Assessment of driving after stroke--a pluridisciplinary task

Area of Science:

• Neurology
• Rehabilitation Medicine
• Traffic Safety

Background:

• Stroke survivors often face challenges returning to driving.
• Assessing driving fitness post-stroke requires a multidisciplinary approach.
• Predictors for driving ability after stroke need further elucidation.

Purpose of the Study:

• To analyze the driving fitness assessment procedure for stroke patients.
• To identify predictors influencing the team's decision on driving ability.
• To evaluate the effectiveness of car adaptations and training.

Main Methods:

• Retrospective analysis of 200 stroke clients' data.
• Evaluation of vision (acuity, field), neuropsychological functions (divided attention).
• Assessment using track and/or on-road tests (reaction time, anticipation, speed, positioning).

Main Results:

• 54% of clients were deemed fit to drive; 9% could resume after adaptation/training.
• Vision, divided attention, and on-road test performance were key predictors.
• Cognitive impairment was the primary reason for failing the driving test.
• Car adaptation was recommended for 35% of cases, often involving secondary controls and automatic transmission.

Conclusions:

• Multidisciplinary team input is crucial for effective driving fitness evaluation.
• Streamlining the assessment by dividing it into two parts and removing subtests can improve cost-effectiveness.
• In-car track tests have high validity and can reduce the need for in-traffic tests for unsafe drivers.
• Car adaptation and training are often necessary for individuals with hemi-paresis to safely resume driving.