International Journal of Physical Medicine & Rehabilitation
Open Access

Abstract

Effects of Long (Above-Elbow) Upper Limb Immobilization on Simulated Driving Performance: An Experimental Pilot Study

Francois Cabana, Marie-Victoria Dorimain, Mathieu Hamel, Vincent Décarie, Karina Lebel and Hélène Corriveau

Background: Driving a motor vehicle is essentially incompatible with a limb immobilization according to the Quebec road safety code. The incapacity to drive due to an upper limb immobilization has an important potential socio-economic effect for patients, yet there is no consensus on the impact of upper limb immobilization on driving safety. Materials and Methods: Our study aimed to characterise the effects of long upper limb immobilization on simulated driving. A sample of 12 healthy participants tested the effect of three conditions (without immobilization and immobilization of the left or right upper limb) on three independent tasks on a driving simulator: 1) maximal range of movement (ROM); 2) angular deviation and precision; and 3) impact of the immobilization during on-road simulated driving. Participants were also tested for grip strength and completed a questionnaire on perceived difficulty, insecurity, physical discomfort and fatigue. Results: The data from absence of immobilization was compared to left or right arm immobilization. Maximum ROM to the right and left were significantly diminished with respective immobilizations, as well as angular deviation (p=0.019; p=0.050) and precision (p=0.019; p=0.028). No significant differences were observed however for the tasks of on-road simulated. Hand-grip was significantly reduced with an immobilization and participant’s perception of difficulty and insecurity increased with an immobilization on either arm. Conclusion: Above-elbow upper limb immobilization significantly affected ROM in a driving simulator and increased perceived difficulty and insecurity. As such, both left and right arm immobilization may affect driving performance and safety.