Car-driving abilities of people with tetraplegia

Objectives: To examine the relationship between the spinal cord injury (SCI) level, age,, and car-driving ability in people with tetraplegia and to explore the association between car-driving ability and social activity. Design: Retrospective clinical survey. Setting: Rehabilitation center in Japan. Patients: Sixty-two subjects with traumatic complete tetraplegia. Interventions: Driving evaluation; comprehensive driver's training (muscle strengthening, transfer training, adjustment of equipment, on-road training); and questionnaire (car-driving status, employment, participation in sports). Main Outcome Measures: The SCI level (Zancolli's classification), age, functional status of activities of daily living (ADLs), and driving ability were obtained from the medical records. Vocational status and engagement in sports activities were investigated by questionnaire. Results: The SCI level and age strongly influenced the patients' ability to drive a car independently. The highest neurologic level in which independent driving was achievable was C6A. Toilet transfer ability almost paralleled the ability to drive a car. Eighty-four percent of the people with tetraplegia who had a defined job could drive independently and 70% of the driving-independent individuals held a job. Half of driving-independent individuals participated in some sports activities. Conclusions: Toilet transfer ability is a reliable indicator for driver's training. Driving ability is an important factor that allows individuals with tetraplegia to participate in work and sports-related activities.