OBJECTIVE: To estimate the extent to which body structure, function, activity, and context explain driving resumption at 1 year. DESIGN: Cohort study with relationships modeled in a path analysis. SETTING: Three urban Canadian communities. PARTICIPANTS: Patients admitted to hospital with acute stroke who had driven before their stroke (n=290) who participated in a longitudinal study of stroke outcomes. MAIN OUTCOME MEASURES: Driving resumption 1 year after the initial stroke diagnosis. RESULTS: One hundred seventy-seven patients (61%) returned to driving after 1 year. Direct relationships were found between measures of strength and motor activity (Stroke Impact Scale), cognition (Mini-Mental State Examination), type of stroke (hemorrhagic vs ischemic), and driving resumption at 1 year. The effects of stroke severity, fatigue, and sex on driving resumption were mediated through strength and motor activity shown by a model that had excellent fit (comparative fit index=.985, Tucker-Lewis Index=.952, root mean square error of approximation=.046). CONCLUSIONS: There are multiple direct and indirect influences on driving resumption at 1 year, from the type of stroke, physical strength and motor activity, cognition, sex, and fatigue measured at 3 months. The paths outlined by this model highlight how stroke sequelae influence community mobility, as well as factors related to driving resumption that are amenable to intervention. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
OBJECTIVE: To estimate the extent to which body structure, function, activity, and context explain driving resumption at 1 year. DESIGN: Cohort study with relationships modeled in a path analysis. SETTING: Three urban Canadian communities. PARTICIPANTS: Patients admitted to hospital with acute stroke who had driven before their stroke (n=290) who participated in a longitudinal study of stroke outcomes. MAIN OUTCOME MEASURES: Driving resumption 1 year after the initial stroke diagnosis. RESULTS: One hundred seventy-seven patients (61%) returned to driving after 1 year. Direct relationships were found between measures of strength and motor activity (Stroke Impact Scale), cognition (Mini-Mental State Examination), type of stroke (hemorrhagic vs ischemic), and driving resumption at 1 year. The effects of stroke severity, fatigue, and sex on driving resumption were mediated through strength and motor activity shown by a model that had excellent fit (comparative fit index=.985, Tucker-Lewis Index=.952, root mean square error of approximation=.046). CONCLUSIONS: There are multiple direct and indirect influences on driving resumption at 1 year, from the type of stroke, physical strength and motor activity, cognition, sex, and fatigue measured at 3 months. The paths outlined by this model highlight how stroke sequelae influence community mobility, as well as factors related to driving resumption that are amenable to intervention. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Authors: Elyse L Aufman; Marghuretta D Bland; Peggy P Barco; David B Carr; Catherine E Lang Journal: Am J Phys Med Rehabil Date: 2013-07 Impact factor: 2.159