From the Guidelines
No, a patient with right upper limb paralysis may not be able to drive safely, as driving requires complex skills in cognition, perception, emotional control, and motor control, which can be affected by stroke 1.
Driving Assessment
To determine if a patient with right upper limb paralysis can drive safely, a clinical assessment of their physical, cognitive, and behavioral functions is necessary 1.
- This assessment should evaluate the patient's ability to perform complex tasks required for driving, such as coordination, reaction time, and decision-making.
- The assessment should also consider the patient's ability to adapt to any physical limitations, such as paralysis, and their ability to use assistive devices or modified vehicles.
State Laws and Regulations
State laws and regulations regarding driving after a stroke vary, and some states require individuals with neurological conditions to report their condition to the state agency 1.
- Physicians should use their best judgment when assessing a patient's ability to drive and inform patients and families of their options and risks 1.
- A tactful but candid discussion with the patient and family about the risks of driving is essential, and physicians may need to suggest further treatment or restricted driving schedules 1.
From the Research
Driving Safety with Right Upper Limb Paralysis
- The ability of a patient with right upper limb paralysis to drive safely is a complex issue, with various factors to consider, including the type of immobilization and the individual's overall health 2, 3, 4.
- A study published in 2013 found that most people were able to safely drive with upper limb cast immobilization, but driving in a left above-elbow cast was considered unsafe 2.
- However, another study published in 2009 found that upper-limb immobilization, particularly right-arm immobilization, can adversely affect responses to routine hazards, such as pedestrians crossing or vehicles emerging from a concealed entrance 4.
- The effects of upper-limb immobilization on driving safety are not well understood, and there is a lack of guidance for patients, physicians, and lawmakers on deciding whether a patient is safe to return to driving with upper extremity immobilization 3, 5.
- A study published in 2000 found that many adults with right upper-limb paralysis retain the ability to accurately represent prehensile movements involving the impaired limb, suggesting that motor imagery may be preserved in some individuals with hemiparesis or hemiplegia 6.
- Ultimately, the decision to drive with right upper limb paralysis should be made on an individual basis, taking into account the patient's overall health, the type of immobilization, and their ability to respond to hazards safely 2, 3, 4, 5.