From the Guidelines
Patients should not drive for at least one month after a stroke, and then undergo a comprehensive assessment to determine their fitness to drive, as recommended by the Canadian Council of Motor Transport Administrators (CCMTA) Medical Standards for Drivers 1.
Key Considerations for Driving After a Stroke
- The assessment should include evaluations of sensory, motor, and cognitive functions, such as vision, visual fields, visual attention, reading comprehension, strength, coordination, reaction time, perception, problem-solving, speed of decision making, and judgment 1.
- Patients with residual neurological deficits related to driving ability should undergo a full comprehensive driving evaluation, including a government-sanctioned on-road assessment, to determine their fitness to drive 1.
- Some patients may require vehicle modifications, such as spinner knobs, left foot accelerators, or hand controls, to accommodate physical limitations, and medications that cause drowsiness may further restrict driving ability.
Importance of Healthcare Provider Evaluation
- Patients should not drive until cleared by their healthcare provider, who will assess their cognitive function, vision, motor skills, and reaction time, and provide guidance on exercises to facilitate a safe return to driving when appropriate.
- Healthcare providers should use their best judgment in evaluating patients' physical or mental impairments that might adversely affect driving abilities, and consider state laws and regulations regarding reporting of neurological conditions 1.
Rehabilitation and Recovery
- Patients should work with their rehabilitation team on exercises specifically targeting driving-related skills to facilitate a safe return to driving when appropriate, and consider training programs, such as simulator-based training, to help prepare for a road test or the resumption of driving 1.
- Recovery milestones that indicate readiness to drive include normal vision, adequate neck and limb mobility, good coordination, normal reaction times, and intact judgment.
From the Research
Driving Restrictions After a Stroke
There are no research papers provided that directly address driving restrictions after a stroke. However, we can look at the information available on stroke rehabilitation and occupational therapy for adults with stroke.
Stroke Rehabilitation and Occupational Therapy
- Occupational therapy is an important aspect of stroke rehabilitation, aiming to improve the ability of adults with stroke to carry out activities of daily living 2, 3, 4, 5, 6.
- Studies have shown that occupational therapy can improve performance in activities of daily living and reduce the risk of deterioration in these abilities 3, 6.
- However, the effectiveness of occupational therapy for cognitive impairment post-stroke remains unclear, with some studies showing little to no clinical difference in basic activities of daily living immediately after intervention and at follow-up 3, 4.
Implications for Driving
- While there is no direct evidence on driving restrictions after a stroke, the information on stroke rehabilitation and occupational therapy suggests that adults with stroke may experience cognitive and functional impairments that could affect their ability to drive safely.
- Further research is needed to determine the specific implications of stroke rehabilitation and occupational therapy for driving abilities and to inform driving restrictions after a stroke 3, 5.