Most drivers unprepared to get behind the wheel after mild stroke, Canadian researchers find
People who have mild strokes do not receive enough guidance on the challenges of getting back behind the wheel, despite studies that show an increased risk of car accidents, according to Canadian research presented today at the International Stroke Conference.
McGill University researcher Dr. Nicol Korner Bitensky and graduate student Anita Petzold surveyed more than 400 Canadian occupational therapists – the group primarily responsible for driver assessment and intervention – and found that patients rarely get counseling on when to resume driving, even if they indicate a desire to get back on the road.
Dr. Korner Bitensky, a research leader in the Canadian Stroke Network, said there have been few studies identifying successful ways to prepare people to resume safe driving after stroke, which is disturbing “given the importance that driving assumes in maintaining autonomy. We still have important gaps to fill to ensure those who experience a stroke maximize their opportunity to return to safe driving.”
A recent review by the McGill researchers found that, after having a stroke, a person is twice as likely to be involved in a car crash than other drivers. “This is not surprising,” Dr. Korner Bitensky said. “Stroke often affects skills that are known to be important to safe driving, including the ability to quickly scan your visual environment; divide attention between different stimuli that may or may not be important; and use a weakened arm and leg for steering and braking. Ironically, if the stroke affects walking ability, driving may be even more important as it becomes the only way to move around the community.”
Sixty per cent of stroke patients with a mild stroke are discharged directly home from the hospital. McGill research found that “when you ask people what their experiences have been in terms of counseling related to return to driving, they almost universally tell you they cannot recall a conversation about when it will be safe to resume driving or when they are legally permitted to do so,” Dr. Korner Bitensky said. “I have often in my career had patients tell me of leaving the hospital on a weekend pass and trying their hand at driving by cautiously taking their car once around the block to see how it goes.”
Dr. Antoine Hakim, CEO and Scientific Director of the Canadian Stroke Network, said the research “confirms the need for further attention on issues around post-stroke driving.” Dr. Korner Bitensky said she hopes to raise awareness of driving as a major and often neglected area of stroke management and to promote the sharing of tools to determine driver readiness.