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European Journal of Physical and Rehabilitation Medicine 2020 August;56(4):386-93

DOI: 10.23736/S1973-9087.20.06098-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Role of vehicle assistive devices for safe return to driving after severe acquired brain injury

Antonio DE TANTI 1 , Francesco BALDARI 2, Giuseppe PEDRAZZI 3, Maria G. INZAGHI 4, Raffaella BENOLDI 1, Paola ABBATI 1, Gerardo MALANGONE 5, Claudio MARTINI 6, Donatella SAVIOLA 1

1 Centro Cardinal Ferrari - Santo Stefano Riabilitazione, Fontanellato, Parma, Italy; 2 Department of Motor Vehicles, Bologna, Italy; 3 Unit of Neurosciences, Center of Robust Statistics (Ro.S.A.), Department of Medicine and Surgery, University of Parma, Parma, Italy; 4 Laboratory of Neuropsychology, Quarenghi Clinical Institute, S. Pellegrino, Bergamo, Italy; 5 Allmobility, Reggio Emilia, Italy; 6 ARCA Autoscuola Moderna, Parma, Italy



BACKGROUND: Driving is a complex activity that requires a wide range of cognitive, behavioral, sensory and motor competences that are often impaired in cases of severe acquired brain injury (sABI). A safe return to driving is an objective significantly correlated with recovery of personal independence and social-occupational role.
AIM: The study investigated elements predictive of the possibility of a safe return to driving after sABI, concentrating on motor disability and the need to prescribe vehicle assistive devices.
DESIGN: Retrospective study.
SETTING: Out-patients of a rehabilitation center for sABI.
POPULATION: A series of 217 patients with stable sABI, well reintegrated at family and social level, were enrolled between January 2006 and June 2019.
METHODS: The subjects were assessed for residual competences. Those who passed assessment of cognitive-behavioral and visual impairment were assessed for motor disability and the need for vehicle assistive devices to enable a safe return to driving.
RESULTS: About 79% of the population were judged suitable for a return to driving. More than 50% of the latter were only able to return to driving with the aid of vehicle assistive devices. Etiological and demographic variables were not predictive of assessment outcome, whereas the various Griffith motor disability categories were correlated with need for vehicle assistive devices, which are most needed in non-traumatic subjects.
CONCLUSIONS: Although the literature on return to driving after brain injury focuses mainly on cognitive-behavioral impairment, in a significant percentage of cases it is also necessary to carefully analyse and manage motor disabilities that may result from sABI.
CLINICAL REHABILITATION IMPACT: Evaluation of the competences necessary for a return to driving after sABI requires a multiprofessional team that must also assess motor disability and know the possible vehicle assistive devices that can enable most candidates to overcome the limits imposed by their disability.


KEY WORDS: Automobile driving; Traumatic brain injuries; Stroke; Self-help devices

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