Many adolescents return to driving within 2 weeks of a concussion
Nearly half of adolescent drivers returned to driving fewer than 2 weeks after a concussion on average, according to a study published in the Journal of Adolescent Health.
“Driving is a cognitively demanding task, and returning to driving too quickly for adolescents after a concussion may exacerbate symptoms,” Catherine McDonald, PhD, RN, FAAN, a senior fellow at the Center for Injury Research and Prevention at Children’s Hospital of Philadelphia and an associate professor of nursing in the department of family and community health at Penn Nursing, told Healio Primary Care. “Just as in returning to other activities too quickly, symptoms such as headaches, dizziness or sensitivity to light may be triggered with returning to driving too quickly.
“In addition, if an adolescent is impaired due to their concussion in symptoms such as slowed reaction time, headaches or poor judgement, this may increase their risk for a crash,” she continued.
McDonald and colleagues collected data on adolescents aged 16 to 19 years who were seen for a concussion at a specialty clinic and included in the Children’s Hospital of Philadelphia’s Minds Matter Concussion Registry, which prospectively collects electronic health record data for patients seen for a concussion within the health care network.
In a cross-sectional analysis, the researchers evaluated patients who were diagnosed with a concussion within 28 days of an injury and had an initial care visit at the concussion specialty care program from January 31, 2017, through August 21, 2018. Within the program, participants completed a questionnaire that assessed their driving practices before and after injury.
A total of 332 adolescent drivers who experienced a concussion were included in the study. The average time from injury to presentation at the program was 12.3 days.
The researchers found that of these patients, 46.9% reported that they had returned to driving since their injury. Meanwhile, only 15.4% reported returning to exercise, 6% said they returned to organized sports and 63% said they returned to school after their injury. Only 9.1% of adolescents who were still in school were recommended by a provider to return to school without accommodations.
Among those who reported returning to driving after injury, 58.9% said that they did not change their driving practices.
In those who did change their driving behaviors, the most common changes included limiting the number and distance of their trips and avoiding nighttime driving.
McDonald and colleagues found that Post-Concussion Symptom Inventory scores were higher in adolescents who said they were driving but changed their driving practices compared with those who did not change their driving practices and those who had not driven since their injury.
McDonald said that while there are no formal recommendations for adolescents returning to driving after concussion, it is “generally accepted” that they should not do so within 24 to 48 hours of their injury.
“With no clear evidence-based guidelines, a gradual return to driving activities may be needed,” she said. “An important first step is for clinicians to talk with parents and adolescents about driving after concussion and educate on the importance of symptom monitoring in that gradual return. Anticipatory guidance should also cover how symptoms may affect driving behaviors or may be exacerbated by returning to driving too quickly.”