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Changes in Driving Behaviors After Concussion in Adolescents

  • Catherine C. McDonald
    Correspondence
    Address correspondence to: Catherine C. McDonald University of Pennsylvania, School of Nursing Claire Fagin Hall 418 Curie Boulevard, 414, Philadelphia, PA 19104.
    Affiliations
    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
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  • Divya Jain
    Affiliations
    Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

    Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Eileen P. Storey
    Affiliations
    Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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  • Madeline Gonzalez
    Affiliations
    Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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  • Christina L. Master
    Affiliations
    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
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  • Kristy B. Arbogast
    Affiliations
    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
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      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.

      Keywords

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