title: Driving and reintegration into the community in patients after stroke.
abstract: OBJECTIVE
  To investigate the relationship between driving versus not driving and community integration after stroke. Much research on patients who drive after experiencing a stroke has focused on driving assessment protocols; little attention has been given to the implications of assessment outcomes.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Six driving evaluation centers in Ontario, Canada.
  
  
  METHODS
  Fifty-three community-dwelling patients who were referred for a driving assessment after they experienced a stroke.
  
  
  METHODS
  Data on demographics, living circumstances, health status, driving habits, and driving history were gathered via a semistructured interview and various questionnaires administered on 3 occasions: study entry (> or =1 month after stroke; n = 53), 3 months (n = 44), and 1 year (n = 43).
  
  
  METHODS
  Reintegration into the community at 1 year, as evaluated with the Reintegration to Normal Living Index (RNLI).
  
  
  RESULTS
  The participants had sustained a stroke an average of 12.3 months before study entry. Two subjects were driving at study entry. At 1 year, 28 (65%) of 43 subjects had passed their driving test and had resumed/continued driving. Nondrivers had a significantly lower mean RNLI score than drivers. Subjects who were not driving at study entry but had resumed driving by 1 year had a significant increase in RNLI score (P = .011). Driving was significantly associated with community integration after adjustment for concomitant health status (P < .001). Driving and health status were associated with community integration at 1 year, accounting for 32% of the variance in RNLI score.
  
  
  CONCLUSIONS
  Driving after stroke was significantly associated with community integration in patients after adjustment for health status (P < .001). Community decision-makers may decide to use the study results when determining the transportation needs of stroke survivors who self-limit their driving because of weather, time of day, or distance concerns.
authors.affiliation: Candrive Research Program, Canadian Institutes of Health Research, Ottawa, ON K1N 5C8, Canada. hfinestone@bruyere.org
authors.forename: Hillel M
authors.initials: HM
authors.lastname: Finestone
authors.forename: Meiqi
authors.initials: M
authors.lastname: Guo
authors.forename: Paddi
authors.initials: P
authors.lastname: O'Hara
authors.forename: Linda
authors.initials: L
authors.lastname: Greene-Finestone
authors.forename: Shawn C
authors.initials: SC
authors.lastname: Marshall
authors.forename: Lynn
authors.initials: L
authors.lastname: Hunt
authors.forename: Jennifer
authors.initials: J
authors.lastname: Biggs
authors.forename: Anita
authors.initials: A
authors.lastname: Jessup
mesh_terms: D000368:Aged; D001334:Automobile Driving; D005163:Factor Analysis, Statistical; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011446:Prospective Studies; D000071939:Stroke Rehabilitation