hb```b``e`x9400pjn7@3BV4u:0pT1 Ai3 DL```* !55dFB0)scg,!N d EGD0g*`B18:D`lvdYFCjiv a7\`dt\dX*fd``!| b`x1Jo+5M! x But this approval is for the safety of yourself and others. Doctors rely on feedback from a certified driver rehabilitation specialist to decide if a person is fit to drive. Call the ElderCare Locator at 1-800-677-1116 and ask for your local Office on Aging, or go to their website at www.eldercare.gov. WebDriving After Stroke Driving is often a major concern after a stroke. Evidence-based review on epilepsy and driving. Physical effects. Register. Read on for more information about how and when to get back on the road after a stroke. This may feel like a big loss of independence. Neurologists meet with people who may have had a stroke, seizures, movement problems (like PD), or a disease that causes problems with vision, thinking, memory, and judgment. Apart from these conditions, any genetic cause of stroke is related to the inheritance of risk factors between family members, including high blood pressure and high cholesterol. Studies that start with the same scientific question sometimes lead to very different answers. It may take planning ahead on your part, but it will get you to the places you want to go and the people you want to see. For instance, are there tests that can be done in the doctor's office? How can you tell if youre safe to drive after having a stroke? One type included on-road driving and using driving simulators. government site. How much driving experience a person had before the stroke also did not seem to make a difference. 05:42. Driving after stroke. Recovery can take place in a range of facilities, including your own home. Some options include: To find transportation services in your area, visit www.eldercare.acl.gov or call the national ElderCare Locator at 800-677-1116 and ask for your local Office on Aging. Although the study does not provide all the answers, it provides some suggestions. The recommended duration of non-driving after a first seizure varies widely between jurisdictions, influenced by various factors including the community perception of an acceptable relative level of risk for an accident (the accident risk ratio; ARR). Studies suggest that patients who pass the on-road driver evaluation testing are no more likely to be involved in car crashes than other drivers. Driving provides a sense of independence and freedom, but safety takes on even greater importance. There are treatment options that may, Yes, the use or misuse of several illegal drugs can cause strokes even on the first use. Until the full extent of your stroke is known, there is no way to tell if and when you will be able to return to driving. %%EOF G{E"F'9/aQ)e*rdUc|XWIChP>. Results: Objectives: The authors first gathered all studies that had anything to do with driving after stroke. Most of the time, a person having a stroke is unaware theyre having one, and the understanding a stroke is happening falls to people who witness the symptoms. Its important to remember that your safety and the safety of other drivers on the road is the most important thing. Blood pressure control and stroke: an ounce of prevention is worth a pound of cure. To find a driver rehabilitation specialist near you, go to. If you can't drive because of problems from your stroke, and you do not have other options, check with your stroke rehab center and public transit agency. They carefully reviewed the medical literature on this topic, and combined the results of many previous studies about driving after a stroke. New treatments work only if given within a few hours after the onset of a stroke. This may feel like a big loss of independence. For most people, driving represents freedom, control and independence. 1-301-652-2682 Hemorrhagic stroke is caused by the bursting of a blood vessel in the brain. Ischemic stroke is caused by an interruption of blood flow to the brain. drive. Talk with your doctor and your loved ones about driving. You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid It's free for patients who qualify and is real road training, not simulators. WebIf you have had a stroke and you try to drive, you may: have trouble turning the steering wheel or applying the brake; become easily frustrated or confused while driving; drift across lane markings, into other lanes; and. 05:42. Some of these signs include: Needing instructions from passenger Easily frustrated or confused Drifting across lanes Getting lost in their own neighborhood Driving faster or slower than the posted speed Making slow or poor decisions Difficulty managing steering wheel or other controls within the car EPILEPSY. The best way to treat a stroke is early recognition and early treatment. sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and. Cochrane Database Syst Rev. higgs-boson@gmail.com. Injury to the brain may change how you do things. Groups of experts have agreed on a standard way of performing these techniques. Acute symptomatic seizures and hippocampal sclerosis: the major contributor for post-stroke epilepsy? Regulating drivers with epilepsy in Maryland: Results of the application of a United States consensus guideline. The assessment involves driving for about 45 minutes with a trained evaluator (or driving in a computer simulator). www.ninds.nih.gov, American Occupational Therapy Association You and healthcare professionals will work together to decide when youre safe to get back on the road. This may be hard to accept. If youve had a stroke, you may be wondering if you can drive again. When looking at people who have had a stroke, the location (in the brain) of where the stroke occurred might affect how well the person did after the stroke. Usually, people with these types of strokes will have many family members who have had strokes. Doctors are always searching for simple tests that can assess driver safety. This damage can cause paralysis, speech problems, loss of feeling, memory and reasoning problems, coma, and possibly death. You also can contact the: American Stroke Association The way that doctors approach and treat a TIA is almost identical to a stroke, and experiencing a TIA is an equivalent risk factor to any other type of stroke for having another stroke. have difficulty thinking clearly about the traffic around you. There are many ways to assess driver safety. