On-road driving remediation following acquired brain injury: a randomized controlled trial

Abstract

Objective: To investigate the relationship between on-road driving remediation and achieving fitness to drive following acquired brain injury. Design: Randomized controlled trial. Setting: Tertiary hospital outpatient driver assessment and rehabilitation service, Australia. Participants: Thirty-five participants (54.3% male), aged 18–65 years, 41 days-20 years post-acquired brain injury (including stroke, aneurysm, traumatic brain injury) recommended for on-road driving remediation following occupational therapy driver assessment were randomly assigned to intervention (n = 18) and waitlist control (n = 17) groups. Intervention: Intervention group received on-road driving remediation delivered by a qualified driving instructor in a dual-control vehicle. The waitlist control group completed a 6 week period of no driving-related remediation. Main measure: Fitness to drive rated following the conduct of an on-road occupational therapy driver assessment with a qualified driving instructor where outcome assessors were blinded to group allocation. Results: The intervention group were significantly more likely to achieve a fit to drive recommendation than no driving specific intervention (p = 0.003). Conclusion: Following comprehensive assessment, individualized on-road driving remediation programs devised by an occupational therapist with advanced training in driver assessment and rehabilitation and delivered by a qualified driving instructor are significantly associated with achieving fitness to drive after acquired brain injury.