Driving After a Stroke

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Driving After a Stroke

Considerations for getting behind the wheel

In most parts of the world, driving our personal vehicle is how we get to work, shop, socialize, and participate in our communities. An unexpected medical event like a stroke may greatly disrupt the ability to drive and subsequently interfere with all that we do.

For some, the changes from a stroke are subtle and for others, they are more significant. Strokes can create changes in vision, cognition and physical abilities. Since driving requires all of these abilities, returning to driving after a stroke requires careful consideration even for those with subtle changes.

Vision considerations for driving

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A stroke may or may not affect the vision areas of the brain. But for those that have vision changes, there can be a wide range of challenges.

Drivers use their vision to:

A stroke may cause a visual field cut. Depending on the area of the field cut, an individual may have difficulty seeing a pedestrian or identifying a turn lane at an intersection.

A stroke can paralyze or weaken the muscles that control eye movements. Consequently, a person driving after a stroke may have trouble with depth perception and scanning, making it more difficult to judge gaps, park, or respond to hazards.

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Physical abilities and driving

Physical skills are used to maneuver the vehicle and control many other functions such as defrost, wipers and turn signals.

After a stroke, individuals may experience weakness, paralysis, and sensory loss on one side of the body. If the right leg is affected, it may make it difficult to operate the gas and brake pedals.

If the left arm is affected, a driver may have difficulty operating the turn signal or turning the steering wheel.

Cognitive abilities and driving

Cognitive skills are also crucial for driving. Drivers use their cognitive skills to concentrate on the roadway, make decisions about hazards and other roadway conditions.

After a stroke, it is not uncommon for an individual to experience a slower thinking pace. This is often referred to as decreased processing speed.
A driver needs to process information at speeds of 55 mph or higher in order to respond and react to hazards.

After a stroke, individuals may also experience more difficulty making decisions, solving problems, and sequencing steps.

A driver uses these skills to manage hazards and respond to routine driving situations. In addition, a stroke can cause problems like inattention to a visual field.

Despite the person’s vision being intact, the brain ignores information on one side of the visual field. If driving, one might not identify a vehicle or pedestrian in their peripheral field.

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Always consult with your doctor

Since driving is complex and potentially puts other roadway users at risk, it is important to consult your doctor to determine readiness to return to driving and learn the steps required to get back on the road.

Doctors typically know what the requirements are at licensing agencies such as the Department of Motor vehicles. Some jurisdictions require retesting driving skills after a stroke. Your doctor may also refer you to rehabilitation professionals and occupational therapists that specializes in driving rehabilitation.

These health care professionals can assess your readiness to drive. They may test your vision, cognitive, and physical skills for driving. They may also assess your driving skills with a driving simulator or behind the wheel in a dual controlled vehicle.

Most driving rehabilitation programs also offer interventions for individuals that would benefit. These interventions might include adaptive equipment to compensate for physical deficits, or strategies to manage vision and cognitive challenges.

And if you are not ready for driving, they can recommend therapeutic activities to help prepare you for driving in the future.

Driving After a Stroke

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Maryfrances Gross
University of Kentucky 
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Upstate University Hospital of Syracuse
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Occupational Therapist
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Adaptive Mobility Services, LLC
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