{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:32:14Z","timestamp":1792661534924,"version":"4.5.0"},"reference-count":60,"publisher":"National Athletic Trainers' Association","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the association between clinical measures and driving simulator performance in college students within a week of a concussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>Forty-three college students with concussion and 46 controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Greater dual-task cost was associated with increased road-edge excursions (\n                      <jats:italic>P<\/jats:italic>\n                      = .018) and SDS (\n                      <jats:italic>P<\/jats:italic>\n                      = .009). Higher VOMS symptom provocation was associated with less SDS (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .050). A higher Complex Figure copy score was associated with decreased centerline crossings (\n                      <jats:italic>P<\/jats:italic>\n                      = .001), road-edge excursions (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), SDS (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and SDLP (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .050). A slower Complex Figure copy completion time was associated with lower SDS (\n                      <jats:italic>P<\/jats:italic>\n                      = .010). A higher Complex Figure delayed score was associated with fewer road-edge excursions and lower SDLP (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .050). Longer Complex Figure delayed completion time was associated with greater SDS (\n                      <jats:italic>P<\/jats:italic>\n                      = .03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0058.25","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T08:37:37Z","timestamp":1750235857000},"page":"870-880","source":"Crossref","is-referenced-by-count":1,"title":["Driving After Concussion: Clinical Measures Associated With Postconcussion Driving"],"prefix":"10.4085","volume":"60","author":[{"given":"Kumiko","family":"Hashida","sequence":"first","affiliation":[{"name":"Department of Kinesiology, University of Georgia, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia D.","family":"Drattell","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, University of Georgia, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Love","sequence":"additional","affiliation":[{"name":"KR Love Quantitative Consulting and Collaboration, Athens, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Lynall","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, University of Georgia, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell K.","family":"Gore","sequence":"additional","affiliation":[{"name":"Shepherd Center, Complex Concussion Clinic, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"Devos","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center, Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianne D.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, University of Georgia, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"11","key":"i1938-162X-60-12-870-b01","series-title":"Am J Sports Med","first-page":"2654","article-title":"Epidemiology of sports-related concussion in NCAA athletes from 2009\u20132010 to 2013\u20132014: incidence, recurrence, and mechanisms","volume":"43","author":"Zuckerman","year":"2015","unstructured":"Zuckerman SL,\nKerr ZY,\nYengo-Kahn A,\nWasserman E,\nCovassin T,\nSolomon GS. Epidemiology of sports-related concussion in NCAA athletes from 2009\u20132010 to 2013\u20132014: incidence, recurrence, and mechanisms. Am J Sports Med. 2015;43(11):2654\u20132662. doi:10.1177\/0363546515599634"},{"issue":"4","key":"i1938-162X-60-12-870-b02","series-title":"Phys Sportsmed","first-page":"87","article-title":"Tracking neurocognitive performance following concussion in high school athletes","volume":"38","author":"Covassin","year":"2010","unstructured":"Covassin T,\nElbin RJ,\nNakayama Y. Tracking neurocognitive performance following concussion in high school athletes. Phys Sportsmed. 