Article

No long-term studies have been reported on the effect of training
programs on driving after stroke. The authors' primary aim was to
determine the effect of simulator versus cognitive rehabilitation therapy on
fitness-to-drive at 5 years poststroke. A second aim was to investigate
differences in clinical characteristics between stroke survivors who resumed and
stopped driving. METHODS: In a previously reported randomized controlled trial,
83 stroke survivors received 15 hours of simulator training (n = 42) or cognitive
therapy (n = 41). In this 5-year follow-up study, 61 participants were
reassessed. Fitness-to-drive decisions were obtained from medical, visual,
neuropsychological, and on-road tests; 44 participants (simulator group, n = 21;
cognitive group, n = 23) completed all assessments. The primary outcome measures
were fitness-to-drive decision and current driving status. RESULTS: The authors
found that 5 years after stroke, 18 of 30 participants (60%) in the simulator
group were considered fit to drive, compared with 15 of 31 (48%) in the cognitive
group (P = .36); 34 of 61 (56%) participants were driving. Current drivers were
younger (P = .04), had higher Barthel scores (P = .008), had less comorbidity (P
= .01), and were less severely depressed (P = .02) than those who gave up
driving. CONCLUSIONS: The advantage of simulator-based driving training over
cognitive rehabilitation therapy, evident at 6 months poststroke, had faded 5
years later. Poststroke drivers were younger and less severely affected and
depressed than nondrivers.

Langue : ANGLAIS