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Abstract
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Driving safety is often significantly reduced after stroke due to an increased risk of reinfarction. As the rate of recurrent strokes significantly decreases after time intervals of three and six months poststroke,1 physicians usually recommend driving breaks of three or six months, respectively. Besides the risk of reinfarction, however, driving safety is reduced due to functional deficits caused by the stroke. Both factors limit mobility in stroke survivors. Since mobility is crucial for an independent life, it is not surprising that more than half of the patients consider the recovery of driving fitness being a key target of stroke rehabilitation.2
To be able to specify when driving safety is back to normal again, it is relevant to know whether the length of a driving break is actually related to driving fitness. To our knowledge, studies investigating primarily the relation between the length of a driving break and on-road driving performance in stroke survivors are completely missing. Since time plays a crucial role in the recovery of driving-relevant cognitive, sensory, and motor functions, however, it is reasonable to assume that on-road-driving fitness recovers accordingly. In 2011, Devos and colleagues published a systematic review and meta-analysis.3 This study included on-road studies assessing fitness to drive in patients after stroke. Up to now, there is no new meta-analytical on-road data for stroke survivors, except a review article4 that included no new on-road studies. Although the data presented by Devos and colleagues show substantial heterogeneity, they indicate that across several studies 46% of stroke survivors do not pass an on-road driving assessment. Given that only 13% who return to driving have undergone a formal driving assessment beforehand,3 these results suggest that there may be many stroke survivors who resume driving too early and despite impaired fitness to drive. Data on the relation between the lengths of driving breaks and on-road driving performances that may have allowed more specific assumptions were not presented in the Devos article.
For this reason, we reanalyzed the relationship between on-road pass rates and time since stroke onset of the studies in the Devos article.3 In 18 out of 30 studies, information about the number of stroke survivors who passed an on-road driving assessment and the corresponding time interval between stroke onset and on-road assessment was given. ...
Language: en |