Who Can Drive After a Stroke?

Simple Medical Tests Can Help Determine Which Stroke Patients Are More Likely to Be Safe Drivers, Researchers Say

Medically Reviewed by Laura J. Martin, MD on February 22, 2011
From the WebMD Archives

Feb. 23, 2011 -- Wondering if it's OK for someone you know to drive a car after they've had a stroke? A few simple tests at the doctor's office can help determine who is more likely to be a safe driver after a stroke.

Driving after a stroke can raise concerns for many people. A stroke can cause slowed movement, which affects reaction time. Any problems with vision, movement, or thinking could affect driving safety.

Many patients who have had a stroke return to driving without any type of formal safety assessment. An on-road driving test is the most thorough way to gauge a driver's abilities. This assessment takes about 45 minutes and involves driving with a trained evaluator or driving in a computer simulator. The test can sometimes be costly and inconvenient.

Researchers reporting in this week's issue of Neurology propose an alternative: They say a driving skills assessment test done in-office can help predict whether it is safe for a patient to get behind the wheel after a stroke.

Half of Stroke Patients Pass Driving Test

The Belgium-based research team reviewed all available studies regarding driving after a stroke. They looked at the combined results of 30 studies, which involved more than 1,700 stroke patients, with an average age of about 61. In every study, driving ability was gauged during an on-road test.

A little more than half of the stroke patients passed the on-road driving safety test.

In most cases, the on-road test was done about nine months after the stroke occurred. However, some patients took the test after just two months.

But the review raised an interesting question: Do all stroke patients need an on-road driving test? Study author Hannes Devos, MSc, of Catholic University of Leuven in Belgium says there are three simple tests that can be done in-office to determine if an on-road driving test is warranted.

Office Tests to Gauge Driving Ability

The following tests can be done in a doctor's office to help determine who is more likely to fail an on-road driving evaluation. The assessment takes about 15 minutes.

  • A road sign recognition test assesses traffic knowledge and visual comprehension. You might be asked to match certain road signs to particular driving scenarios.
  • A compass task examines vision, mental speed, and attention abilities.
  • A trail marking test measures visual-motor tracking and visual scanning abilities. An example would be to draw a line between a letter and a number.

The tests correctly identified 80%-85% of unsafe drivers post-stroke, according to the study. The following scores suggested the person was more likely to fail an on-road driving test:

  • Road sign test: below 8.5 out of 12
  • Compass task test: below 25 out of 32
  • Trail marking test: taking more than 90 seconds to complete test

Patients who do not pass the doctor’s office driving test should be referred for further on-road assessment, the researchers say.

WebMD Health News



News release, American Academy of Neurology.

Karceeski, S. Neurology, Feb. 22, 2011: pp e35-e38.

Devos, H. Neurology, Feb. 22, 2011; vol 76: pp 747-756.

American Stroke Association web site: "Can I Drive After a Stroke?"

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