Return to drive after non-evolutive brain damage: French recommendations

Return to drive after brain damage is a crucial question either for patients than health professionals. The Societe francaise de medicine physique et de readaptation (SOFMER) and Comete France association developed recommandations for patient's identification, evaluation and accompaniment as part of their project to resume to drive. The place of rehabilitation process and patient's focus has been also discussed. Aims: Using a literature review, the aim was to define clinical pathways to determine people who need a fitness to drive evaluation after a non-evolutive brain damage as well as the assessment process. Method: Following the method for Clinical practice guidelines, 1388 abstracts were identified, among which 379 were analysed and confronted with the working group's experience. The draft propositions were submitted to a review group before being validated by the High French Health Autority. Result: No article enabled the development of recommendations above the "expert opinion''. The detection of sensory (visual), sensitive, motor and/or cognitive sequelaes is needed before return to drive. It is not recommended to return to drive in case of unilateral spatial neglect. Different assessment strategies, function of sequeale's gravity, are proposed after stroke or brain injury. In case of sequeale, the assessment process (clinical, cognitive, on road evaluation) has to be pluriprofessional. The results are the subject of a pluriprofessional synthesis, shared with the patient and, if possible, in the presence of a close. An accompaniment to maintain the best mobility of the person is needed, whatever the assessment result. (C) 2017 Elsevier Masson SAS. All rights reserved.