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

年轻人脑震荡后驾驶的纵向评估 (LAPDYA)

• 批准号: 10634952
• 负责人: Julianne D Schmidt
• 金额: $ 40.84万
• 依托单位: UNIVERSITY OF GEORGIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10634952
• 关键词: Accidents; Acute; Address; Age; Automobile Driving; Brain Concussion; Brain Injuries; Caring; Clinical; Clinical assessments; Communities; Data; Equilibrium; Exhibits; Feeling; Freedom; Frequencies; Fright; Funding; Future; Gait; General Population; Global Positioning System; Goals; Health Professional; Hour; Impairment; Incidence; Individual; Injury; Knowledge; Lateral; Measures; Medical; Memory; Mission; Motor; Motor Skills; National Institute of Neurological Disorders and Stroke; Neurocognition; Neurocognitive; Outcome; Outcome Assessment; Participant; Patients; Performance; Policy Maker; Positioning Attribute; Public Health; Publishing; Readiness; Recommendation; Recovery; Reporting; Research; Research Personnel; Risk; Risk Factors; Safety; Sampling; Speed; Symptoms; Time; United States; United States National Institutes of Health; Vehicle crash; Visual; Work; clinical predictors; clinically relevant; cognitive skill; college; comparison control; driving safety; evidence base; evidence based guidelines; executive function; functional disability; impaired driving performance; improved; injury burden; innovation; medical attention; mild traumatic brain injury; outcome prediction; processing speed; psychosocial; translational study; unsafe driving; young adult

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.

项目概要/摘要 美国每年发生 380 万起脑震荡。只有 44% 的人患有脑震荡 尽管对脑震荡后驾驶存在紧急担忧，但在受伤后随时减少驾驶 安全、有记录的驾驶障碍以及脑震荡后感觉不安全驾驶的报告。最多 脑震荡患者仅在受伤后 24-48 小时内减少驾驶。驾驶是一个 高度复杂的活动，需要视觉、运动和认知技能，而这些技能在活动后通常会受到损害 脑震荡。脑震荡患者在受伤后 48 小时内越过中心线的频率更高 在整个症状恢复过程中车辆控制较差。然而，脑震荡后的时间进程 驾驶障碍尚未得到表征。迫切需要 1) 确定何时发生脑震荡 个人应该恢复驾驶，并且 2) 确定准备好进行脑震荡评估的关键预测因素 返回驾驶。在没有正式建议的情况下，受损的脑震荡驾驶员面临着以下风险： 自己和路上的其他人。第一个具体目标是比较脑震荡患者的模拟驾驶 个人和非脑震荡的轭在五个纵向时间点（受伤前基线， 第 2 天、第 4 天（无症状且不受限制的医疗许可）以及从第 2 天到第 2 天的日常自然驾驶 第 9 天。驾驶建议必须是适当的并且是脑震荡损伤所必需的，因为 过于严格的建议会错误地剥夺脑震荡患者的独立性，并可能 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个体的模拟驾驶表现 整个脑震荡恢复过程。为了实现这些目标，100 个脑震荡和 100 个轭匹配控制 年轻的成年大学运动员将完成模拟驾驶评估和剧烈脑震荡 受伤前基线、第 2 天、第 4 天、无症状和不受限制的医疗许可的评估电池。 从第 2 天到第 9 天（7 总计天数）。这项研究将确定脑震荡后驾驶的急性和亚急性时间过程 损伤并确定脑震荡后驾驶表现的关键预测因素。这项创新的成果 该方法将产生广泛而积极的影响，将提高脑震荡患者和 普通大众，指导卫生专业人员的做法，为研究人员的未来工作提供信息，以及 通过提供基于证据的建议来管理政策制定者的工作 震荡驾驶。