Barriers to Driving and Community Integration After Traumatic Brain Injury

Rapport, Lisa J.; Hanks, Robin A.; Bryer, Renee Coleman

doi:10.1097/00001199-200601000-00004

Cited by 83 publications

(75 citation statements)

References 35 publications

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“…Unfortunately, this is a likely scenario given the prevalence of driving cessation following brain insult. In a survey of fifty-one traumatic brain injury (TBI) survivors 1 year postinjury in the USA, Rapport, Hanks and ColemanBryer [4] found that 61% of participants had not resumed driving. Similarly, in a sample of stroke survivors 1 year post-onset in the UK, Legh-Smith, Wade and Langton-Hewer [9] reported that 58% of participants did not resume driving.…”

Section: Impact Of Driving Cessationmentioning

confidence: 99%

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Validation of the Activities of Community Transportation model for individuals with cognitive impairments

Sohlberg

Fickas

Lemoncello

et al. 2009

Disability and Rehabilitation

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Section: Impact Of Driving Cessationmentioning

confidence: 99%

“…autism, Down syndrome) or acquired (e.g. stroke, brain injury) conditions face numerous obstacles to independent community travel [1][2][3][4][5]. For example, limited communication ability, challenging behaviours and impaired cognition impact the navigation skills requisite for successful community navigation [2,3,6].…”

Section: Introductionmentioning

confidence: 99%

Validation of the Activities of Community Transportation model for individuals with cognitive impairments

Sohlberg

Fickas

Lemoncello

et al. 2009

Disability and Rehabilitation

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“…In the context of ABI, family members may need to help their relatives manage activity limitations in areas such as returning to work, participating in community life, self-care, and driving . Not being able to drive has been highlighted as one of the most significant activity limitations, resulting in substantial practical and psychological losses for the individual with ABI (Rapport, Hanks, & Bryer, 2006). An ABI necessitates a mandatory stop to driving (Austroads, 2012) and family members usually take on the role of transport provision during this period of time (Turner et al, 2007).…”

Section: Background and Significance Of Thesis "There Are Just Four Kmentioning

confidence: 99%

“…Driving is perceived as a necessity as it provides practical opportunities for community access and productive activities (Liddle, Fleming, et al, 2012;Rapport et al, 2006). Although there are alternative transport methods available that could enable an individual's continued access to out-of-home activities, barriers such as lack of knowledge about alternative transport, the cost of some transportation methods such as taxis, and environmental considerations such as the weather often hinders the use of alternative transport (Logan, Dyas, & Gladman, 2004).…”

Section: Abi and Drivingmentioning

confidence: 99%

“…Disruption to driving has been highlighted as a significant activity limitation resulting in substantial practical and psychological and symbolic losses (Mezuk & Rebok, 2008;Rapport et al, 2006). Even with the availability of alternative transport, functional mobility is reduced and people report spending less time in social and leisure activities and lower life satisfaction (Finestone et al, 2010;Liddle, Gustafsson, Bartlett, & McKenna, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Family members’ needs and experiences related to driving disruption following acquired brain injury

Liang¹

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Family members often assume the caregiving role after an individual sustains an acquired brain injury (ABI). A mandated period of driving disruption following an ABI means that individuals will often rely heavily on family members for transport and emotional support.However, research on driving disruption has largely focused on the impact, assessment and rehabilitation of the individual with ABI, with little attention given to family members. In order to develop an understanding for approaches to support family members better, this thesis aimed to explore the needs and experiences of family members during driving disruption following an ABI.The first aim of the thesis was to gain a broader understanding of the issue by conducting a scoping review of the literature on family members' needs and experiences during driving disruption across all health conditions. The scoping review found that driving disruption is a stressful and complex issue with communication and emotional implications for family members. The review highlighted differences in experiences according to health condition, permanence of driving disruption and nature of the caregiver occupation, and identified the need for further research on the issue of driving disruption for family members of individuals with ABI.A prospective, mixed methods, longitudinal study, with a phenomenological approach was conducted with family members of individuals with ABI who were experiencing driving disruption. Recruitment was stratified according to time post-ABI to gain a range of perspectives. Data were collected from 15 family members at three time-points: recruitment to study, 3 and 6 months later. Self-report questionnaires measuring family members' quality of life and well-being were administered at the first time-point, and semistructured interviews were conducted at each time-point. All interviews incorporated the use of a map to elicit qualitative and quantitative data about family members' current travel patterns as a result of driving disruption. The data were analysed using different approaches in a series of four studies.The first two studies aimed to gain an in-depth understanding about the experiences of family members of individuals experiencing driving disruption due to ABI across the recovery continuum. Both studies examined the mixed methods cross-sectional data from the first time-point. The first study explored the differences in family members' experiences iii at the early (<1 year post-ABI) and later stages (>1 year post-ABI) using a mixed methods, phenomenological approach. Family members in the later group reported more challenges with greater intensity. These challenges included changes in everyday activities, the impact on their emotions, consequences for the whole family, and effects on physical health. The later group had lower ratings of health and well-being, and higher caregiver strain.The second study investigated the specific changes family members experienced in everyday activities with a focus on the impact of driving disru...

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The influence of THC:CBD oromucosal spray on driving ability in patients with multiple sclerosis‐related spasticity

Celius

Vila

2018

Brain and Behavior

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BackgroundDriving ability is a key function for the majority of patients with multiple sclerosis (MS) to help maintain daily interactions. Both physical and cognitive disability, as well as treatments, may affect the ability to drive. Spasticity is a common symptom associated with MS, and it may affect driving performance either directly or via the medications used to treat it. In this article, we review the evidence relating the antispasticity medicine, Δ9‐tetrahydrocannabinol:cannabidiol (THC:CBD) oromucosal spray (Sativex®), and its potential impact on driving performance.MethodsArticles were identified by searching PubMed from 1/1/2000 to 30/6/2017 using a specified list of search terms. The articles identified using these search terms were augmented with relevant references from these papers and other articles known to the authors.ResultsThe results from THC:CBD oromucosal spray driving studies and real‐world registries did not show any evidence of an increase in motor vehicle accidents associated with THC:CBD oromucosal spray. The majority of patients reported an improvement in driving ability after starting THC:CBD oromucosal spray, and it was speculated that this may be related to reduced spasticity and/or better cognitive function. It should be noted that THC blood levels are significantly lower than the levels associated with recreational use of herbal cannabis.Conclusions THC:CBD oromucosal spray was shown not to impair driving performance. However, periodic assessment of patients with MS driving ability is recommended, especially after relapses and changes in treatment. Blood THC measurements might be above authorized thresholds for some countries following administration of THC:CBD oromucosal spray, thus specific knowledge of each country's driving regulations and a medical certificate are recommended.

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Barriers to Driving and Community Integration After Traumatic Brain Injury

Abstract: Significant others have substantial influence on post-TBI driving outcome. The findings highlight the importance of independent driving to community integration, as well as psychoeducation of survivors and their families.

Cited by 83 publications

References 35 publications

Validation of the Activities of Community Transportation model for individuals with cognitive impairments

Validation of the Activities of Community Transportation model for individuals with cognitive impairments

Family members’ needs and experiences related to driving disruption following acquired brain injury

The influence of THC:CBD oromucosal spray on driving ability in patients with multiple sclerosis‐related spasticity

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