Patient factors associated with return to driving poststroke: findings from a multicenter cohort study.
OBJECTIVE
To estimate the extent to which body structure, function, activity, and context explain driving resumption at 1 year.


METHODS
Cohort study with relationships modeled in a path analysis.


METHODS
Three urban Canadian communities.


METHODS
Patients admitted to hospital with acute stroke who had driven before their stroke (n=290) who participated in a longitudinal study of stroke outcomes.


METHODS
Driving resumption 1 year after the initial stroke diagnosis.


RESULTS
One hundred seventy-seven patients (61%) returned to driving after 1 year. Direct relationships were found between measures of strength and motor activity (Stroke Impact Scale), cognition (Mini-Mental State Examination), type of stroke (hemorrhagic vs ischemic), and driving resumption at 1 year. The effects of stroke severity, fatigue, and sex on driving resumption were mediated through strength and motor activity shown by a model that had excellent fit (comparative fit index=.985, Tucker-Lewis Index=.952, root mean square error of approximation=.046).


CONCLUSIONS
There are multiple direct and indirect influences on driving resumption at 1 year, from the type of stroke, physical strength and motor activity, cognition, sex, and fatigue measured at 3 months. The paths outlined by this model highlight how stroke sequelae influence community mobility, as well as factors related to driving resumption that are amenable to intervention.
Perrier
Marie-Josée
MJ
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. 8mp38@queensu.ca
Korner-Bitensky
Nicol
N
Mayo
Nancy E
NE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000706:statistics & numerical data*; D002170:Canada; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011788:Quality of Life; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D014505:Urban Population