Neurological and Musculoskeletal Disorders Essay

Neurological and Musculoskeletal Disorders Essay Assignment Paper

Motor, sensory, and/or
cognitive deficits may adversely affect strength, coordination, reaction time, range of motion, visual perception,
processing speed, judgment, problem solving, attention, memory, and/or awareness, in terms of a driver’s ability to
perform the actions necessary to safely operate a motor vehicle.
Disorders affecting cognition such as epilepsy, stroke, traumatic brain injury, Parkinson’s disease, dementia, and
encephalopathy as well as disorders affecting neuromuscular function such as multiple sclerosis, Parkinson’s disease,
muscular dystrophy, cerebral palsy, myasthenia gravis, amyotrophic lateral sclerosis, spinocerebellar ataxia, foot
drop, neuropathy, and spinal cord disorders all may present their own unique barriers to safe motor vehicle operation.
What’s more, there is considerable overlap in the clinical manifestations of these disorders. A driver with these
conditions may have chronic functional limitations that have the potential to affect safe operation of a motor vehicle
and should be evaluated. When functional abilities are in question, a road test may be recommended by the clinician
or required by BMV.Neurological and Musculoskeletal Disorders Essay.

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Many of these conditions may result in symptoms or impairments that fall under more than one Functional Ability
Profile (FAP) and will need to be evaluated using more than one FAP. For example, following a stroke a driver may
experience a visual field or acuity disturbance and may also need adaptive equipment. This person would need to be
evaluated using both the Stroke and the Visual Disorders FAP’s. A person with Parkinson’s Disease may have
cognitive or psychiatric deficits as well as the neurological and motor deficits. They would need to be evaluated using
the Parkinson’s, as well as the Dementia or Mental Disorders FAP. BMV will use the most restrictive FAP to
determine the fitness of a person to drive.Neurological and Musculoskeletal Disorders Essay.
Neurological disorders may have an unpredictable, episodic, or progressive course and require periodic evaluation
by a qualified medical practitioner. The treating clinician shall determine the timing of evaluation but should have a
working knowledge of a driver’s current condition when filling out the Driver Medical Evaluation (CR-24) form.
When completing the CR-24 the driver must have been seen within the past 12 months or less.Neurological and Musculoskeletal Disorders Essay.
Individuals with any number of neurological and musculoskeletal conditions may use adaptive equipment when
driving. Person’s that use adaptive equipment when driving must take a road test. Although referral to a driving
rehabilitation specialist may be indicated in some cases, it is not required by BMV. When BMV requires a road test,
it will be administered by a BMV Driver’s License Examiner. The road test will determine whether the person is
allowed to drive and if there are driving restrictions.
Conditions which require review include but are not limited to the following:
Amputation or Limb Deficiency
Amputation or limb deficiencies may be either congenital or acquired of the upper or lower extremities, with
functional implications to safe driving being the decreased ability to operate one or more of the vehicle controls.
Adaptive driving equipment will require consideration depending on the specific limb deficiency, use of prosthesis
and overall functional abilities of the person. Evaluation by a driving rehabilitation specialist may be appropriate
depending on the extent of impairment. However, it is not required and does not take the place of the BMV road
test. The Miscellaneous Musculoskeletal and Neurological Functional Ability Profile should be used to assess
potential for driving impairment.Neurological and Musculoskeletal Disorders Essay.
Arthritis or Joint Disorders
This category would include related conditions such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis,
and spinal stenosis, among others. Affected structures include joints of axial and appendicular skeleton, and/or
spinal nerves. These conditions can cause pain, decreased strength and range of motion, and impaired functional
mobility, potentially altering the ability to safely operate motor vehicle controls. In assessing these persons for
potential driving impairment, overall functional performance of the person in terms of ability to perform activities of
daily living should be taken into consideration to help determine if adaptive equipment or strategies may be needed.
Miscellaneous Musculoskeletal and Neurological Conditions Functional Ability Profile should be used to assess
driving impairment.Neurological and Musculoskeletal Disorders Essay.
Cerebrovascular Accident (CVA or Stroke)
Stroke may have a complicated and variable presentation. Residual impairments may include altered strength, mobility,
coordination, motor planning, sensation, spatial planning, body or environmental awareness, vision, communication,
judgment, and cognition. Motor deficits or contractures may require upper or lower extremity adaptive equipment for
driving. Due to the possibility of multiple potential deficits, a comprehensive evaluation by a driving rehabilitation
specialist may be indicated but is not required. Use the TBI/Stroke Functional Ability Profile to assess impairment.
Other medical issues following a stroke may include seizures, cognitive impairment, and/or visual disorders which need
to be evaluated separately using the proper Functional Ability Profile for those conditions. Please note that a transient
ischemic attack (TIA) by definition has no residual deficit and is therefore not subject to the Stroke FAP.

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Miscellaneous Musculoskeletal and Neurological Conditions
Neurologic and musculoskeletal conditions with the potential to impair a person’s ability to safely operate a motor
vehicle are numerous, and therefore have not all been specifically listed. Even if these conditions have not been
adequately identified in any of the other categories, they still should be evaluated. Examples of neuromuscular
conditions which would be appropriately evaluated using the Miscellaneous Musculoskeletal and Neurological
Conditions FAP include but are not limited to muscular dystrophy, cerebral palsy, amyotrophic lateral sclerosis,
peripheral/other neuropathies, syringomyelia, as well as any generalized deconditioning syndrome due to any
etiology which reduces functional capacity to drive.Neurological and Musculoskeletal Disorders Essay. These conditions may require personal medical equipment or
adaptive accessories to operate a motor vehicle, cause deficits in mobility, sensation, strength, coordination, reaction
time, range of motion, and/or other abilities needed to safely operate a motor vehicle. Referral to a driving
rehabilitation specialist, although not required, may be indicated in some cases. Also, persons who have an implanted
spinal cord/dorsal column stimulator are advised to turn off the device prior to driving due to the potential for
unexpected changes in stimulation with activity that could possibly be unsafe. When visual, cognitive, psychiatric or
other conditions also exist, they should be evaluated separately using the appropriate profile.
Multiple Sclerosis (MS)
Multiple Sclerosis is a highly variable disor

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