In-office tests may help OK driving after stroke
February 21st, 2011
02:16 PM ET

In-office tests may help OK driving after stroke

Giving stroke survivors three relatively simple tests during a doctor's visit may help physicians determine who is capable of getting back behind the wheel, according to research in the medical journal Neurology.

Half of those who suffer from stroke want to resume driving, but only about 1 in 10 gets any type of formal driving evaluation to confirm fitness to be on the road, say researchers.

"There are really no hard and fast rules on how to evaluate patients except to send them off to take driving tests. So here is a great way of helping to screen them {stroke patients} right from the office," explains Dr. Gene Sung, director of the Stroke Center at the University of Southern California, who was not affiliated with the study.

Researchers analyzed 30 studies from North America, Europe and Australia that included more than 1,700 stroke survivors who had all taken on-road driving tests. A little over half of the drivers passed.  In 80% of the patients, the scores on the office tests accurately predicted who would pass or fail the on-road driving test.

"Fitness to drive is predicted by tests that evaluate cognitive functions important for driving such as visual scanning, visuospatial abilities, visual comprehension, executive reasoning and shifting of attention, " says study author Hannes Devos with the Department of Rehabilitation Sciences at Catholic University of Leuven in Belgium.

One test specifically looked at how well stroke patients recognize road signs and their ability to match signs to particular driving situations. Another used a tool similar to a board game to test knowledge of traffic flow in a roundabout. The last measured mental and physical quickness by monitoring the speed and accuracy of drawing lines between letters and numbers.

Driving is usually not an options for those who suffer from major stroke. Patients in this study had fully recovered from mild or moderate stroke and their average age was 61, which is younger than the general stroke population. But partial use of an arm or leg or other limitations in movement did not mean that stroke survivors were more likely to fail the driving test than others, researchers found. Car adaptations such as modifications to the steering wheel for one hand driving or switching the gas pedal from the right to the left can help.

Researchers looked at four specific studies on accident rates and three of the four found that stroke patients who pass driving tests were no more likely to get in car accidents than other drivers.

Physicians can refer stroke patients for on-road evaluations to determine their fitness to drive but these are often costly, according to the researchers. Sung says these office tests may offer another option.

“I think there still needs to be more studies to confirm this finding, but these tests should make it easier for physicians to screen patients for whether they can resume driving after stroke,” says Sung.

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