Functional independence measure at rehabilitation admission as a predictor of return to driving after traumatic brain injury

Abstract

Objective: To examine the utility of three common measures as predictors of return to driving after traumatic brain injury (TBI): Glasgow Coma Score (GCS) within the first 24 hours of injury and both Functional Independence Measure (FIM) and Disability Rating Scale (DRS) at rehabilitation admission.

Methods: Seventy-two participants with TBI completed a questionnaire that assessed return to driving post-TBI, as measured by reinstatement of the driver’s license. Participants who did not return to driving for non-medical reasons or who had not driven pre-injury and did not obtain a driver’s license post-injury were excluded from analysis. This produced a final sample of 59 participants. Scores on GCS, FIM and DRS, leveraged from an existing database, were compared between participants who had and those who had not returned to driving post-injury. Multiple logistic regression analysis was performed to determine the relationship of each predictor variable to return to driving.

Results: Only the FIM score at rehabilitation admission was significantly associated with return to driving (p < 0.01). FIM score had a sensitivity of 72% and specificity of 73% with respect to return to driving.

Conclusions: This study supports the use of FIM at rehabilitation admission as a predictor of return to driving. Future studies should be directed at identifying other measures to be used in combination with FIM to accurately predict return to driving post-TBI.

• Automobile driving
• outcome measures
• recovery of function
• rehabilitation
• traumatic brain injury

Acknowledgements

The authors thank the staff members of the Toronto Rehabilitation Institute–University Health Network, ABI Service, for their assistance in data collection. The statistical advice of Ivan Steenstra and the research assistance of Patricia Aznar and Carolyn Go is also gratefully acknowledged. Equipment and space have been funded with grants from the Canada Foundation for Innovation and the Province of Ontario. The views expressed here do not necessarily reflect those of the Ontario Ministry of Health and Long-Term Care.