Driving, brain injury and assistive technology

Abstract

Individuals with brain injury often present with cognitive, physical and emotional impairments which impact their ability to resume independence in activities of daily living. Of those activities, the resumption of driving privileges is cited as one of the greatest concerns by survivors of brain injury. The integration of driving fundamentals within the hierarchical model proposed by Keskinen represents the complexity of skills and behaviors necessary for driving. This paper provides a brief review of specific considerations concerning the driver with TBI and highlights current vehicle technology which has been developed by the automotive industry and by manufacturers of adaptive driving equipment that may facilitate the driving task. Adaptive equipment technology allows for compensation of a variety of operational deficits, whereas technological advances within the automotive industry provide drivers with improved safety and information systems. However, research has not yet supported the use of such intelligent transportation systems or advanced driving systems for drivers with brain injury. Although technologies are intended to improve the safety of drivers within the general population, the potential of negative consequences for drivers with brain injury must be considered. Ultimately, a comprehensive driving evaluation and training by a driving rehabilitation specialist is recommended for individuals with brain injury. An understanding of the potential impact of TBI on driving-related skills and knowledge of current adaptive equipment and technology is imperative to determine whether return-to-driving is a realistic and achievable goal for the individual with TBI.

Impact of Biofeedback Interventions on Driving Performance in Individuals with Persistent Post-Concussive Symptoms

“…The results of this study further indicate that individuals with PPCS require specialized driving evaluations, as previously identified [6,9,52,53]. However, only half of physicians 'almost always' provide driving guidance following a concussion [54].…”

Rethinking Driving Assessment: A Hypothesis-Driven Proposal for Cognitive Evaluation

“…Many studies have attested to the efficacy of implementing measures for decreasing the frequency of road crashes, particularly among older drivers [14]. These measures range from cognitive training programs designed to enhance attention, memory, and decision-making [15][16][17], and physical fitness programs that target the improvement of strength and flexibility essential for operating a vehicle [18,19] to the use of assistive driving devices like advanced driver-assistance systems (ADAS) which provide crucial environmental information to drivers [20,21].…”