Highlights
- •Chronic stroke impairments across the motor, cognitive, visual, and communication domains negatively impact transportation access. Interventions to improve transportation access in this population are limited despite the effect of mobility on health and quality of life.
- •Thirty-six interventions addressed walking ability in those with motor impairments – a key leg in any trip but insufficient alone for mobility in most communities.
- •Three studies investigated driving and two investigated public transit use. Transit could be a key bridge for the mobility gap for those who cannot or do not want to return to driving. Interventions that address cognitive and communication difficulties could be particularly impactful in this population.
- •Only one study intervened at a systems level by training transit drivers, and no studies incorporated a transportation engineer. Systems-level solutions can accompany individual interventions to broaden access, and may have positive impacts in other populations as well.
Abstract
Introduction
Chronic stroke survivors live with a wide range of disabilities that impact activities of daily living. One of these is transportation and mobility, which is a key link to the world around them and has implications for health and quality of life. This review sought to answer the question “What interventions are available for chronic stroke survivors to improve their transportation and/or community access?”
Methods
A scoping literature review was carried out, identifying 27,650 abstracts (after removal of duplicates) from five databases. After review and extraction, 41 articles were included for analysis, focusing on quantitative papers that tested a transportation intervention.
Results
While emergency transportation in the acute domain is well-represented in the literature, the chronic (≥6 months post-stroke) timeline is less studied. Of the 41 included articles, the vast majority (N = 35) addressed motor deficits related to walking. Three addressed driving ability. Only two studies addressed public transportation use despite it being an important link in the transportation system that does not require the ability to drive.
Conclusions
There are clear gaps in the literature for interventions aiming to improve transportation access and community mobility for chronic stroke survivors. In particular, more attention can be paid to visual, cognitive, and communication-related deficits as they relate to transportation access. […]
TBI Rehabilitation 