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Updated: Jun 20, 2026
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Driving After Concussion: Clinical Measures Associated With Postconcussion Driving
Kumiko Hashida1, Julia D Drattell1, Kim Love2
1Department of Kinesiology, University of Georgia, Athens.
Context:
Postconcussion driving assessment has been limited to driving simulators, which are not clinically feasible. There is a need to equip clinicians with tools that can assist in making recommendations on return to driving.
Objective:
To determine the association between clinical measures and driving simulator performance in college students within a week of a concussion.
Design:
Cross-sectional study.
Setting:
Laboratory.
Patients Or Other Participants:
Forty-three college students with concussion and 46 controls.
Main Outcome Measures:
Clinical outcomes included total symptom score, dual-task tandem gait completion time, dual-task cost (the percentage decline in performance under dual task versus single task), Complex Figure performance, Useful Field of View performance, and Vestibular/Ocular Motor Screening (VOMS) symptom provocation score. Driving simulator outcomes included the number of collisions, speed exceedances, stop signs missed, centerline crossings, and road-edge excursions. Within each of the drive segments, we collected standard deviation of speed (SDS) and lane position (SDLP). Separate models for each clinical assessment and driving outcome with negative binomial and linear regression models were used.
Results:
Greater dual-task cost was associated with increased road-edge excursions (P = .018) and SDS (P = .009). Higher VOMS symptom provocation was associated with less SDS (all P < .050). A higher Complex Figure copy score was associated with decreased centerline crossings (P = .001), road-edge excursions (P < .001), SDS (P < .001), and SDLP (all P < .050). A slower Complex Figure copy completion time was associated with lower SDS (P = .010). A higher Complex Figure delayed score was associated with fewer road-edge excursions and lower SDLP (all P < .050). Longer Complex Figure delayed completion time was associated with greater SDS (P = .03).
Conclusions:
Dual-task and Complex Figure tests might be useful when assessing postconcussion driving ability. Higher VOMS symptom provocation was associated with better driving performance, possibly indicating that individuals experiencing vestibular-oculomotor symptoms may adopt more cautious strategies.
