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Prediction of Driving after Stroke: A Prospective Study

From the Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium, aakinwuntan{at}mcg.edu

H. Feys, PhD

From the Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium

W. De Weerdt, PhD

From the Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium

G. Baten, OT

CARA, Belgian Road Safety Institute, Brussels, Belgium

P. Arno, PhD

CARA, Belgian Road Safety Institute, Brussels, Belgium

C. Kiekens, MD

Department of Physical Medicine and Rehabilitation, University Hospital Pellenberg, Belgium

The process of determining whether patients with stroke should drive again often involves off-road evaluations and road tests that usually take about 2 to 3 h to complete. Objectives. This prospective study sought to identify the combination of tests that best predicts fitness to drive after stroke. The main aim was to develop a short and predictive predriving assessment battery. Methods. Sixty-eight consecutive stroke patients were studied who performed a mandatory predriving assessment at the Belgian Road Safety Institute, Brussels, within 18 months. Performance in a predriving assessment included medical examination (when needed), visual and neuropsychological evaluations, and an on-road test. Based on these assessments, a physician, psychologist, and the driving safety expert who administered the tests decided if a subject was either "fit to drive,""temporarily unfit to drive," or "unfit to drive." Results. Logistic regression analysis revealed a combination of visual neglect, figure of Rey, and on-road tests as the model that best predicted (R² = 0.73) fitness to drive after stroke. Using a discriminant function that included the 3 tests of the logistic model, the fitness to drive judgments of 59 (86.8%) subjects were correctly predicted. The sensitivity and specificity of the predictions were 79.4% and 94.1%, respectively. Conclusion. Fitness to drive after stroke can be predicted from performance on a few road-related tests with a high degree of accuracy. However, some individuals require extended assessments and further tests.

Key Words: Cerebrovascular accident • Motor vehicles • Neuropsychological tests • Visual tests • Road test • Rehabilitation.

Neurorehabilitation and Neural Repair, Vol. 20, No. 3, 417-423 (2006)
DOI: 10.1177/1545968306287157


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