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 ex plore 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 spor ts). Main Outcome Measures: The SCI level (Zancolli's classification), age, func tional status of activities of daily living (ADLs), and driving ability wer e obtained from the medical records. Vocational status and engagement in sp orts 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 independe nt driving was achievable was C6A. Toilet transfer ability almost parallele d the ability to drive a car. Eighty-four percent of the people with tetrap legia who had a defined job could drive independently and 70% of the drivin g-independent individuals held a job. Half of driving-independent individua ls participated in some sports activities. Conclusions: Toilet transfer ability is a reliable indicator for driver's t raining. Driving ability is an important factor that allows individuals wit h tetraplegia to participate in work and sports-related activities.