2010;38(4):87\u201393. doi:10.3810\/psm.2010.12.1830"},{"issue":"8","key":"i1938-162X-60-12-870-b03","series-title":"J Neurotrauma","first-page":"1571","article-title":"Driving after concussion: is it safe to drive after symptoms resolve","volume":"34","author":"Schmidt","year":"2017","unstructured":"Schmidt JD,\nHoffman NL,\nRanchet M, et al. Driving after concussion: is it safe to drive after symptoms resolve? J Neurotrauma. 2017;34(8):1571\u20131578. doi:10.1089\/neu.2016.4668"},{"issue":"3","key":"i1938-162X-60-12-870-b04","series-title":"Appl Neuropsychol","first-page":"138","article-title":"Utility of the UFOV test with mild traumatic brain injury","volume":"12","author":"Schneider","year":"2005","unstructured":"Schneider JJ,\nGouvier WD. Utility of the UFOV test with mild traumatic brain injury. Appl Neuropsychol. 2005;12(3):138\u2013142. doi:10.1207\/S15324826AN1203_3"},{"issue":"10","key":"i1938-162X-60-12-870-b05","series-title":"Am J Sports Med","first-page":"2732","article-title":"Longitudinal assessment of postconcussion driving: evidence of acute driving impairment","volume":"51","author":"Schmidt","year":"2023","unstructured":"Schmidt JD,\nLynall RC,\nLempke LB,\nMiller LS,\nGore RK,\nDevos H. Longitudinal assessment of postconcussion driving: evidence of acute driving impairment. Am J Sports Med. 2023;51(10):2732\u20132739. doi:10.1177\/03635465231184390"},{"issue":"2","key":"i1938-162X-60-12-870-b06","series-title":"J Sport Health Sci","first-page":"145","article-title":"Slowed driving-reaction time following concussion-symptom resolution","volume":"10","author":"Lempke","year":"2021","unstructured":"Lempke LB,\nLynall RC,\nHoffman NL,\nDevos H,\nSchmidt JD. Slowed driving-reaction time following concussion-symptom resolution. J Sport Health Sci. 2021;10(2):145\u2013153. doi:10.1016\/j.jshs.2020.09.005"},{"issue":"4","key":"i1938-162X-60-12-870-b07","series-title":"Neuropsychology","first-page":"493","article-title":"Driving after concussion: the acute effect of mild traumatic brain injury on drivers\u2019 hazard perception","volume":"24","author":"Preece","year":"2010","unstructured":"Preece MH,\nHorswill MS,\nGeffen GM. Driving after concussion: the acute effect of mild traumatic brain injury on drivers\u2019 hazard perception. Neuropsychology. 2010;24(4):493\u2013503. doi:10.1037\/a0018903"},{"issue":"2","key":"i1938-162X-60-12-870-b08","series-title":"J Am Geriatr Soc","first-page":"332","article-title":"Driving cessation and health outcomes in older adults","volume":"64","author":"Chihuri","year":"2016","unstructured":"Chihuri S,\nMielenz TJ,\nDiMaggio CJ, et al. Driving cessation and health outcomes in older adults. J Am Geriatr Soc. 2016;64(2):332\u2013341. doi:10.1111\/jgs.13931"},{"key":"i1938-162X-60-12-870-b09","series-title":"Med Sci Sports Exerc","first-page":"912","article-title":"Driving after concussion: symptom clusters and neurocognition uniquely relate to post-concussion driving performance","volume":"57","author":"Hashida","year":"2024","unstructured":"Hashida K,\nDrattell J,\nDevos H,\nGore R,\nLynall R,\nSchmidt J. Driving after concussion: symptom clusters and neurocognition uniquely relate to post-concussion driving performance. Med Sci Sports Exerc. 2024;57:912\u2013920. doi:10.1249\/mss.0000000000003623"},{"issue":"2","key":"i1938-162X-60-12-870-b10","series-title":"Br J Sports Med","first-page":"102","article-title":"CARE Consortium Investigators. Return to play and risk of repeat concussion in collegiate football players: comparative analysis from the NCAA Concussion Study (1999\u20132001) and CARE Consortium (2014\u20132017)","volume":"54","author":"McCrea","year":"2020","unstructured":"McCrea M,\nBroglio S,\nMcAllister T, et al.; CARE Consortium Investigators. Return to play and risk of repeat concussion in collegiate football players: comparative analysis from the NCAA Concussion Study (1999\u20132001) and CARE Consortium (2014\u20132017). Br J Sports Med. 2020;54(2):102\u2013109. doi:10.1136\/bjsports-2019-100579"},{"issue":"3","key":"i1938-162X-60-12-870-b11","series-title":"Arthroscopy","first-page":"887","article-title":"Median time to return to sports after concussion is within 21 days in 80% of published studies","volume":"39","author":"Wait","year":"2023","unstructured":"Wait TJ,\nEck AG,\nLoose T, et al. Median time to return to sports after concussion is within 21 days in 80% of published studies. Arthroscopy. 