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.
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. 8mp38@queensu.ca
Marie-Josée
MJ
Perrier
Nicol
N
Korner-Bitensky
Nancy E
NE
Mayo
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