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DOI: 10.1055/s-0042-103156
Change in Driving Performance following Arthroscopic Shoulder Surgery
Publication History
accepted after revision 08 February 2016
Publication Date:
03 August 2016 (online)
![](https://www.thieme-connect.de/media/sportsmed/201609/lookinside/thumbnails/5217_10-1055-s-0042-103156-1.jpg)
Abstract
The current study aimed to measure perioperative changes in driving performance following arthroscopic shoulder surgery using a validated driving simulator.
21 patients who underwent arthroscopic surgery for rotator cuff or labral pathology were tested on a driving simulator preoperatively, and 6 and 12 weeks postoperatively. An additional 21 subjects were tested to establish driving data in a control cohort. The number of collisions, centerline crossings, and off-road excursions were recorded for each trial. VAS and SPADI scores were obtained at each visit.
The mean number of collisions in the study group significantly increased from 2.05 preoperatively to 3.75 at 6 weeks (p<0.001), and significantly decreased to 1.95 at 12 weeks (p<0.001). Centerline crossings and off-road excursions did not significantly change from preoperative through 12 weeks, although centerline crossings were statistically different from the controls at each time point (p<0.001). Surgery on the dominant driving arm resulted in greater collisions at 6 weeks than surgery on the non-dominant driving arm (p<0.001).
Preliminary data shows that driving performance is impaired for at least 6 weeks postoperatively, with a return to normal driving by 12 weeks. Driving is more profoundly affected in conditions that require avoiding a collision and when the dominant driving arm is involved.
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References
- 1 Bedard MB, Parkkari M, Weaver B, Riendeau J, Dahlquist M. Assessment of driving performance using a simulator protocol: validity and reproducibility. Am J Occup Ther 2010; 64: 336-340
- 2 Bertaso A, Pascali JP, Liotta E, Polettini A. Assessment of fitness to drive in correlation with narcotic and psychotropic drug use. Epidemiologic study in Verona. G Ital Med Lav Ergon 2011; 33: 125-133
- 3 Carr DBSJ, Manning L, Sempek J. Physicians’s guide to assessing and counseling older drivers. National Highway Traffic and Safety Administration (NHTSA) 2010; 2
- 4 Chesher GB. The influence of analgesic drugs in road crashes. Accid Anal Prev 1985; 17: 303-309
- 5 Chong PY, Koehler EA, Shyr Y, Watson JT, Weikert DR, Rowland JH, Lee DH. Driving with an arm immobilized in a splint: a randomized higher-order crossover trial. J Bone Joint Surg Am 2010; 92: 2263-2269
- 6 Colvin AC, Egorova N, Harrison AK, Moskowitz A, Flatow EL. National trends in rotator cuff repair. J Bone Joint Surg Am 2012; 94: 227-233
- 7 Dobbs B. Medical Conditions and Driving: A Review of the Scientific Literature (1960–2000). vol 2005, 2005 edn. Washington, DC: US Department of Transportation National Highway Traffic Safety Administration;
- 8 Egol KA, Sheikhazadeh A, Koval KJ. Braking function after complex lower extremity trauma. J Trauma 2008; 65: 1435-1438
- 9 Egol KA, Sheikhazadeh A, Mogatederi S, Barnett A, Koval KJ. Lower-extremity function for driving an automobile after operative treatment of ankle fracture. J Bone Joint Surg Am 2003; 85-a: 1185-1189
- 10 Giddins GE, Hammerton A. “Doctor, when can I drive?’: a medical and legal view of the implications of advice on driving after injury or operation. Injury 1996; 27: 495-497
- 11 Gotlin RS, Sherman AL, Sierra N, Kelly M, Scott WN. Measurement of brake response time after right anterior cruciate ligament reconstruction. Arthroscopy: the journal of arthroscopic & related surgery 2000; 16: 151-155
- 12 Gregory JJ, Stephens AN, Steele NA, Groeger JA. Effects of upper-limb immobilisation on driving safety. Injury 2009; 40: 253-256
- 13 Harriss DJAG. Ethical Standards in Sports and Exercise Science Research: 2014 Update. Int J Sports Med 2012; 34: 1025-1028
- 14 Blinded to review Hasan S. Chay E, Atanda A, McGee Jr AW, Jazrawi LM, Zuckerman JD. The effect of shoulder immobilization on driving performance. J Shoulder Elbow Surg 2014;
- 15 Hau R, Csongvay S, Bartlett J. Driving reaction time after right knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 2000; 8: 89-92
