Citation

Takasaki H, Treleaven J, Johnston V, Jull G. Spine 2013; 38(18): 1554-1560.

Affiliation

NHMRC Centre of Clinical Research Excellence - Spinal Pain, Injury and Health, Division of Physiotherapy, School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Queensland, Australia.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0b013e31829adb54

PMID

23698571

Abstract

STRUCTURED ABSTRACT: Study Design. Cross-sectionalObjective. To conduct a preliminary analysis of the physical, cognitive and psychological domains contributing to self-reported driving difficulty after adjusting for neck pain, dizziness and relevant demographics in chronic whiplash-associated disorders (WAD) using hierarchical regression modeling.Summary of Background Data. Pain is a risk factor for car crashes and dizziness may affect fitness to drive. Both symptoms are common in chronic WAD and difficulty driving is a common complaint in this group. Chronic WAD is often accompanied by physical, cognitive and psychological impairments. These impairments may contribute to self-reported driving difficulty beyond neck pain, dizziness and relevant demographics.Methods. Forty individuals with chronic WAD participated. Dependent variables were the magnitude of self-reported driving difficulty assessed in the strategic, tactical and operational levels of the Neck Pain Driving Index. Three models were developed to assess the contributions of independent variables (physical, cognitive and psychological domains) to each of the three dependent variables after adjusting for neck pain intensity, dizziness and driving demographics. The measures included were: physical domain-range and maximum speed of head rotation, performances during gaze stability, eye-head coordination and visual dependency tests; cognitive domain-self-reported cognitive symptoms including fatigue and the Trail Making Tests; and psychological domain-general stress, traumatic stress, depression, and fear of neck movements and driving.Results. Symptom duration was relevant to driving difficulty in the strategic and tactical levels. The cognitive domain increased statistical power to estimate the strategic and operational levels (P<.1) beyond other contributors. The physical domain increased statistical power to estimate the tactical level (P<.1) beyond other contributors.Conclusion. Physical and cognitive impairments independently contributed to self-reported driving difficulty in chronic WAD beyond neck pain, dizziness and symptom duration.

Language: en