Lower Extremity / Q000293:injuries*; D008297:Male; D061214:Patient Safety; D012656:Self-Help Devices; D012775:Shoes; D000066908:Simulation Training / Q000379:methods*; D055815:Young Adult
keywords: braking time; immobilization; reaction time; safe driving; surgical shoe; walking boot