Measurement of brake response time after right anterior cruciate ligament reconstruction.

OBJECTIVE Recommendations on safe driving after anterior cruciate ligament (ACL) reconstruction have been largely intuitive. We studied brake response time in patients who participated in outpatient rehabilitation after right ACL reconstruction. DESIGN Prospective, repeated measures design comparing 14 patients post-ACL reconstruction with 21 subjects with normal knees. INTERVENTIONS AND MAIN OUTCOME MEASURES The following measures were assessed every 2 weeks for 10 weeks: brake response time, 6-meter walk time, knee range of motion, pain, and joint effusion. Statistical testing used analysis of covariance with repeated measures. Significant variables were analyzed separately and post hoc tests conducted using the least squares differences method. Both groups were compared with published norms from the American Automobile Association. RESULTS No significant gender differences across main effects were detected. Brake response times for men improved significantly after week 6 (p < .05) and week 10 (p < .01). Brake response times for women in the ACL treatment group matched controls at 6 weeks. Six-meter walk times for control subjects were faster than those for the ACL group preoperatively (2.6 sec vs 5.5 sec), but equalized by week 6. CONCLUSIONS After right ACL reconstruction, brake reaction times of rehabilitated men and women matched those of established controls after 4 to 6 weeks. Measuring brake response times during rehabilitation may ensure that individual patients return to driving in a safe and timely manner.

[1]  K. Shelbourne,et al.  Accelerated rehabilitation after anterior cruciate ligament reconstruction , 1990, The American journal of sports medicine.

[2]  J Törnros,et al.  Effect of driving speed on reaction time during motorway driving. , 1995, Accident; analysis and prevention.

[3]  N. Mayo,et al.  Determining medical fitness to drive: physicians' responsibilities in Canada. , 1989, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[4]  W MacDonald,et al.  The effect of total hip replacement on driving reactions. , 1988, The Journal of bone and joint surgery. British volume.

[5]  F. Noyes,et al.  Advanced muscle training after ACL reconstruction: weeks 6 to 52. , 1992, Orthopedics.

[6]  K. Wilk,et al.  Current concepts in the treatment of anterior cruciate ligament disruption. , 1992, The Journal of orthopaedic and sports physical therapy.

[7]  M. Pitman,et al.  The intraoperative evaluation of the neurosensory function of the anterior cruciate ligament in humans using somatosensory evoked potentials. , 1992, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[8]  Freddie H. Fu,et al.  Current Concepts for Rehabilitation following Anterior Cruciate Ligament Reconstruction. , 1992, The Journal of orthopaedic and sports physical therapy.

[9]  B Schlag,et al.  Elderly drivers in Germany--fitness and driving behavior. , 1993, Accident; analysis and prevention.

[10]  P. Kyberd,et al.  Driver reaction times after total knee replacement. , 1994, The Journal of bone and joint surgery. British volume.

[11]  P. L. Olson,et al.  Driving and perceptual/cognitive skills: behavioral consequences of brain damage. , 1981, Archives of physical medicine and rehabilitation.