Driving eligibility guidelines post-injury steered in new direction

Getting back behind the wheel after a mild traumatic brain injury (mTBI), such as concussion, should take longer than national medical guidelines currently advise.

Research led by occupational therapist Anne Baker has exposed an inconsistency across Australian hospitals in their suggested time frames for people to return to driving post mTBI.

Dr Baker says she was motivated to conduct the research following her time working as an OT on a trauma ward.

"It was clear that different hospitals recommended different time frames to patients for a return to driving, so we wanted to establish a time trajectory in the recovery of the skills required for safe driving, and for the safety of others on the roads," Dr Baker says.

"Current national medical guidelines for driving after an mTBI are 24 hours," Dr Baker says.

Dr Baker's concerns led to a nationwide survey of hospital emergency departments as part of her doctoral thesis.

Her supervisor, Curtin University Professor Carolyn Unsworth says WA was well represented in this study, making up more than a third of the emergency department respondents.

"There was no consensus on when is the safest time to recommend a return to driving following an mTBI," she says.

The research also involved a study of 60 mTBI patients alongside a control group of 60 orthopaedic injury patients.

The groups were assessed at 24-48hrs and two weeks post injury.

Few participants back behind the wheel

The researchers conducted a mini mental state examination, an occupational therapy-drive home maze test, a road craft test, hazard perception test and interview.

They found less than half the mTBI cohort had returned to driving after two weeks.

"We were surprised to find few patients had actually returned to driving, even after being advised they could drive two weeks after their injury," Dr Baker says.

The participants' reasons for not wishing to return to driving, despite being given medical permission included not feeling 100 per cent right, headaches, pain and dizziness.

The researchers were also surprised to find that age was no factor in predicting who would drive sooner after an mTBI.

"The research challenged stereotypes that the young would find it easier to return to driving and this was not the case," Dr Baker says.

Prof Unsworth says there was very little evidence-based, clinical guidelines to assist clinicians in facilitating their clients return to driving after experiencing an mTBI.

"Our research shows some people were not ready to return to driving for several months and may actually need support to drive again," Prof Unsworth says.