Clinical evaluation of the driving ability in stroke patients

Objectives - Stroke often causes physical, cognitive and psychomotor dysfun ction, which markedly decreases the driving ability of stroke patients. The aim of this study was to evaluate the driving ability of stroke patients u sing multidisciplinary clinical evaluation and driving-related laboratory t ests. Materials and methods - A neurologist evaluated the driving ability o f 20 male stroke patients on the basis of his own clinical examination and the observations and measurements of a neurological multidisciplinary rehab ilitation team. After that a traffic psychologist evaluated the patients' d riving ability on the basis of the driving-related cognitive and psychomoto r laboratory tests. The patients themselves also evaluated their driving ab ility, as did their spouses. All the evaluations were carried out independe ntly using the same 10-point scale. The control group consisted of 20 healt hy males, matched by age and driving experience, who went through the same laboratory test package as the patients did. Results - The stroke patients had more deficiencies in all tested driving related cognitive and psychomot or functions than the controls. The neurologist and the psychologist togeth er evaluated 12 (60%) of the 20 stroke patients being unable to drive; 8 pa tients out of 11 with non-dominant hemisphere lesion and 4 in the dominant group. The patients themselves and their spouses had a clear tendency to ov erestimate driving ability compared to the estimates of the neurologist and the psychologist. The hit-rate of the evaluations of the neurologist and t raffic psychologist (75%) was high. Conclusion - Stroke patients form a ris k group as drivers due to their decreased cognitive and psychomotor abiliti es, and driving ability should always be evaluated after stroke. The result s suggest that multidisciplinary neurological teams are able to evaluate th e driving ability of stroke patients reliably. A careful evaluation of driv ing ability without a driving test requires assessment of cognitive and psy chomotor functions critical in driving, which is not feasible for physician s without the support of a multidisciplinary team and/or traffic-related la boratory tests.