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Am Fam Physician. 1998;57(7):1679-1680

Little is known about the extent to which patients resume driving after a stroke, what advice they receive concerning driving and what assessment, if any, is performed to evaluate their driving capability. Fisk and colleagues conducted a survey of patients to answer these questions.

The 290 patients participating in the survey had been seen in the psychology service of a university rehabilitation center. The survey was conducted in Alabama, a state where no laws restrict driving after a stroke or require an evaluation before a person who has had a stroke can resume driving.

Patients were interviewed three months to six years after the stroke. To assess functional ability, a functional independence score for each patient was obtained from the rehabilitation center's database. While patients who resumed driving generally had higher scores than those who did not resume driving, there was considerable overlap in the scores of these two groups.

Thirty percent of the 290 patients reported that they had resumed driving after the stroke. Forty-eight percent of the survey participants stated that they had not received any advice concerning driving after the stroke, and 87 percent did not receive any evaluation of their ability to drive after the stroke. When a driving assessment was performed, the test most commonly given was a vision test. Five percent of the patients received an evaluation of their driving capabilities in an on-road driving situation. For those patients who reported receiving advice about driving, physicians were mentioned as the source by 33 percent, and family members were mentioned by 27 percent.

The survey results revealed two distinct groups of drivers. Some patients reported driving no more than three days per week and fewer than 25 miles each week, whereas others (one fourth to one third of those who resumed driving) reported driving six to seven days per week and between 100 to 200 miles each week. Information about urban versus rural driving was not obtained in the survey, so the relationship between driving environment and amount of driving is not clear.

The authors conclude that stroke survivors often make decisions about their ability to drive without professional input. Physicians must address this issue to decrease the risk for motor vehicle accidents in patients who have had a stroke.

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Copyright © 1998 by the American Academy of Family Physicians.

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