Two profiles of post-stroke drivers based on their driving perception

Objective: Stroke is the leading cause of acquired disability in adults, and can induce different sequelae which impact on abilities such as driving. This study investigated how post-stroke patients perceived their driving practice and behavior. The aim of this study was to determine different profiles of post-stroke drivers according to their driving perception. Methods: Among 86 post-stroke patients who had undergone an official fitness-to-drive assessment in 2019 in the Kerpape Center or the Henry Gabrielle Hospital (France), 69 returned to drive. These 69 participants completed a questionnaire about their socio-demographic and clinical characteristics, and driving perception, approximately three years after resuming driving. Questions about driving perception were statistically analyzed using hierarchical clustering analysis. Socio-demographic, driving, and clinical characteristics from the clusters obtained were then compared. Results: Clustering analysis revealed two profiles of post-stroke drivers. One group consisting of 2/ 3 of the participants reported modified driving behavior, while the other group perceived no driving changes. A higher proportion of participants from the modified driving group reported driving significantly less, experiencing less pleasure, increased tiredness and more fear when driving post-stroke than those from the unmodified driving group. They also stated that they experienced more difficulties, avoided more situations, and implemented more driving strategies than participants in the unmodified driving group. Participants in the modified driving group were also younger (p = 0.014), lived in more rural areas (p = 0.028), and had more sequelae, including fatigue (p = 0.002), motor sequelae (p = 0.035), and cognitive sequelae (p = 0.013) than participants who did not modify their driving. Conclusions: Two profiles of post-stroke drivers were identified: those who had perceived the need to modify their driving behavior, and those who had perceived no driving changes. Differences in socio-demographic characteristics may partly explained the divergencies between the two groups. Other factors such as self-awareness of driving abilities may influence their driving perception. Two lines of action could be investigated to enable post-stroke drivers to better appreciate their driving abilities. The first would be to develop targeted support programs to help drivers become more aware of their own abilities, for example using video support during on-road training to replay critical situations and improve awareness of their own abilities. A second approach would be to deploy technological driving assistance systems. A monitoring system enabling the driver to adjust his driving in real time could be very useful and relevant to develop.