From the Guidelines
Driving restrictions after a stroke are crucial for ensuring the safety of both the patient and others on the road, and patients should typically refrain from driving for at least one month after a stroke, as recommended by the Canadian Council of Motor Transport Administrators (CCMTA) Medical Standards for Drivers 1. The primary reason for these restrictions is that strokes can significantly impair cognitive functions, vision, motor skills, and reaction time, all of which are essential for safe driving.
Key Impairments Affecting Driving Ability
- Visual field deficits
- Spatial awareness problems
- Reduced limb strength or coordination
- Slowed processing speed
- Potential seizure risk Additionally, certain medications prescribed after a stroke, such as anticonvulsants or sedatives, can further impair driving ability 1.
Assessment and Clearance for Driving
Before returning to driving, patients typically need medical clearance from their healthcare provider, which may involve formal driving assessments conducted by occupational therapists or specialized driving rehabilitation specialists. These evaluations test reaction time, visual scanning, judgment, and physical capability to operate vehicle controls safely 1.
Recent Findings on Cognitive Impairment and Driving
A recent scientific statement from the American Heart Association/American Stroke Association highlights the importance of cognitive abilities in returning to driving after a stroke, with better attention and executive function being most closely related to successful driving 1. However, the evidence for specific cognitive assessment tools or training programs to improve driving outcomes is not yet strong, emphasizing the need for individualized assessment and rehabilitation plans.
From the Research
Driving Restrictions After a Stroke
- Driving restrictions are implemented after a stroke to ensure the safety of the patient and others on the road, as a stroke can result in permanent cognitive and/or physical impairment that may affect an individual's fitness to drive 2.
- Studies have shown that health professionals often have limited knowledge of driving restrictions following a stroke or transient ischaemic attack (TIA), which can lead to inconsistent assessment and advice for patients 3, 4.
Importance of Assessing Fitness to Drive
- Assessing fitness to drive (FTD) is crucial after a stroke or TIA to prevent accidents and ensure public safety 3.
- However, research has found that many health professionals lack knowledge of FTD restrictions, particularly for commercial vehicle use, and may not provide accurate information to patients 3, 4.
Current State of Driving Restrictions
- Despite the importance of driving restrictions, studies have found that regulations are often not followed, and patients may not receive adequate information about driving cessation 2.
- Further investigation is needed to address the gaps in knowledge and practice among health professionals and to ensure that patients receive consistent and accurate advice about driving restrictions after a stroke 2, 4.