Doctor, when can I drive?-the range of elbow motion while driving a car.


Journal

Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499

Informations de publication

Date de publication:
Jun 2019
Historique:
received: 11 07 2018
revised: 17 11 2018
accepted: 19 11 2018
pubmed: 17 2 2019
medline: 8 8 2019
entrez: 17 2 2019
Statut: ppublish

Résumé

Immobilization of the upper extremity after an acute injury or postoperatively affects an individual's ability to safely operate a motor vehicle. The elbow is particularly sensitive to immobilization, with subsequent stiffness leading to functional limitations. Most activities of daily living are successfully achieved within a "functional arc" of elbow motion between 30° and 130° of flexion. No objective guidelines exist regarding the range of motion needed to safely operate a vehicle. In this study, we measured the range of motion of right and left elbows while driving a manual-transmission car. Using electro-goniometers, we measured the flexion and extension, as well as pronation and supination, of the right and left elbows in 20 healthy, right hand-dominant subjects while driving a car. These measurements were recorded on (1) city streets, (2) country roads, and (3) highways. For city streets, the range of motion in terms of flexion and pronation/supination was 15°-105° and 0°-45°/0°-35°, respectively, for the right elbow and 20°-95° and 0°-45°/0°-40°, respectively, for the left. For country roads, it was 10°-100° and 0°-40°/0°-35°, respectively, for the right elbow and 20°-95° and 0°-30°/0°-30°, respectively, for the left. For highways, it was 5°-100° and 0°-40°/0°-35°, respectively, for the right elbow and 20°-90° and 0°-30°/0°-25°, respectively, for the left. Mean pronation was significantly higher for the right elbow (P < .01). This study describes the range of elbow motion identified to drive a car with a manual transmission and a left-sided steering wheel. Mean pronation of the right elbow is significantly higher than that of the left. Further studies are needed to investigate the relevance of movement restrictions as they relate to handedness, steering-wheel side, and driving impairment.

Sections du résumé

BACKGROUND BACKGROUND
Immobilization of the upper extremity after an acute injury or postoperatively affects an individual's ability to safely operate a motor vehicle. The elbow is particularly sensitive to immobilization, with subsequent stiffness leading to functional limitations. Most activities of daily living are successfully achieved within a "functional arc" of elbow motion between 30° and 130° of flexion. No objective guidelines exist regarding the range of motion needed to safely operate a vehicle. In this study, we measured the range of motion of right and left elbows while driving a manual-transmission car.
MATERIALS AND METHODS METHODS
Using electro-goniometers, we measured the flexion and extension, as well as pronation and supination, of the right and left elbows in 20 healthy, right hand-dominant subjects while driving a car. These measurements were recorded on (1) city streets, (2) country roads, and (3) highways.
RESULTS RESULTS
For city streets, the range of motion in terms of flexion and pronation/supination was 15°-105° and 0°-45°/0°-35°, respectively, for the right elbow and 20°-95° and 0°-45°/0°-40°, respectively, for the left. For country roads, it was 10°-100° and 0°-40°/0°-35°, respectively, for the right elbow and 20°-95° and 0°-30°/0°-30°, respectively, for the left. For highways, it was 5°-100° and 0°-40°/0°-35°, respectively, for the right elbow and 20°-90° and 0°-30°/0°-25°, respectively, for the left. Mean pronation was significantly higher for the right elbow (P < .01).
CONCLUSION CONCLUSIONS
This study describes the range of elbow motion identified to drive a car with a manual transmission and a left-sided steering wheel. Mean pronation of the right elbow is significantly higher than that of the left. Further studies are needed to investigate the relevance of movement restrictions as they relate to handedness, steering-wheel side, and driving impairment.

Identifiants

pubmed: 30770312
pii: S1058-2746(18)30883-8
doi: 10.1016/j.jse.2018.11.053
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1139-1145

Informations de copyright

Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Auteurs

David Latz (D)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

Erik Schiffner (E)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany. Electronic address: erik.schiffner@med.uni-duesseldorf.de.

Johannes Schneppendahl (J)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

Falk Hilsmann (F)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

Lars Fabian Seiler (LF)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

Pascal Jungbluth (P)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

Robert Alexander Kaufmann (RA)

Department of Orthopaedic Surgery, University Hospital, Pittsburgh, PA, USA.

Joachim Windolf (J)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

Sebastian Viktor Gehrmann (SV)

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

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Classifications MeSH