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). This decision is made considering the severity of your stroke, what (if any) long-term effects youre experiencing, and the laws unique to your state or region. Combining the results of similar studies is important for several reasons. The authors found that 54% of the 1,728 stroke patients who took an on-road assessment were able to pass. WebIf you have had a stroke and you try to drive, you may: have trouble turning the steering wheel or applying the brake; become easily frustrated or confused while driving; drift across lane markings, into other lanes; and. Many factors can influence a study's results. You may enroll in a driver rehabilitation program put on by your local DMV, and run by a rehab specialist or occupational therapist after your stroke. What are the laws about driving if youve had a stroke? Driving is a complex skill. Some steps you can take to determine if youre ready to drive again include: Many people have residual effects after having a stroke, and people can work diligently to regain some of the function that they lost. Driving Therapy (3:33-4:56) It accounts for about 15% of strokes. Driving after a stroke can be an exciting return to normalcy and independence, and many people do return to the road after having a stroke. This site needs JavaScript to work properly. www.niapublications.org/engagepages/drivers.asp. BMJ Open. These studies were selected because they measured the same thing: passing or failing the on-road assessment. WebImpaired Driving Laws Georgias Impaired Driving Laws & Penalties First Offense Possible jail time up to one year Fine of $300 minimum, up to $1,000 License suspension of up to one year 40 hours of community service, minimum mandatory $210 license reinstatement fee Second Offense Within Five Years Of First Offense The Compass test is an examination of vision, attention, and mental speed. The goal of this brochure is to help you, your family and your health care professional talk about how a stroke may affect your ability to drive safely. Getting around after a stroke is important but safety is even more important. Injury to the brain is painless, and because the brain is being injured, the brain is usually unable to perceive any issues that come from a stroke as a problem. For example, a clot-busting drug must be given within 3 hours of stroke onset. Physical effects. Because of their medical expertise, doctors (and in many places, occupational therapists) are often asked for their opinion about a driver's safety.4 In some instances, the answer may be clear. G[nzUMm+ This meant that the studies could be easily combined. Finally, they wanted to determine if patients who resumed driving after a stroke were more likely to be involved in car crashes than other drivers. 1-888-478-7653 (1-888-4-STROKE) For families who are sure or fairly sure that driving should no longer be an activity for a loved one, these tests can be a big help in terms of satisfying everyone involved that getting The parts of the brain a stroke damages may cause confusion. Driving is one of those skills that our patients most want to regain for independence. WebBut post-stroke road tests could make up these gaps. endstream endobj 850 0 obj <>/Metadata 66 0 R/OCProperties<>/OCGs[859 0 R]>>/Outlines 108 0 R/PageLabels 842 0 R/PageLayout/SinglePage/Pages 844 0 R/PieceInfo<>>>/StructTreeRoot 159 0 R/Type/Catalog>> endobj 851 0 obj <>/ExtGState<>/Font<>/Pattern<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 90/StructParents 0/Type/Page>> endobj 852 0 obj <>stream or For families who are sure or fairly sure that driving should no longer be an activity for a loved one, these tests can be a big help in terms of satisfying everyone involved that getting The .gov means its official. All rights reserved. Careers. Consider these resources for more information on where to find rehabilitation services after a stroke. There are many programs and driver rehabilitation courses that you can take to help you build more confidence in driving once again. Disclaimer. Neurology 2002;59:E1-E2. Dr. Devos and colleagues carefully followed the expert guidelines. However, this decision is extremely dependent on the type and severity of a stroke and what kind of lingering symptoms youre experiencing. drive. 2023 Jan 23;1(1):CD013847. drive. WebOff-road tests shown to predict driving ability after stroke are: the figure of Rey test; the dot cancellation test, road sign recognition and square matrix tests from the SDSA and the Motor-free Visual Perception test However, the MEP is of the opinion that while neuropsychological tests may provide a reasonable guide as New research suggests that erythritol, a common artificial sweetener, may increase heart attack and stroke risks. 10 Best Brain Exercises for Stroke Recovery, Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, having a thorough assessment by a neurologist to determine if you have any residual effects from your stroke, checking with your states Department of Motor Vehicles (DMV) or Department of Driver Services (DDS) to see whether your doctor or healthcare professional needs to report your health status before you can drive again, difficulty with awareness, attention, learning, judgment, and memory, trouble controlling or expressing emotions and becoming easily frustrated or confused, drifting into other lanes or forgetting traffic laws, forgetting certain aspects of driving while on the road, experiencing disorientation, confusion, and intense frustration, an evaluation of your physical and mental abilities required for safe driving, if indicated by the evaluation, a driver training program, taxis, or other ride-share services like Uber or Lyft, paratransit services (special transportation services for people with disabilities, some offer door-to-door service). Epub 2017 Jun 1. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. 