Patterns, Predictors, and Associated Benefits of Driving a Modified Vehicle After Spinal Cord Injury: Findings From the National Spinal Cord Injury Model Systems

• Published in: Archives of physical medicine and rehabilitation Vol. 92; no. 3; pp. 477 - 483
• Main Authors: Norweg, Anna, PhD, OTR, Jette, Alan M., PT, PhD, Houlihan, Bethlyn, MSW, MPH, Ni, Pengsheng, MD, MPH, Boninger, Michael L., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2011
• Subjects: Activities of daily living; Adolescent; Adult; Age; Age Factors; Automobile driving; Automobile Driving - psychology; Automobile Driving - statistics & numerical data; Cross-Sectional Studies; Depression; Employment; Female; Hospitals; Humans; Male; Middle Aged; Mobility; Pain; Paraplegia; Physical Medicine and Rehabilitation; Races; Rehabilitation; Retrospective Studies; Sex; Sex Factors; Socioeconomic Factors; Spinal cord injuries; Spinal Cord Injuries - psychology; Spinal Cord Injuries - rehabilitation; Spinal cord injury; Trauma Severity Indices; Young Adult; Craig Hospital Inventory of Environmental Factors; spinal cord injury; OR; MSCIS; Patient Health Questionnaire-9; SF-12; health-related quality of life; odds ratio; PHQ-9; NSCI; QOL; Medical Outcomes 12-Item Short Form Health Survey; ADLs; CHIEF; Automobile driving; Employment; activities of daily living; Model Spinal Cord Injury Systems; SCI; HRQOL; Spinal cord injuries; Rehabilitation; quality of life; National Spinal Cord Injury
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2010.07.234

Abstract Norweg A, Jette AM, Houlihan B, Ni P, Boninger ML. Patterns, predictors, and associated benefits of driving a modified vehicle after spinal cord injury: findings from the National Spinal Cord Injury Model Systems. Objectives To investigate the patterns, predictors, and benefits associated with driving a modified vehicle for people with spinal cord injuries (SCIs). Design Cross-sectional retrospective survey design. Settings Sixteen Model SCI Systems (MSCISs) throughout the United States. Participants People (N=3726) post-SCI from the National MSCIS Database. Interventions Not applicable. Main Outcome Measures Driving, employment, and community reintegration post-SCI. Results The study found that 36.5% of the sample drove a modified vehicle after SCI. Significant predictors of driving a modified vehicle post-SCI included married at injury, younger age at injury, associate's degree or higher before injury, paraplegia, a longer time since the injury, non-Hispanic race, white race, male sex, and using a wheelchair for more than 40 hours a week after the injury (accounting for 37% of the variance). Higher activity of daily living independence (in total motor function) at hospital discharge also increased the odds of driving. Driving increased the odds of being employed at follow-up by almost 2 times compared with not driving postinjury (odds ratio, 1.85). Drivers tended to have higher community reintegration scores, especially for community mobility and total community reintegration. Driving was also associated with small health-related quality-of-life gains, including less depression and pain interference and better life satisfaction, general health status, and transportation availability scores. Conclusions The associated benefits of driving and the relatively low percentage of drivers post-SCI in the sample provide evidence for the need to increase rehabilitation and assistive technology services and resources in the United States devoted to facilitating driving after SCI.