Journal: The Journal of school nursing : the official publication of the National Association of School Nurses

Article Title: An Integrative Review of Return to Driving After Concussion in Adolescents

doi: 10.1177/1059840520963625

Figure Lengend Snippet: Summary of Studies Included in the Integrative Review.

Article Snippet: MacDonald et al. (2018) , Level III , Design: Retrospective chart review Purpose: Determine clinical measures that influence a physician’s decision to restrict driving postconcussion in adolescents , Setting: Nationwide Children’s Hospital sports medicine clinic Sample characteristics: 183 Patients ages 16 and older seen at the clinic with a sports-related concussion within 30 days of injury; only 113 of which had CogState computerized neurocognitive test (CNT) data , IV: Physician clearance to drive at initial visit DV: Patient-reported symptom burden, postural stability, reaction times from CogState CNT , Mann-Whitney U and χ 2 tests to compare continuous and categorical variables between patients who were and were not cleared to drive Multivariable logistic regression to determine patient factors and symptoms associated with driving status , Patients who were cleared were significantly more likely to have a shorter duration of symptoms, lower symptom score, lower scores for each symptom, andCogState CNT administration CogState CNT administration had the largest effect size (nearly 6×) Total symptom score and symptom of “feeling slowed down” were significantly associated with driving status , Single-center, retrospective design Only assessed what influenced decision making, not correlations between the patient factors/symptoms and actual driving performance All subjects did not complete CogState CNT , An assessment of reaction time measures using CNT was highly associated with a clinician’s recommended driving status for their adolescent patients, but this does not indicate that good reaction times on this assessment is related to better driving performance.

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