Multicenter case-control study of driving behaviors 2–3 years after traumatic brain injury rehabilitation

Abstract

Of major importance for the social participation of adults with traumatic brain injury (TBI) is the possibility to drive. Return to safe driving is usually addressed during rehabilitation, but we know little about driving abilities and behaviours in the years following TBI. The aim of this study was to evaluate if individuals with a TBI having passed a driving evaluation differed, in terms of self-reported driving behaviours and documented driving offences, from those who did not undergo a driving evaluation, and from normal controls. A total of 162 adults aged 18–60 years old participated in this study: 48 with mild/moderate/severe TBI whose license was suspended after injury and reinstated following a driving evaluation during outpatient rehabilitation (TBI-DE) and 24 with TBI who maintained their driving privileges without undergoing a driving evaluation (TBI-NE), recruited from 6 rehabilitation centers, 2–3 years after rehabilitation; 90 normal control participants paired for age, sex and geographical region, recruited from the general population. Self-reported driving abilities and habits, driving anger expression, driving sensation seeking, breach of rules of driving, and driving accidents and offences were measured during a telephone interview. Objective driving offences were obtained from the Quebec Automobile Insurance Board with participants’ consent. The TBI-DE group included significantly more individuals with moderate and severe TBI than the TBI-NE group, and reported significantly lower scores for verbal expression of anger and use of vehicle to express anger compared to controls. However, the TBI-DE group presented significantly more objective driving offences before their TBI and more demerit points after their TBI than the control group. Also, a significantly higher frequency of serious accidents was documented in the TBI-DE group compared to other groups. Self-perceived risky driving behaviours may be underestimated by some individuals with TBI and should be specifically addressed during and after rehabilitation.