Examination of Naturalistic Driving Behavior and Risk Events Across Concussion Recovery

Driving simulator studies show that individuals with acute concussion present notable alterations in driving performance and perform better as recovery progresses. Although driving simulators create a safe environment and are capable of immersing individuals in realistic driving scenarios, they fail to capture daily naturalistic driving behavior throughout concussion recovery. Therefore, the purpose of the study was to assess the feasibility of collecting naturalistic driving and explore driving behaviors and risk events in individuals with concussion, relative to the control group. Twelve individuals with concussion and 17 non-concussed controls installed a GPS sensor in their personal vehicle for a 14-day period. We compared driving behavior (total distance driven, total duration driven, average speed, and number of trips taken per day) and risk events (number of hard brakings and sudden accelerations) captured between groups. Hedge's g and linear mixed regression models were used to compare driving behavior and risk events. Individuals with concussion appeared to drive less and slower prior to day 3 post-concussion but displayed similar driving behavior after day 3 of post-concussion, relative to the control group. Additionally, we observed a pattern that the concussion group drove slower than the control group across concussion recovery. Our study provides preliminary evidence that suggests a need for a return to driving strategy to ensure the safety of individuals with concussion.