2017 Volume 16 Issue 2 Pages 46-54
To manage a rehabilitation program and support work resumption, we examined the rehabilitation processes of five stroke patients who had worked as taxi drivers. We analyzed the results of the following neuropsychological examinations: Mini-Mental State Examination （MMSE）; Kohs Block Design Test; Trail Making Test A and B; Paced Auditory Serial Addition Task; Behavioural Inattention Test （BIT）; Wechsler Adult Intelligence Scale III; and Wechsler Memory Scale-Revised （WMS-R）. We assessed driving ability using a simple driving simulator （Honda Safety Navi） and the Honda Driving Simulator, which is an interactive, realistic, and technically advanced simulator. All the patients had nearly normal cognitive function, with an MMSE of 28 or more, and displayed no inattention deficiency based on the BIT. Only one patient showed a lower WMS-R score than the reference value indicated in a previous study. With the other neuropsychological examinations, all the patients had higher scores than the reference values. In the beginning of the rehabilitation process, all the patients confirmed that they wished to resume driving. They then underwent standardized neuropsychological training and simulator-based driving training as both inpatient and outpatient rehabilitation. Additionally, two patients received on-road driving training. In the workplace reinstatement process, employers indicated that it was preferable that the patients initially return to non-driving jobs before resuming taxi driving. Reducing the driving duration, such as avoiding late-night shifts, was also indicated as desirable following reinstatement. In addition to reacquiring driving ability through rehabilitation, post-stroke taxi drivers need employer support with respect to working conditions. For such drivers to resume work, the cooperation of all related staff, such as physicians, rehabilitation therapists, employers, and driving school instructors, is essential for the care of these patients.
