Driving after concussion: is it safe to drive after symptoms resolve?
Driving after concussion: is it safe to drive after symptoms resolve?
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脑震荡后驾驶：症状消失后驾驶安全吗？
DOI：
10.1136/bjsports-2016-097270.134
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发表时间：
2017
影响因子：
18.4
通讯作者：
Benson Batchelder
中科院分区：
文献类型：
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作者：
Theresa Miyashita;Benson Batchelder
目的 比较脑震荡参与者和对照组参与者的模拟驾驶表现。设计横截面。设置实验室。受试者 14 名脑震荡参与者和 14 名非脑震荡参与者，年龄和驾驶经验与对照组相匹配，没有神经系统疾病、药物导致嗜睡或大量吸毒/酗酒（年龄：20.3 岁，95%CI：19.9,20.7）。干预参与者完成了7.6分钟、20.5公里的驾驶模拟任务，内容包括弯道、人行横道、事故、城乡、行人、超车和避让。脑震荡参与者在无症状后 48 小时内完成驾驶模拟（脑震荡后 15.9 天，95% CI：10.7,21.0），并由医疗专业人员使用多方面脑震荡评估视为临床康复。结果衡量 我们比较了各组之间的事故总数、罚单和车道偏移。我们还比较了整个模拟分段的平均速度（公里/小时）、速度标准差、横向车道位置（米）和横向车道位置标准差。使用单向方差分析（α=0.05）。结果 与对照组相比，脑震荡参与者更频繁地偏离车道（脑震荡：10.9，95%CI：8.3,13.5；对照组：7.4，95%CI：6.0,8.8；p=0.02）。与对照组相比，在第一次（震荡：1.1m，95%CI：0.8,1.5；对照组：0.7m，95%CI：0.6，0.9；p=0.02）和最终曲线（震荡：1.2m，95%CI：1.1,1.3；对照组：1.0m， 95％CI：0.9，1.1；p=0.04）。结论 尽管被认为临床已康复，但脑震荡的参与者不太能够将车辆置于车道中央，并且更频繁地撞到路肩，尤其是在弯道行驶时。脑震荡可能会损害安全驾驶所需的视觉、运动和/或认知技能。需要进一步的研究来确定脑震荡后何时可以安全地恢复驾驶。竞争利益 无。
Objective To compare simulated driving performance between concussed and control participants. Design Cross-sectional. Setting Laboratory. Subjects Fourteen concussed participants and 14 non-concussed age and driving experience matched controls with no neurological disorders, medications causing drowsiness, or heavy drugs/alcohol use (Age: 20.3years, 95%CI:19.9,20.7). Intervention Participants completed a 7.6 minute, 20.5km driving simulation task containing curves, crosswalks, accidents, rural/urban areas, pedestrians, overtaking, and evasion. Concussed participants completed driving simulation within 48 hours of becoming asymptomatic (15.9 days post-concussion, 95%CI: 10.7,21.0) and were deemed clinically recovered by a medical professional using a multifaceted concussion evaluation. Outcome measures We compared total number of accidents, tickets, and lane excursions between groups.We also comparedaverage velocity (km/hr), standard deviation of velocity, lateral lane position (m), and lateral lane position standard deviation throughout simulation subsections. One-way ANOVAs were used (α=0.05). Results Concussed participants committed more frequent lane excursions compared to controls (concussed: 10.9, 95%CI:8.3,13.5; controls: 7.4, 95%CI:6.0,8.8; p=0.02). Concussed participants exhibited greater lateral lane position standard deviation compared to controls during the first (concussed: 1.1m, 95%CI: 0.8,1.5; controls: 0.7m, 95%CI:0.6, 0.9; p=0.02) and final curve (concussed: 1.2m, 95%CI:1.1,1.3; controls: 1.0m, 95%CI:0.9,1.1; p=0.04). Conclusions Despite being considered clinically recovered, concussed participants were less able to centre the vehicle in the lane and entered the shoulder more frequently, especially when navigating curves. A concussion may impair visual, motor, and/or cognitive skills necessary to safely drive. Further research is needed to determine when it is safe to return to driving following concussion. Competing interests None.