Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
Arch Phys Med Rehabil. 2010 Jun;91(6):868-73. doi: 10.1016/j.apmr.2010.03.009.
To estimate the extent to which body structure, function, activity, and context explain driving resumption at 1 year.
Cohort study with relationships modeled in a path analysis.
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.
Driving resumption 1 year after the initial stroke diagnosis.
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).
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.
评估身体结构、功能、活动和环境在多大程度上可以解释患者在 1 年内恢复驾驶的情况。
队列研究，采用路径分析对关系进行建模。
加拿大三个城市社区。
因急性卒中住院且在卒中前有驾驶史的患者（n=290），他们参加了一项关于卒中结局的纵向研究。
卒中初始诊断后 1 年的驾驶恢复情况。
177 名患者（61%）在 1 年后恢复驾驶。在卒中后 1 年，力量和运动活动（卒中影响量表）、认知（简易精神状态检查）、卒中类型（出血性 vs 缺血性）与驾驶恢复之间存在直接关系。卒中严重程度、疲劳和性别对驾驶恢复的影响是通过力量和运动活动来介导的，该模型拟合度良好（比较拟合指数=0.985，Tucker-Lewis 指数=0.952，均方根误差近似值=0.046）。
从卒中类型、3 个月时的身体力量和运动活动、认知、性别和疲劳等方面来看，有多种直接和间接因素影响 1 年内的驾驶恢复。该模型所概述的路径强调了卒中后遗症如何影响社区活动能力，以及与驾驶恢复相关的可干预因素。
