Driving With a Chronic Whiplash-Associated Disorder: A Review of Patients' Perspectives

Takasaki H, Johnston V. Treleaven J, Pereira M, Jull G. Driving with a chronic whiplash-associated disorder: a review of patients' perspectives. Arch Phys Med Rehabil 2011;92:106-10. Objective: To document troublesome driving tasks and any changes in driving behavior reported by people with chronic whiplash-associated disorders (WADs). Design: Descriptive study; semistructured interview. Setting: Tertiary institution. Participants: Patients (N=33) with chronic WAD. Interventions: Not applicable. Main Outcome Measures: Neck Disability Index (NDI), visual analog scale for neck pain at rest and while driving, exposure section of the Driving Habit Questionnaire, self-rating perceived current driving ability, semistructured interview about presenting symptoms, troublesome driving tasks, and perceived changes in driving behavior after a whiplash injury. Results: Subjects (24 of 33; 73%) reported a decrease in driving ability, rating an average of 6.7 +/- 2.2 on an 11-point scale (0, unable to drive; 10, driving at preinjury level). These subjects scored higher on the NDI (41.8%+/- 18.4%), experienced greater neck pain at rest (4.3 +/- 2.1/10) and while driving (5.7 +/- 2.1/10), and reported decreased concentration more frequently than those who rated their driving ability at a preinjury level (ie, 10). The most frequently nominated troublesome driving tasks were checking blind spots, prolonged driving, and reversing/reverse parking, and the most frequently cited changes in driving behavior included more use of trunk rotation (75%), altered steering wheel grip (63%), more anxious/nervous while driving (54%), and more cautious driving (50%). Conclusions: The chronic whiplash population appears to have unique troublesome driving tasks (eg, prolonged driving, checking blind spots) that are not readily detected in currently available driving ability/difficulty scales, suggesting that a new scale may be required for this population.