- 16 Hobman JW, Southern SJ. Upper limb splints and the right to drive – who decides?. Br J Plast Surg 2004; 57: 354-357
- 17 Hoffman L, McDowd JM. Simulator driving performance predicts accident reports five years later. Psychol Aging 2010; 25: 741-745
- 18 Horrey WJ, Lesch MF, Dainoff MJ, Robertson MM, Noy YI. On-board safety monitoring systems for driving: review, knowledge gaps, and framework. J Safety Res 2012; 43: 49-58
- 19 Kalamaras MA, Rando A, Pitchford DG. Driving plastered: who does it, is it safe and what to tell patients. ANZ J Surg 2006; 76: 439-441
- 20 Katz LM, Hsu S, Miller SL, Richmond JC, Khetia E, Kohli N, Curtis AS. Poor outcomes after SLAP repair: descriptive analysis and prognosis. Arthroscopy 2009; 25: 849-855
- 21 Lee HC, Lee AH, Cameron D. Validation of a driving simulator by measuring the visual attention skill of older adult drivers. Am J Occup Ther 2003; 57: 324-328
- 22 Lee HC, Lee AH, Cameron D, Li-Tsang C. Using a driving simulator to identify older drivers at inflated risk of motor vehicle crashes. J Safety Res 2003; 34: 453-459
- 23 MacDonald W, Owen JW. The effect of total hip replacement on driving reactions. J Bone Joint Surg Br 1988; 70: 202-205
- 24 Maes V, Grenez O, Charlier C, Smet H, Verstraete A, Wennig R. Classification of medicines according to their influence on driving ability. Acta Clin Belg Suppl 1999; 1: 82-88
- 25 Marcotte TD, Heaton RK, Wolfson T, Taylor MJ, Alhassoon O, Arfaa K, Ellis RJ, Grant I. The impact of HIV-related neuropsychological dysfunction on driving behavior. The HNRC Group. J Int Neuropsychol Soc 1999; 5: 579-592
- 26 Marshall SC, Man-Son-Hing M. Multiple chronic medical conditions and associated driving risk: a systematic review. Traffic injury prevention 2011; 12: 142-148
- 27 Mayhew DR, Simpson HM, Wood KM, Lonero L, Clinton KM, Johnson AG. On-road and simulated driving: concurrent and discriminant validation. J Safety Res 2011; 42: 267-275
- 28 Mets MA, Kuipers E, de Senerpont Domis LM, Leenders M, Olivier B, Verster JC. Effects of alcohol on highway driving in the STISIM driving simulator. Hum Psychopharmacol 2011; 26: 434-439
- 29 Meuser TM, Carr DB, Irmiter C, Schwartzberg JG, Ulfarsson GF. The American Medical Association Older Driver Curriculum for Health Professionals: Changes in Trainee Confidence, Attitudes & Practice Behavior. Gerontol Geriatr Educ 2010; 31: 290-309
- 30 Namdari S, Yagnik G, Ebaugh DD, Nagda S, Ramsey ML, Williams Jr GR, Mehta S. Defining functional shoulder range of motion for activities of daily living. J Shoulder Elbow Surg 2012; 21: 1177-1183
- 31 Nguyen T, Hau R, Bartlett J. Driving reaction time before and after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2000; 8: 226-230
- 32 Onyekwelu I, Khatib O, Zuckerman JD, Rokito AS, Kwon YW. The rising incidence of arthroscopic superior labrum anterior and posterior (SLAP) repairs. Journal of shoulder and elbow surgery 2012; 21: 728-731
- 33 Parsons JA, Mamdani M, Bhattacharyya O, Fortin CM, Melo M, Salmon C, Raptis SR, Bain D, O’Campo P. Narcotic analgesic utilization amongst injured workers: using concept mapping to understand current issues from the perspectives of physicians and pharmacists. BMC Health Serv Res 2011; 11: 280-280
- 34 Peters KS, McCallum S, Briggs L, Murrell GA. A comparison of outcomes after arthroscopic repair of partial versus small or medium-sized full-thickness rotator cuff tears. J Bone Joint Surg Am 2012; 94: 1078-1085
- 35 Rosen E, Stigson H, Sander U. Literature review of pedestrian fatality risk as a function of car impact speed. Accid Anal Prev 2011; 43: 25-33
- 36 Shechtman O, Classen S, Awadzi K, Mann W. Comparison of driving errors between on-the-road and simulated driving assessment: a validation study. Traffic Inj Prev 2009; 10: 379-385
- 37 Spalding TJ, Kiss J, Kyberd P, Turner-Smith A, Simpson AH. Driver reaction times after total knee replacement. J Bone Joint Surg Br 1994; 76: 754-756
- 38 Ware JC, Risser MR, Manser T, Karlson Jr KH. Medical resident driving simulator performance following a night on call. Behav Sleep Med 2006; 4: 1-12
- 39 Williams Jr G, Kraeutler MJ, Zmistowski B, Fenlin Jr JM. No difference in postoperative pain after arthroscopic versus open rotator cuff repair. Clin Orthop Relat Res 2014; 472: 2759-2765