Driving after stroke

Abstract

Driving a motor vehicle is an important instrumental activity of daily living recognized across countries and cultures. Driving provides convenience, independence, and mobility. However, after a stroke, patients may exhibit visual, cognitive, behavioral, and motor symptoms that may negatively affect driving ability. Patients often ask healthcare providers when they can resume driving. It can be difficult to identify those who are fit to drive, those who are not, and those who would benefit from driving rehabilitation. The aim of this chapter is to present evidence to guide clinical decision-making in returning to drive after stroke. The authors are from three different continents and represent important disciplines involved in driving after stroke: medicine, occupational therapy, physiotherapy, and psychology. We first explain the importance of return to driving as a key rehabilitation goal in post-stroke care. We then present an evidence-based overview of key issues related to driving after stroke. Afterwards, we provide a framework for driving screening, assessment, and intervention based on best evidence and practice. An illustrative case study is presented to demonstrate the multiple factors involved in a driving assessment and rehabilitation after stroke.