Citation

Perrier MJ, Korner-Bitensky N, Mayo NE. Arch. Phys. Med. Rehabil. 2010; 91(6): 868-873.

Affiliation

Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.apmr.2010.03.009

PMID

20510976

Abstract

Perrier M-J, Korner-Bitensky N, Mayo NE. Patient factors associated with return to driving poststroke: findings from a multicenter cohort study. OBJECTIVE: To estimate the extent to which body structure, function, activity, and context explain driving resumption at 1 year. DESIGN: Cohort study with relationships modeled in a path analysis. SETTING: Three urban Canadian communities. PARTICIPANTS: Patients admitted to hospital with acute stroke who had driven before their stroke (n=290) who participated in a longitudinal study of stroke outcomes. MAIN OUTCOME MEASURES: Driving resumption 1 year after the initial stroke diagnosis. RESULTS: One hundred seventy-seven patients (61%) returned to driving after 1 year. Direct relationships were found between measures of strength and motor activity (Stroke Impact Scale), cognition (Mini-Mental State Examination), type of stroke (hemorrhagic vs ischemic), and driving resumption at 1 year. The effects of stroke severity, fatigue, and sex on driving resumption were mediated through strength and motor activity shown by a model that had excellent fit (comparative fit index=.985, Tucker-Lewis Index=.952, root mean square error of approximation=.046). CONCLUSIONS: There are multiple direct and indirect influences on driving resumption at 1 year, from the type of stroke, physical strength and motor activity, cognition, sex, and fatigue measured at 3 months. The paths outlined by this model highlight how stroke sequelae influence community mobility, as well as factors related to driving resumption that are amenable to intervention.

Language: en