Post-concussion Driving Management Practices Among Certified Athletic Trainers

Abstract

Abstract Purpose To describe post-concussion driving management practices and opinions among athletic trainers (ATs) and to compare practices across highest earned degree, setting, and years certified. Methods A survey weblink was emailed to a convenience sample of 8,723 ATs (10.8% response rate [945/8723]; years certified=14.5±10.7; years worked clinically=12.4±9.4). The validated survey captured AT driving management practices and opinions (agreement on a seven-point Likert scale). We compared the percentage of patients instructed to refrain from driving across highest earned degree, setting, and years certified using Kruskal-Wallis tests (alpha=0.05). Results When asked whether they recommended concussed patients refrain from driving, 58.5% of ATs responded “sometimes” (n=553/945), 37.9% responded “always” (n=358/945), and 3.6% responded “never” (n=34/945). ATs most commonly: recommended patients refrain from driving until symptom resolution (44.7%, n=399/892); utilized their clinical exam to determine readiness to return-to-drive (64.9%, n=579/892); and provided instructions verbally (94.2%, n=840/892). ATs agreed that “patients that are impaired by a concussion are a danger on the road”, but only somewhat agreed that “patients with suspected concussion should not drive a motor vehicle until cleared to do so by a medical professional” (median=5). High school (60.5±37.6%) and clinic-based ATs (66.5±31.2%) trended towards higher percentages of patients instructed to refrain from driving relative to college (52.3±38.2%; H(2)=5.92,p=0.052). No other differences observed. Conclusion ATs recommend driving restrictions to some, but not all, concussed patients. ATs recognize post-concussion driving dangers, but do not strongly endorse refraining from driving after concussion. High school and clinic-based ATs may manage more adolescent novice drivers and, therefore, act more conservatively.