Introduction:
Guidelines established by prominent governing bodies recommend that patients should wait a minimum of one month before resuming driving after stroke; however, these guidelines are not based on empirical evidence. Furthermore, many patients report resuming driving within the one-month period post-stroke. The aim of this study was to investigate the driving performance of mild stroke patients within the acute phase of injury. It was hypothesized that patients with acute stroke would exhibit more errors in general (e.g. collisions, speed exceedances, centre line crossings) and during cognitively demanding aspects of driving (i.e. left turns with traffic), but not routine aspects of driving (i.e. straight driving and right turns).
Methods:
The current study used driving simulator technology (STISIM) to compare the driving performance of 10 patients with acute mild ischemic stroke (NIHSS<7, within 7 days post-stroke) to that of 10 healthy, age- and education-matched controls. Patients and controls completed several driving tasks that increased in complexity, from routine right and left turns to cognitively demanding left turns with traffic, where most accidents occur, and a bus following task, which requires a high degree of sustained attention.
Results:
On average, stroke patients committed over twice as many errors as controls (12.4 vs 6.0, p< 0.01). Although there was no difference between patients and controls in the number of errors committed during routine right and left turns, patients committed more errors during left turns with traffic (2.4 vs 1.3, p<0.05) and a bus following task (8.2 vs 2.1, p<0.05).
Conclusions:
Patients with acute mild ischemic stroke may be able to maintain driving performance during basic tasks (e.g. straight driving, right turns) and deficits may become apparent during cognitively complex tasks (e.g. left turns with traffic and bus following). The results highlight the importance of healthcare professionals providing driving advice to their patients post-stroke, particularly in the acute phase of injury. Future longitudinal research is required to determine when patients with mild stroke can safely resume driving.