Longitudinal Assessment of Post-concussion Driving in Young Adults (LAPDYA)

项目概要/摘要 美国每年发生380万起脑震荡。只有44%的脑震荡患者 在受伤后的任何时候减少驾驶，尽管对脑震荡后驾驶的紧急关注 安全，记录的驾驶障碍，以及脑震荡后感觉不安全驾驶的报告。最 减少驾驶的脑震荡患者仅在受伤后24 - 48小时内减少驾驶。驾驶是一 高度复杂的活动，需要视觉，运动和认知技能，这些技能通常在 脑震荡。脑震荡患者在受伤后48小时内更频繁地穿过中心线， 在整个症状恢复过程中对溶媒的控制较差。然而，脑震荡后的时间进程 驾驶障碍尚未得到表征。有一个关键的需要1）确定何时脑震荡 个人应该回到驾驶和2）确定关键的脑震荡评估预测准备， 回到驾驶。在没有正式建议的情况下，受损的脑震荡司机有可能 自己和别人在路上。第一个具体的目的是比较脑震荡和脑震荡之间的模拟驾驶。 在五个纵向时间点（损伤前基线， 第2天，第4天，无症状，无限制的医疗检查）和每日自然驾驶从第2天到第4天， 第九天。驾驶建议必须是适当的和必要的脑震荡损伤，因为 过于严格的建议错误地剥夺了脑震荡患者的独立性， 劝阻个人寻求医疗护理。第二个具体目标是确定广泛使用的 脑震荡评估结果可预测脑震荡患者的模拟驾驶表现 整个脑震荡恢复过程中为了实现这些目标，100例脑震荡和100例对照组 年轻的成人大学运动员将完成模拟驾驶评估和强烈的脑震荡 在损伤前基线、第2天、第4天、无症状和无限制医疗许可时进行成套评估。 自然驾驶（用车载全球定位系统测量）将从第2天到第9天（7 天数共计）。这项研究将确定急性和亚急性时间过程中的脑震荡后驾驶 并确定脑震荡后驾驶表现关键预测因素。这一创新成果 这种方法将产生广泛和积极的影响，将提高脑震荡患者的安全性， 一般人群，指导卫生专业人员的做法，告知研究人员的未来工作， 通过提供基于证据的建议来充实决策者的工作， 脑震荡驾驶

PROJECT SUMMARY/ABSTRACT Upwards of 3.8 million concussions occur annually in the United States. Only 44% of concussed individuals reduce their driving at any point following injury despite emergent concerns over post-concussion driving safety, documented driving impairment, and reports of feeling unsafe driving after a concussion. Most concussed individuals who reduce their driving only do so for 24-48 hours following the injury. Driving is a highly complicated activity that requires visual, motor, and cognitive skills, which are commonly impaired after concussion. Concussed individuals cross the centerline more frequently within 48 hours of injury and present with poorer vehicle control throughout the full symptom recovery. Yet, the time course of post-concussion driving impairment has not been characterized. There is a critical need to 1) determine when concussed individuals should return to driving and 2) identify the key concussion assessment predictors of readiness to return to driving. In the absence of formal recommendations, impaired concussed drivers are at risk to themselves and others on the road. The first specific aim is to compare simulated driving between concussed individuals and non-concussed yoked matched controls across five longitudinal timepoints (pre-injury baseline, day 2, day 4, asymptomatic, and unrestricted medical clearance) and daily naturalistic driving from day 2 to day 9. Driving recommendations must be appropriate and necessitated by concussion impairments, since excessively strict recommendations wrongfully strip concussed patients of their independence and may dissuade individuals from seeking medical care. The second specific aim is to identify widely used concussion assessment outcomes that predict simulated driving performance among concussed individuals throughout concussion recovery. To address these aims, 100 concussed and 100 yoked matched control young adult college athletes will complete a simulated driving assessment and a robust concussion assessment battery at pre-injury baseline, day 2, day 4, asymptomatic, and unrestricted medical clearance. Naturalistic driving (measured with in-car global positioning systems) will be captured from day 2 to day 9 (7 days total). This study will determine the acute and subacute time course of post-concussion driving impairment and determine key predictors of post-concussion driving performance. Results from this innovative approach will have a broad and positive impact that will improve the safety of both concussed individuals and the general population, guide the practices of health professionals, inform the future work of researchers, and substantiate the work of policy-makers by providing evidence-based recommendations for managing post- concussion driving.