Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Wednesday, February 15, 2017

Driving after Concussion: Is It Safe To Drive after Symptoms Resolve?

What is the objective protocol to judge when stroke survivors are able to return to driving? I just did it, but did have a driving evaluation which was difficult because there was no practice ahead of time. I never talked to my doctor on this, he knew nothing about stroke recovery and I saw no need to even attempt to engage him on this.
Maybe your doctor can look at these and actually help you get back to driving.

Predicting road test performance in drivers with stroke

Stroke survivor, researchers encourage patients to discuss driving with their doctors

Stroke survivors more likely to make dangerous driving errors

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http://online.liebertpub.com/doi/abs/10.1089/neu.2016.4668
To cite this article:
Schmidt Julianne D., Hoffman Nicole L., Ranchet Maud, Miller L. Stephen, Tomporowski Phillip D., Akinwuntan Abiodun E., and Devos Hannes. Journal of Neurotrauma. January 2017, ahead of print. doi:10.1089/neu.2016.4668.
Online Ahead of Print: January 24, 2017
Online Ahead of Editing: December 13, 2016

Author information

Julianne D. Schmidt,1 Nicole L. Hoffman,1 Maud Ranchet,2,3 L. Stephen Miller,4 Phillip D. Tomporowski,1 Abiodun E. Akinwuntan,5 and Hannes Devos2,5
1Department of Kinesiology, University of Georgia, Athens, Georgia.
2Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, Georgia.
3Laboratory Ergonomics and Cognitive Sciences applied to Transport, Lyon, France.
4Department of Psychology, University of Georgia, Athens, Georgia.
5University of Kansas Medical Center, Kansas City, Kansas.
Address correspondence to:
Julianne D. Schmidt, PhD, ATC
Department of Kinesiology
University of Georgia
330 River Road
Athens, GA 30602
E-mail:

ABSTRACT

Post-concussion impairments may result in unsafe driving performance, but little research is available to guide consensus on when concussed individuals should return to driving. The purpose of this study was to compare driving performance between individuals with and without a concussion and to explore relationships between neuropsychological and driving performance. Fourteen participants with concussion (age 20.2 ± 0.9 years old) and 14 non-concussed age- and driving experience–matched controls (age 20.4 ± 1.1 years old) completed a graded symptom checklist, a brief neuropsychological exam, and a 20.5 km driving simulation task. Participants with a concussion completed driving simulation within 48 h of becoming asymptomatic (15.9 ± 9.0 days post-concussion). One-way analyses of variance were used to compare total number of crashes, tickets, and lane excursions, as well as standard deviation of lateral position (SDLP) and standard deviation of speed. Pearson's correlations were conducted to explore the relationship between the neuropsychological and driving performance separately by group (α = 0.05). Participants with a concussion committed more frequent lane excursions (concussed 10.9 ± 4.5; controls 7.4 ± 2.4; p = 0.017) and exhibited greater SDLP, compared with controls, during the first curve (concussed 45.7 ± 21.3 cm, controls 27.4 ± 6.1 cm; p = 0.030) and final curve (concussed 39.6 ± 24.4 cm; controls 33.5 ± 21.3 cm; p = 0.036). Poorer performance on symbol digit modalities (r = −0.54), Rey Osterrieth Complex Figure (r = −0.53), verbal memory (r = −0.77), and motor speed (r  = −0.54) were correlated with more frequent lane excursions in the concussed group, but not in the control group. Despite being asymptomatic, concussed participants exhibited poorer vehicle control, especially when navigating curves. Driving impairments may persist beyond when individuals with a concussion have returned to driving. Our study provides preliminary guidance regarding which neuropsychological functions may best indicate driving impairment following concussion.

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