2023;39(3):887\u2013901. doi:10.1016\/j.arthro.2022.11.029"},{"issue":"1","key":"i1938-162X-60-12-870-b12","series-title":"Clin J Sport Med","first-page":"13","article-title":"Unreported concussion in high school football players: implications for prevention","volume":"14","author":"McCrea","year":"2004","unstructured":"McCrea M,\nHammeke T,\nOlsen G,\nLeo P,\nGuskiewicz K. Unreported concussion in high school football players: implications for prevention. 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Tracking neurocognitive performance following concussion in high school athletes. Phys Sportsmed. 2010;38(4):87\u201393. doi:10.3810\/psm.2010.12.1830"},{"issue":"8","key":"i1938-162X-60-12-870-b03","series-title":"J Neurotrauma","first-page":"1571","article-title":"Driving after concussion: is it safe to drive after symptoms resolve","volume":"34","author":"Schmidt","year":"2017","unstructured":"Schmidt JD,\nHoffman NL,\nRanchet M, et al. Driving after concussion: is it safe to drive after symptoms resolve? J Neurotrauma. 2017;34(8):1571\u20131578. doi:10.1089\/neu.2016.4668"},{"issue":"3","key":"i1938-162X-60-12-870-b04","series-title":"Appl Neuropsychol","first-page":"138","article-title":"Utility of the UFOV test with mild traumatic brain injury","volume":"12","author":"Schneider","year":"2005","unstructured":"Schneider JJ,\nGouvier WD. Utility of the UFOV test with mild traumatic brain injury. Appl Neuropsychol. 2005;12(3):138\u2013142. doi:10.1207\/S15324826AN1203_3"},{"issue":"10","key":"i1938-162X-60-12-870-b05","series-title":"Am J Sports Med","first-page":"2732","article-title":"Longitudinal assessment of postconcussion driving: evidence of acute driving impairment","volume":"51","author":"Schmidt","year":"2023","unstructured":"Schmidt JD,\nLynall RC,\nLempke LB,\nMiller LS,\nGore RK,\nDevos H. Longitudinal assessment of postconcussion driving: evidence of acute driving impairment. Am J Sports Med. 2023;51(10):2732\u20132739. doi:10.1177\/03635465231184390"},{"issue":"2","key":"i1938-162X-60-12-870-b06","series-title":"J Sport Health Sci","first-page":"145","article-title":"Slowed driving-reaction time following concussion-symptom resolution","volume":"10","author":"Lempke","year":"2021","unstructured":"Lempke LB,\nLynall RC,\nHoffman NL,\nDevos H,\nSchmidt JD. Slowed driving-reaction time following concussion-symptom resolution. J Sport Health Sci. 2021;10(2):145\u2013153. doi:10.1016\/j.jshs.2020.09.005"},{"issue":"4","key":"i1938-162X-60-12-870-b07","series-title":"Neuropsychology","first-page":"493","article-title":"Driving after concussion: the acute effect of mild traumatic brain injury on drivers\u2019 hazard perception","volume":"24","author":"Preece","year":"2010","unstructured":"Preece MH,\nHorswill MS,\nGeffen GM. Driving after concussion: the acute effect of mild traumatic brain injury on drivers\u2019 hazard perception. Neuropsychology. 2010;24(4):493\u2013503. doi:10.1037\/a0018903"},{"issue":"2","key":"i1938-162X-60-12-870-b08","series-title":"J Am Geriatr Soc","first-page":"332","article-title":"Driving cessation and health outcomes in older adults","volume":"64","author":"Chihuri","year":"2016","unstructured":"Chihuri S,\nMielenz TJ,\nDiMaggio CJ, et al. Driving cessation and health outcomes in older adults. 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Arch Psychol. 1944;30:206\u2013356."},{"issue":"1","key":"i1938-162X-60-12-870-b22","series-title":"J Am Geriatr Soc","first-page":"77","article-title":"Can high-risk older drivers be identified through performance-based measures in a Department of Motor Vehicles setting","volume":"54","author":"Ball","year":"2006","unstructured":"Ball KK,\nRoenker DL,\nWadley VG, et al. Can high-risk older drivers be identified through performance-based measures in a Department of Motor Vehicles setting? J Am Geriatr Soc. 2006;54(1):77\u201384. doi:10.1111\/j.1532-5415.2005.00568.x"},{"key":"i1938-162X-60-12-870-b23","series-title":"Int J Gen Med","first-page":"359","article-title":"Standard operation procedures for conducting the on-the-road driving test, and measurement of the standard deviation of lateral position (SDLP)","volume":"4","author":"Verster","year":"2011","unstructured":"Verster JC,\nRoth T. 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