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Using Naturalistic Methods to Examine Real-World Driving Behavior in Individuals With TBI Upon Return to Driving

A Pilot Study

Hua, Phuong, BPsych(Hons); Charlton, Judith L., PhD; Ponsford, Jennie L., PhD; Gooden, James R., DPsych; Ross, Pamela E., PhD; Bédard, Michel, PhD; Marshall, Shawn, MD; Gagnon, Sylvain, PhD; Stolwyk, Renerus J., DPsych

The Journal of Head Trauma Rehabilitation: January/February 2019 - Volume 34 - Issue 1 - p E55–E60
doi: 10.1097/HTR.0000000000000410
Focus on Clinical Research and Practice

Objectives: To characterize the real-world driving habits of individuals with traumatic brain injury (TBI) using naturalistic methods and to demonstrate the feasibility of such methods in exploring return to driving after TBI.

Methods: After passing an on-road driving assessment, 8 participants with TBI and 23 matched controls had an in-vehicle device installed to record information regarding their driving patterns (distance, duration, and start/end times) for 90 days.

Results: The overall number of trips, distance and duration or percentage of trips during peak hour, above 15 km from home or on freeways/highways did not differ between groups. However, the TBI group drove significantly less at night, and more during the daytime, than controls. Exploratory analyses using geographic information system (GIS) also demonstrated significant within-group heterogeneity for the TBI group in terms of location of travel.

Conclusions: The TBI and control groups were largely comparable in terms of driving exposure, except for when they drove, which may indicate small group differences in driving self-regulatory practices. However, the GIS evidence suggests driving patterns within the TBI group were heterogeneous. These findings provide evidence for the feasibility of employing noninvasive in-car recording devices to explore real-world driving behavior post-TBI.

Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences (Ms Hua and Drs Ponsford, Gooden, and Stolwyk) and Monash University Accident Research Centre (Ms Hua and Dr Charlton), Monash University, Victoria, Australia; Monash-Epworth Rehabilitation Research Centre, Victoria, Australia (Drs Ponsford, Gooden, and Stolwyk); Epworth Rehabilitation, Victoria, Australia (Dr Ross); Centre for Research and Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada (Dr Bédard); and Department of Medicine (Dr Marshall) and School of Psychology (Dr Gagnon), University of Ottawa, Ontario, Canada.

Corresponding Author: Renerus J. Stolwyk, DPsych, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, 18 Innovation Walk, Clayton Campus, Monash University, VIC 3800, Australia (

This research project was jointly funded by the Transport Accident Commission (Victoria, Australia) and the Ontario Neurotrauma Foundation (Ontario, Canada).

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The authors declare no conflicts of interest.

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