Stroke and driving

Abstract

A major contributor to poststroke patients' independence is their ability to drive. Most poststroke patients desire to drive to maintain autonomy, an active lifestyle, and social contacts. No uniform method exists to evaluate poststroke patients' driving ability. Evaluation methods usually focus on vision, cognition, and motor function. A minimum level of visual acuity is required in every state, but there are significant variations between states. Most states require a visual acuity of 20/40 to 20/70 in at least one eye to obtain a valid driver license. Usually, a patient who has only one functional eye may drive a private vehicle but not a commercial vehicle. A stroke often results in a homonymous visual field defect. The larger the homonymous visual field defect, the more likely it is that the patient will lose his/her driver's license. Many stroke patients are unaware of the field loss that has occurred. A driver rehabilitation specialist is usually an occupational therapist who has specialized in driver evaluation and assessment. Doctors and state agencies refer to a driver rehabilitation specialist patients who do not qualify legally to drive, require new devices to drive, or have a change in their medical history that puts them at risk for an accident.