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CURRENT ISSUEEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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  RETURN TO DRIVING AFTER TRAUMATIC BRAIN INJURY - Part I
Guest Editors: Bruno Gradenigo, Anna Mazzucchi


Europa Medicophysica 2001 December;37(4):201-8

language: English

When and how should people be authorised to drive after severe head injuries?

Debelleix X.

From the ­Réseau ­UEROS Aqui­taine - ­France


FULL TEXT  REPRINTS


­Starting to ­drive ­again ­after a ­head ­injury ­poses prob­lems to ­patients, ­their fam­i­lies, ­their med­ical ­teams and to ­society as ­whole. Insu­rance com­pa­nies are ­also ­affected. The ­present ­paper exam­ines the ­legal frame­work of ­this ­problem in ­France, the ­French lit­er­a­ture on the sub­ject and the per­sonal expe­ri­ence. On the ­basis of infor­ma­tion col­lected, the ­paper iden­ti­fies ­three ­groups of ­patients: 1) ­those suf­fering ­motor impair­ments ­alone who are per­fectly ­capable of ­driving an appro­pri­ately ­adapted ­vehicle. 2) ­those at ­risk of epi­leptic ­fits who may be ­granted a 2-­year pro­vi­sional ­licence ­that ­will be ­extended indef­i­nitely if no ­attacks ­occur; 3) ­those ­with neu­ro­psy­cho­log­ical prob­lems. In ­such ­cases ­there ­appears to be no cor­re­la­tion ­between the ­results of cog­ni­tive per­for­mance ­tests and ­driving ­ability. And ­while ­tests ­designed to ­assess ­frontal ­lobe func­tions may be indic­a­tive, ­they are not abso­lutely pre­dic­tive. ­Tests on atten­tion ­span, ­short-­term ­memory, dex­terity, visuo- s­pa­tial ­capacity, reac­tion ­times and func­tional capac­ities (espe­cially flex­ibility, plan­ning and antic­i­pa­tion) are essen­tial. ­Since ­driving sim­u­la­tors are ­rarely ­used, the on-­road ­driving ­test ­remains the assess­ment “­Gold Stan­dard”. The ­paper con­cludes ­that: assess­ment ­remains an impre­cise art; ­there ­remain ­wide vari­a­tions in the prac­tices of ­care ­teams and Med­ical ­Boards; treat­ment and assess­ment pro­to­cols ­need to be stan­dar­dised.

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