Objective: To study long-term consequences of brain injury on health status, driving characteristics and car accidents. To study whether driving 10 years after brain injury was retrospectively related to cognitive functioning and on-road driving performance 10 years before. Research design: A semi-structured telephone interview with 38 patients with sequelae of brain injury and 49 healthy controls was used. Results: Hypertension, heart disease and vascular disorder were the most frequently reported diseases. The patients reported fatigue, irritability, memory and initiative problems. Concentration and vision problems influenced their driving. Patients had more car accidents reported to an insurance company during the observation period than control subjects. Present driving was retrospectively significantly related to neuropsychological test results but not to on-road test outcome 10 years before. Car accidents were not related to neuropsychological test results or to on-road test outcome 10 years back. Half of the dropouts were stroke patients and they performed significantly worse on the neuropsychological tests but not on the on-road test 10 years before. Conclusion: Neuropsychological tests focusing on information processing speed and attention is a useful screening tool for predicting driving competence. Stroke patients are vulnerable if they continue to drive and need to be evaluated for their driving capacity to drive.

Objective: To study whether metacognition is a prerequisite for coping at the tactical level of driving. Research design: A consecutive series of 30 drivers with acquired brain injury were assessed concerning cognitive functions and driving performance. In addition the drivers assessed their driving performance through self-rating. Results: On average the drivers had cognitive impairments compared to a healthy reference group. The group that passed the driving test and the group that failed the driving test did not differ in terms of cognitive functions. Neither did they differ in their self-ratings of driving performance. However, the group that failed the driving test significantly over-estimated their performances as compared to the assessments made by the professional driving inspector, while the group that passed the test made more accurate self-ratings. Conclusions: One interpretation of these results is that the group that made a more realistic evaluation of their driving performance were more aware of their cognitive capacity compared to those who failed the driving test. They seemed to have a better ability to adjust their driving behaviour at a tactical level. Thus, the subject's metacognition, awareness of his/her own cognitive capacity, is important for coping with cognitive impairments at tactical driving.

Purpose: The aim of this study was to describe functioning and health, and explore the use of the Gross Motor Function Classification System (GMFCS) in an adult population with cerebral palsy (CP).

Methods: From a cohort of 199 persons, 48 persons were selected for structured interviews and functional assessments regarding activities of daily living, motor function, range of motion, pain and general health.

Results: A third of the population had deteriorated in function from adolescence to adulthood according to the GMFCS. The majority were independent in personal ADL, but many of those were dependent in instrumental ADL. Motor function scores reflected problems in walking ability, and limited ROM and pain were common in all functional levels. General health was lower than in a general population. GMFCS seems valid for classifying adults with CP since it is correlated with instruments measuring motor function and ADL in terms of dependence.

Conclusion: Decreased functional ability and secondary musculoskeletal problems are common in adults with CP and general health can be associated with those problems. It is important to further explore health aspects and relations between health status and self-perceived health. The GMFCS is a useful tool, especially for comparisons throughout the life span, but in order to use in an adult population further development is needed.