Evaluation of driving resumption after acquired brain damage: Garches's experiment

Abstract

To describe the assessment of driving abilities practices after acquired brain damage, and the factors associated with driving resumption. Fifty-six traumatic brain injury (TBI) and stroke participants assessed, between 2010 and 2013, from the multidisciplinary consultation of R.-Poincaré hospital (Garches), associating a medical evaluation, to eliminate possible contraindication of driving resumption and estimate the need of vehicle adaptation, a neuropsychologic assessment, and a road test. Study of personal (gender, age, level of studies, driving experience), medical (pathology, time since the accident, duration of coma or post-traumatic amnesia), functional (vehicle adaptation needed) and cognitive (results of neuropsychological tests) factors, being able to influence the ability of driving resumption. Of the 56 patients, 34 (61%) were found suitable to resume driving, at the end of their evaluation. This study advances the impact of several factors on the capacities of driving resumption after acquired brain damage: time since the cerebral accident; severity of the TBI; functional sequelae requiring vehicle adaptations; cognitive disorders. The patients found suitable after the road test, obtained performances significantly better during the neuropsychologic assessment, unless no test, individually considered, allows predicting, in an infallible way, the final result. The measures of time answers in the neuropsychologic tests are the most sensitive. This study consolidates the importance of a global evaluation, associating a road test with the clinical, functional and cognitive evaluations, to appreciate the ability of driving resumption after acquired brain injury.