Patterns, Predictors, and Associated Benefits of Driving a Modified Vehicle After Spinal Cord Injury: Findings From the National Spinal Cord Injury Model Systems

Objectives: To investigate the patterns, predictors, and benefits associated with driving a modified vehicle for people with spinal cord injuries (SCIs). Design: Cross-sectional retrospective survey design. Settings: Sixteen Model SCI Systems (MSCISs) throughout the United States. Participants: People (N=3726) post-SCI from the National MSCIS Database. Interventions: Not applicable. Main Outcome Measures: Driving, employment, and community reintegration post-SCI. Results: The study found that 36.5% of the sample drove a modified vehicle after SCI. Significant predictors of driving a modified vehicle post-SCI included married at injury, younger age at injury, associate's degree or higher before injury, paraplegia, a longer time since the injury, non-Hispanic race, white race, male sex, and using a wheelchair for more than 40 hours a week after the injury (accounting for 37% of the variance). Higher activity of daily living independence (in total motor function) at hospital discharge also increased the odds of driving. Driving increased the odds of being employed at follow-up by almost 2 times compared with not driving postinjury (odds ratio, 1.85). Drivers tended to have higher community reintegration scores, especially for community mobility and total community reintegration. Driving was also associated with small health-related quality-of-life gains, including less depression and pain interference and better life satisfaction, general health status, and transportation availability scores. Conclusions: The associated benefits of driving and the relatively low percentage of drivers post-SCI in the sample provide evidence for the need to increase rehabilitation and assistive technology services and resources in the United States devoted to facilitating driving after SCI.