Effectiveness of a Driving Intervention on Safe Community Mobility for Returning Combat Veterans
Traumatic Brain Injury (TBI), Post Traumatic Stress Disorder (PTSD)
About this trial
This is an interventional treatment trial for Traumatic Brain Injury (TBI) focused on measuring Combat Veterans, Automobile Driving, Fitness to Drive
Eligibility Criteria
Inclusion Criteria:
- Combat Veterans with polytrauma (mild traumatic brain injury (TBI)/ with accompanying post-traumatic stress disorder (PTSD), traumatic limb amputation/fractures) who drove prior to injury/condition.
- Have a valid driver's license or are eligible for a driver's license.
- Are community dwelling.
- Combat Veterans without formal diagnoses who report driving issues (either formal such as violations, citations or motor vehicle crashes, or informal including risky driving or driving stress and/or anxiety)
- Have potential for following driving safety recommendations Mini-Mental State Examination (MMSE 24/30)
- Are able to participate in a driving evaluation battery.
- Inclusion criterion for caregivers is based on their ability to complete a driving questionnaire pre and post intervention.
Exclusion Criteria:
- Combat Veterans who have severe psychiatric (e.g., psychoses) or physical conditions (e.g., missing both arms and/or legs) that will limit ability to drive;
- Have multiple psychotropic medications that may impact mental or physical (due to side-effects) functioning as per the consulting physician;
- Have severe, un-remediable medical conditions (e.g., severe TBI) as per the consulting physician;
- Pregnant females or those planning pregnancy as determined by self-report.
- Exclusion criterion for caregivers is based on the presence of a cognitive or physical impairment that would hinder their ability to complete the questionnaires or make an active contribution.
Sites / Locations
- Malcom Randall VA Medical Center
- University of Florida, Occupational Therapy Department
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Active Comparator
Experimental
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Control Group
Experimental Group
Caregiver Control Group
Caregiver Experimental Group
On-road driving Group
Simulator-drives Evaluation Group
Participants in this group will have the following performed: Institute of Mobility Activity and Participation's clinical battery tests and a simulated driving evaluation, a Brief Driving Behavior Interview, Propensity for Angry Driving Scale, Clinical Driving Assessment, Community Integration Questionnaire, Fitness-to-Drive Screening Measure (FTDS), and a Satisfaction with Life Questionnaire. Driving Safety Education by a traffic safety professional, three x 1 hour sessions to discuss traffic safety rules regarding person, vehicle, environmental factors.
Participants in this group will have the following performed: Institute of Mobility Activity and Participation's clinical battery tests and a simulated driving tests, a Brief Driving Behavior Interview, Propensity for Angry Driving Scale, Clinical Driving Assessment, Community Integration Questionnaire, Fitness-to-Drive Screening Measure(FTDS), and a Satisfaction with Life Questionnaire. Occupational Therapy Driving Intervention (OT-DI) consisting of three x 1 hour sessions to review explicit driving errors, strategies to mitigate errors and receiving feedback from the evaluator after driving the simulator.
Caregiver control group will fill out a Fitness-to-Drive Screening Measure (FTDS) questionnaire at baseline and at the end of the study.
Caregivers of the experimental group will fill out a Fitness-to-Drive Screening Measure (FTDS) questionnaire at baseline and at the end of the study.
A subset of 30 Combat Veterans will be drawn from the control group (15 no.) and experimental group (15 no.). This group of Combat Veterans will will undergo an on-road driving test at baseline and month 5
This group will comprise of 30 Combat Veterans who will be drawn outside of the randomized experimental and and control groups participants. This group will only perform simulator driving triggers evaluation