Changes in Driving Behaviors After Concussion in Adolescents

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. (C) 2020 Society for Adolescent Health and Medicine. All rights reserved.

Automated summary

The study found that many adolescents continued to drive after concussion, despite not yet having returned to exercise or sport; the majority of adolescents were advised to gradually increase cognitive activity after clinical assessment, suggesting a gradual increase in driving may be justified.