Article

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. 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.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS