Many Teens Report Driving Challenges After Concussion

By Lisa Rapaport

January 14, 2021

(Reuters Health) - Teen drivers who sustain concussions may need to resume driving gradually by limiting trips, traveling shorter distances, and staying off the roads at night, a recent study suggests.

Researchers examined data on 322 adolescent drivers aged 16 to 19 years who were diagnosed with a concussion within 28 days of sustaining a head injury, and treated at the specialty concussion program at Children's Hospital of Philadelphia. Overall, 156 (46.9%) returned to driving at the time of their initial specialist visit an average of 12.3 days post-injury.

Far fewer teen drivers in the study had resumed exercise (15.4%) or organized sports (6.0%). And, among the 292 teens attending school, only 9.1% were recommended by providers to return to full-day classes after a clinical evaluation.

Among those who did return to driving, 64 (41%) teens made changes to their driving habits such as limiting trips (n=45), limiting distance (n=14), and avoiding driving at night (n=14).

These results suggest that clinicians need to add driving to the list of activities they discuss as part of a conversation about things that can be safely resumed after a concussion, said lead study author Catherine McDonald of the Center for Injury Research and Prevention at the Children's Hospital of Philadelphia.

"Our study showed us that at first visit to the specialty clinic, a little less than half of adolescents had returned to driving after their concussion, though most had not yet returned to exercise or sports," McDonald said by email. "At the end of the visit, the majority were recommended a gradual return to school with accommodations, indicating that a similar approach to driving may be needed."

Participants in the study had a mean age of 17.5 years, and most were male (53.9%) and non-Hispanic white (83.4%). The most common cause of concussions was being struck by an object (n=132) or being struck by a person (n=78).

Clinicians assessed the severity of symptoms using the Post-Concussion Symptom Inventory (PCSI), and found mean scores were lower (27.4) among teens who reported driving with no changes to their prior habits than for those who reported driving with changes (48.7) or not driving at all since injury (42.3).

Youth were more likely to resume exercise and organized sports when they reported driving with no changes than when they reported driving with changes or not driving at all.

One limitation of the study is that all the participants were seen in a specialty concussion care program, and it's possible results may not be generalizable to all youth who sustain concussions, researchers note in the Journal of Adolescent Health. The study team also lacked data on driving records, length of licensure, or whether teens had learners permits or driving licenses.

Even so, the results add to evidence that concussions can have a lasting impact on patients, said Seth Seabury, a researcher at the University of Southern California, in Los Angeles, who wasn't involved in the study.

"The clinical community needs to think carefully about and provide clear guidance on what activities are productive and safe and will help patients return to full health as quickly and smoothly as possible," Seabury said by email. "This is true of driving, as well as other activities such as schooling or work."

SOURCE: Journal of Adolescent Health, online December 15, 2020.