Efficacy of an Occupational Therapy Driving Intervention for Returning Combat Veterans

Abstract

Polytrauma, including mild traumatic brain injury, posttraumatic stress disorder, and orthopedic conditions, is common among combat veterans (CVs) from Operations Enduring Freedom and Iraqi Freedom. Medical conditions, coupled with deployment-related training, may affect CVs' fitness to drive and contribute to post-deployment crash and injury risks. However, empirical interventions are lacking. Therefore, the study purpose was to examine the efficacy of an occupational therapy driving intervention (OT-DI) with pre and post testing of CVs. Using a DriveSafety 250 simulator, Occupational Therapy-Driver Rehabilitation Specialists recorded driving errors. Eight CVs (mean age = 39.83, SD = 7.80) received three OT-DI sessions, which incorporated strategies to address driving errors and visual search retraining. We determined baseline driving errors (mean = 31.63, SD = 8.96) were double the number of posttest errors (mean = 15.38, SD = 9.71). At posttesting, a significant (p < 0.05) decrease was noted for total errors and lane maintenance. Despite study constraints, preliminary data support the efficacy of the OT-DI.

Keywords

automobile driving intervention study polytrauma

Get full access to this article

View all access options for this article.

References

American Occupational Therapy Association. (2010). Statements: Driving and community mobility. American Journal of Occupational Therapy, 64(6 Suppl.), S112–S124. doi:10.5014/ajot.2010.64S112

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Amick

M.M.

Kraft

McGlinchey

(2013). Driving simulator performance of veterans from the Iraq and Afghanistan wars. Journal of Rehabilitation Research & Development, 50, 463–470.

Carlson

Kehle

Meis

Greer

MacDonald

Rutks

Wilt

T. J.

(2009). The assessment and treatment of individuals with history of traumatic brain injury and post-traumatic stress disorder: A systematic review of the evidence. Retrieved from the National Center for Biotechnology Information website: http://www.ncbi.nlm.nih.gov/books/NBK49144/

Classen

Levy

McCarthy

Mann

W.C.

Lanford

Waid-Ebbs

K.J.

(2009). Traumatic brain injury and driving assessment: An evidence based literature review. American Journal of Occupational Therapy, 63, 580–591.

Classen

Levy

Meyer

Bewernitz

Lanford

D.N.

Mann

W.C.

(2011). Simulated driving performance of combat veterans with mild traumatic brain injury and posttraumatic stress disorder: A pilot study. American Journal of Occupational Therapy, 65, 419–427.

Classen

Monahan

Canonizado

Winter

S.M.

(2014). An occupational therapy driving intervention's utility for a combat veteran. American Journal of Occupational Therapy, 68, 405–411.

Classen

Owens

A. B.

(2010). Simulator sickness among returning combat veterans with mild traumatic brain injury and/or post-traumatic stress disorder. Advances in Transportation Studies, 2010 Special Issue, 45–52.

Classen

Wen

P.S.

Velozo

Bédard

Winter

S.M.

Brumback

Lanford

D.N.

(2012). Psychometrics of the self-report Safe Driving Behavior Measure for older adults. American Journal of Occupational Therapy, 66, 233–241. doi:10.5014/ajot.2012.001834

10.

Congressional Research Service. (2014). U.S. military casualty statistics: Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom. Retrieved from http://www.fas.org/sgp/crs/natsec/RS22452.pdf

11.

Defense and Veterans Brain Injury Center. (2014). DOD numbers for traumatic brain injury. Retrieved from http://dvbic.dcoe.mil/dod-worldwide-numbers-tbi

12.

Hannold

E.M.

Classen

Winter

Lanford

Levy

(2013). Exploratory pilot study of driving perceptions among OIF/OEF veterans with mTBI and PTSD. Journal of Rehabilitation Research & Development, 50, 1315–1330.

13.

Kennedy

R.S.

Lane

N.E.

Berbaum

K.S.

Lilienthal

M.G.

(1993). Simulator Sickness Questionnaire: An enhanced method for quantifying simulator sickness. The International Journal of Aviation Psychology, 3, 203–220.

14.

Lew

H.L.

Amick

M.M.

Kraft

Stein

M.B.

Cifu

D.X.

(2010). Potential driving issues in combat returnees. NeuroRehabilitation, 26, 271–278. doi:10.3233/NRE-2010-0562

15.

Lew

H.L.

Kraft

Pogoda

T.K.

Amick

M.M.

Woods

Cifu

D.X.

(2011). Prevalence and characteristics of driving difficulties in Operation Iraqi Freedom/Operation Enduring Freedom combat returnees. Journal of Rehabilitation Research and Development, 48, 913–926. doi:10.1682/JRRD.2010.08.0140

16.

Lew

H.L.

Rosen

P.N.

Thomander

Poole

J.H.

(2009). The potential utility of driving simulators in the cognitive rehabilitation of combat-returnees with traumatic brain injury. Journal of Head Trauma Rehabilitation, 24, 51–56.

17.

Monahan

(2009). Visual search skills. Richmond, VT: Driver Rehabilitation Institute.

18.

National Institute of Neurological Disorders and Stroke. (2014). NINDS traumatic brain injury information page. Retrieved from http://www.ninds.nih.gov/disorders/tbi/tbi.htm

19.

Owens

Kragh

J.J.

Macaitis

Svoboda

Wenke

(2007). Characterization of extremity wounds in Operation Iraqi Freedom and Operation Enduring Freedom. Journal of Orthopedic Trauma, 21, 254–257.

20.

Zamorski

M.A.

Kelley

A.M.

(2012). Risky driving behaviour. In Psychological aspects of deployment and health behaviours (NATO report TR-HFM-164, pp. 5-1–5-21). Neuilly-sur-Seine, France: Research and Technology Organisation of the North Atlantic Treaty Organisation. Retrieved from http://natorto.cbw.pl/uploads/2012/5/$$TR-HFM-164-ALL.pdf