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Orthopedic and Rehabilitation Engineering

Orthopedic and Rehabilitation Engineering - Poster Session E

Poster L2 - Using a Braking Simulator to Determine a Timeline for Returning to Drive After Right Ankle Injury and Corrective Surgery

Saturday, October 26, 2024

10:00 AM - 11:00 AM EST

Location: Exhibit Hall E, F & G

Presenting Author(s)

Aayushi Arvikar

Department of Biomedical Engineering
Bucknell University, New Jersey, United States

Last Author(s)

Eric A. Kennedy, PhD

Professor of Biomedical Engineering
Bucknell University
Lewisburg, Pennsylvania, United States

Introduction: Depending on fracture severity, anatomy, fixation methodology, soft-tissue damage, and days post-operation, lower right extremity fracture patients are recommended to refrain from driving for 2-12 weeks (Yoursi and Jackson, 2015). The variability with this restriction can impede the quality of life for patients during recovery. Although the available, scarce literature on narrowing down the time to return to driving accounts for lower limb anatomical fracture regions, there are no specific guidelines mentioned per region. By utilizing a braking simulator to precisely assess the postoperative (post-op) brake reaction time and force, this study aims to specifically determine when patients with right ankle fractures are ready to return to driving.

Materials and

Methods: After IRB approval, 31 patients who were licensed drivers with right ankle fractures were recruited in this study and categorized based on the fracture pattern and surgical fixation method. Patients were assessed using a custom-developed braking simulator, mimicking a car, during their post-op clinical follow-up visits. Patients performed three trials of driving-to-emergency stop simulations where brake reaction time and force were recorded. The collected measurements were processed using a MATLAB script and transferred to an Excel database for analysis, where patient’s three trials were averaged. Based on previous studies, a minimum accelerator-to-braking reaction time of 1 second (s) and a maximum force generated while braking exceeding 350 newtons (N) were used as thresholds (Yoursi and Jackson, 2015). Patient outcome data was then categorized into four categories based off these thresholds.

Results, Conclusions, and Discussions: Due to patient follow-up schedules, patients were not tested in the first 25 days following surgery, and most were subjected to initial follow-up testing within 26-75 days post-op. Although a small sample size (n=4), between 26-75 days post-op, no patients were able to meet the 350N force requirement; however, 50% (n=2) of the patients tested within the same time period were able to meet the reaction time threshold. Between 76-125 days post-op, 35% of those tested were able to meet both the brake force and reaction time requirement, while an additional 39% met the reaction time threshold. Of those tested 125+ days post-op, 50% of those tested were able to meet both the brake force and reaction time requirement, while an additional 17% met the reaction time threshold. As we advance this study, it is desirable to reevaluate the force and reaction time requirements as results are interpreted.

Not all patients appear to be meeting criteria at around the same time, highlighting that all cases are unique. This preliminary analysis may also suggest exploring other covariates such as the patient’s age, injury severity, and pain levels to determine a correlation between patient recovery and general guidelines for post-operative recovery before resuming driving.

Acknowledgements (Optional): Claire Hayes from the Department of Biomedical Engineering at Bucknell University. Daniel Hayes, Ahmed Nageeb Mahmoud, and Daniel Horwitz, MD of Geisinger Orthopaedics.