Catherine C McDonald1, Divya Jain2, Eileen P Storey3, Madeline Gonzalez3, Christina L Master4, Kristy B Arbogast5. 1. School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Penn Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: mcdonalc@nursing.upenn.edu. 2. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania. 3. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 4. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Orthopedics, Sports Medicine and Performance Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 5. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Abstract
PURPOSE: Although return to learn, exercise, and sports have evidence-based guidelines, there is limited research investigating return to driving after concussion. The purpose was to characterize and compare adolescent driving behaviors after concussion. METHODS: Using the Minds Matter Concussion Registry, we queried data of adolescents, aged 16-19 years, diagnosed with a concussion ≤28 days of injury and seen between January 31, 2017 and August 31, 2018 at the specialty care concussion program. Outcomes included patient report of: changes postinjury driving behaviors; Post-Concussion Symptom Inventory; return to school, and exercise and sports. Provider recommendations for return to school after initial clinical assessment were also examined. Descriptive statistics, analysis of covariance, and chi-square tests were performed. RESULTS: Of the 332 drivers (46.1% female; mean age 17.5 years, 95% confidence interval [CI], 17.4-17.6), 46.9% had returned to driving since injury. Of those who returned to driving, 58.9% reported "Driving with No Changes." The Post-Concussion Symptom Inventory score was higher among "Driving with Changes" (48.7, 95% CI: 42.2-55.2) than "Driving with No Changes" (27.4, 95% CI: 22.3-32.5, p < .01) and "Has Not Driven Since Injury" (42.3, 95% CI: 38.4-46.3, p < .01). Among the 332 drivers, few had returned to exercise (15.4%) or organized sports (6.0%). Of those in school (n = 291), only 8.9% were provider recommended to return to full school days after clinical assessment. CONCLUSION: Many adolescents continued to drive after concussion, despite not yet having returned to exercise or sport. Nine of 10 were advised to return to school with accommodations to begin a gradual increase in cognitive activity, suggesting a gradual increase in driving may be justified.
PURPOSE: Although return to learn, exercise, and sports have evidence-based guidelines, there is limited research investigating return to driving after concussion. The purpose was to characterize and compare adolescent driving behaviors after concussion. METHODS: Using the Minds Matter Concussion Registry, we queried data of adolescents, aged 16-19 years, diagnosed with a concussion ≤28 days of injury and seen between January 31, 2017 and August 31, 2018 at the specialty care concussion program. Outcomes included patient report of: changes postinjury driving behaviors; Post-Concussion Symptom Inventory; return to school, and exercise and sports. Provider recommendations for return to school after initial clinical assessment were also examined. Descriptive statistics, analysis of covariance, and chi-square tests were performed. RESULTS: Of the 332 drivers (46.1% female; mean age 17.5 years, 95% confidence interval [CI], 17.4-17.6), 46.9% had returned to driving since injury. Of those who returned to driving, 58.9% reported "Driving with No Changes." The Post-Concussion Symptom Inventory score was higher among "Driving with Changes" (48.7, 95% CI: 42.2-55.2) than "Driving with No Changes" (27.4, 95% CI: 22.3-32.5, p < .01) and "Has Not Driven Since Injury" (42.3, 95% CI: 38.4-46.3, p < .01). Among the 332 drivers, few had returned to exercise (15.4%) or organized sports (6.0%). Of those in school (n = 291), only 8.9% were provider recommended to return to full school days after clinical assessment. CONCLUSION: Many adolescents continued to drive after concussion, despite not yet having returned to exercise or sport. Nine of 10 were advised to return to school with accommodations to begin a gradual increase in cognitive activity, suggesting a gradual increase in driving may be justified.
Authors: Paul McCrory; Willem Meeuwisse; Jiří Dvořák; Mark Aubry; Julian Bailes; Steven Broglio; Robert C Cantu; David Cassidy; Ruben J Echemendia; Rudy J Castellani; Gavin A Davis; Richard Ellenbogen; Carolyn Emery; Lars Engebretsen; Nina Feddermann-Demont; Christopher C Giza; Kevin M Guskiewicz; Stanley Herring; Grant L Iverson; Karen M Johnston; James Kissick; Jeffrey Kutcher; John J Leddy; David Maddocks; Michael Makdissi; Geoff T Manley; Michael McCrea; William P Meehan; Shinji Nagahiro; Jon Patricios; Margot Putukian; Kathryn J Schneider; Allen Sills; Charles H Tator; Michael Turner; Pieter E Vos Journal: Br J Sports Med Date: 2017-04-26 Impact factor: 13.800
Authors: Leah J Frommer; Kelly K Gurka; Kevin M Cross; Christopher D Ingersoll; R Dawn Comstock; Susan A Saliba Journal: J Athl Train Date: 2011 Jan-Feb Impact factor: 2.860
Authors: John A Lucas; Justin B Moore; Stephen Davis; Johnell O Brooks; Christopher Miles Journal: Br J Sports Med Date: 2018-03-12 Impact factor: 13.800