Return to Driving After Moderate-to-Severe Traumatic Brain Injury: A Traumatic Brain Injury Model System Study

Thomas A. Novack, Yue Zhang, Richard Kennedy, Lisa J. Rapport, Thomas K. Watanabe, Kimberley R. Monden, Laura E. Dreer, Thomas Bergquist, Charles Bombardier, Robert Brunner, Yelena Goldin, Jennifer Marwitz, Janet P. Niemeier

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: Describe who is able to return to driving (RTD) after moderate-to-severe traumatic brain injury (TBI), when this occurs, who maintains that activity, and the association with outcome. Design: Cross-sectional descriptive study. Setting: Eight follow-up sites of the TBI Model Systems (TBIMS) program. Participants: 618 participants enrolled in the TBIMS and 88 caregivers (N=706). Interventions: Not applicable. Main Outcome Measures: A survey was completed from 1-30 years postinjury focusing on RTD. Descriptors included demographic information, injury severity, and current employment status. Outcome was assessed at the time of the interview, including depression, quality of life, functional status, and community participation. Results: Of 706 respondents, 78% (N = 552) RTD, but 14% (N = 77) of these did not maintain that activity. Of those who RTD, 43% (N = 192) did so within 6 months of the injury and 92% did so within 24 months postinjury. The percentage of people driving after TBI did not differ significantly based on age at time of injury or follow-up. There were significant differences between drivers and nondrivers with respect to severity of injury, seizures, race, education, employment, rural vs urban setting, marital status, and family income. We performed a multivariate logistic regression to examine the association between driving status and demographic variables, adjusting for other variables in the model. The strongest associations were with current employment, family income, race, seizures, and severity of injury. Driving was associated with greater community participation, better functional outcomes, fewer symptoms of depression, and greater life satisfaction. Conclusions: Over a span of 30 years, three-quarters of people experiencing moderate-to-severe TBI return to driving a personal vehicle, although not everyone maintains this activity. Employment, race, family income, and seizures are strongly associated with RTD.

Original languageEnglish (US)
Pages (from-to)1568-1575
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Issue number8
Early online dateMar 8 2021
StatePublished - Aug 1 2021
Externally publishedYes

Bibliographical note

Funding Information:
The TBIMS has been funded by the National Institute on Rehabilitation, Independent Living and Rehabilitation Research for over 30 years to maintain a longitudinal database focusing on recovery after TBI. There are presently 16 funded centers. Based on the TBIMS definition, participants had a history of moderate-to-severe TBI for which they were admitted to an inpatient rehabilitation facility (IRF). Diagnosis was based on the Glasgow Coma Scale score, duration of posttraumatic amnesia, presence of abnormalities on neuroimaging consistent with trauma, and/or evident neurologic disorder reflective of TBI. Participants in the TBIMS have a minimum age of 16. Consent for participation in the TBIMS is obtained from the injured person or a legally authorized representative during acute rehabilitation.

Funding Information:
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research , Administration of Community Living (grant nos. 90DPTB0015 , 90DPTB0006 , 90DPTB0004 , 90DPTB00070 , 90DPTB0014 , 90DPTB0008 , 90DPTB0005 , 90DPTB0012 ).

Publisher Copyright:
© 2021 The American Congress of Rehabilitation Medicine


  • Automobile driving
  • Brain injuries
  • Brain injuries, traumatic
  • Rehabilitation

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, Non-P.H.S.


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