2017 Aug;58(8):1389-1397. doi: 10.1111/epi.13804. This information does not replace the advice of a doctor. Risk of recurrence after a first seizure and implications for driving: further analysis of the Multicentre study of early Epilepsy and Single Seizures. This hurts the brain cells, and can cause you not to be able to speak, to think or see clearly, or to control your body. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. Supporters cheered on former US President Donald Trump as he left Palm Beach, Florida, on Monday, April 3, to face a history-making criminal case in New York.Footage recorded by Greg Aselbekian shows supporters in West Palm Beach and near Palm Beach International Airport cheering on the former president.Trumps motorcade After a stroke, problems with your vision, speech, or ability to move can change your ability to drive safely. Federal government websites often end in .gov or .mil. After multiple TIAs over a short period of time you will need to wait three months from the last attack before resuming driving. If you are interested in getting back to driving after surviving a stroke, then you should get a driving evaluation done that will assess physical, mental, and visual abilities. That may help reduce your risk and impact of future strokes, if they occur. Its very important to call 911 and use the emergency response system any time you see a person having stroke-like symptoms. Driving and Epilepsy: a Review of Important Issues. This restriction must be balanced against the occupational, educational and social limitations that result from patients being ineligible to drive. WebDriver Evaluations. Determining whether youre safe to drive after having a stroke is something that will take time. If you are responding to a comment that was written about an article you originally authored: Risk of a seizure recurrence after a breakthrough seizure and the implications for driving: further analysis of the standard versus new antiepileptic drugs (SANAD) randomised controlled trial. Your neurologist, any rehab specialist youre working with, and your family will work with you to help determine whats the safest choice for you. 849 0 obj <> endobj Additionally, the actual occurrence of seizures while driving was prospectively determined during follow-up. and transmitted securely. For example, one study found that 88% of drivers who took an on-road assessment after a stroke passed the test.2 Another study found only a 24% passing rate.3 When there is such a large difference in results, it can be difficult to know which is the correct answer. This has obvious implications for driving. WebOff-road tests shown to predict driving ability after stroke are: the figure of Rey test; the dot cancellation test, road sign recognition and square matrix tests from the SDSA and the Motor-free Visual Perception test However, the MEP is of the opinion that while neuropsychological tests may provide a reasonable guide as 1995-2023 Healthwise, Incorporated. endstream endobj startxref 1-800-352-9424 WebImpaired Driving Laws Georgias Impaired Driving Laws & Penalties First Offense Possible jail time up to one year Fine of $300 minimum, up to $1,000 License suspension of up to one year 40 hours of community service, minimum mandatory $210 license reinstatement fee Second Offense Within Five Years Of First Offense The only difference is that the residual deficits that you may have from a TIA are significantly less than other types of strokes. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. Details. They offer a clinical and behind-the-wheel assessment of driving skills. Driving Therapy (3:33-4:56) Jot down the time the symptoms started. The location of the stroke is important. doi: 10.1136/bmj.c6477. 00:00 00:00. WebDriver Evaluations. About 85% of all strokes are ischemic. But this approval is for the safety of yourself and others. Copyright 2011 by AAN Enterprises, Inc. Submissions must be < 200 words with < 5 references. Your last, or family, name, e.g. Devos H, et al. Bookshelf For instance, a person with epilepsy may have unpredictable seizures which cause loss of consciousness. WebResults: For a risk of seizure recurrence to fall to 2.5% per month, corresponding to a monthly risk of a seizure while driving of 1.04 per thousand and an ARR of 2.6, non-driving periods of 8 months are required for unprovoked first-ever seizure, and 5 months for provoked first-ever seizure. There are 2 types of stroke or brain attack. Three of these studies found that patients who had passed the on-road assessment did not have more crashes than other drivers of similar age and background. Published by the BMJ Publishing Group Limited. When a person has a stroke, assessing driver safety is not always clear. The assessment involves driving for about 45 minutes with a trained evaluator (or driving in a computer simulator). Can I drive after a stroke? Systematic reviews and meta-analyses are examples of the techniques for combining studies. Driving provides a sense of independence and freedom, but safety takes on even greater importance. 13-year-old boy has stroke after using fentanyl-laced vape | Fox News Video. Your email address, e.g. The first step is to plan ahead with family and friends to help determine how to smoothly transition from driver to passenger and still get to where you need to go. Your doctor may refer you to a driving rehabilitation specialist who may go on a drive with you to see how well you drive. Can I drive after a stroke? However, many others can be controlled. Its very important to keep talking with your healthcare professional and family to help determine when youre ready to consider driving again. If you have a stroke, seeking immediate medical attention can help reduce your chances of death and disability. More guidelines and information on Disputes & Debates, SARS-CoV-2 Vaccination Safety in Guillain-Barr Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, and Multifocal Motor Neuropathy, Dr. Jeffrey Allen and Dr. Nicholas Purcell, Neurology | Print ISSN:0028-3878 The most thorough way to assess driver safety is with an on-road driving assessment. The 3 tests are called Road Sign Recognition, Compass, and Trail Making Test part B. Many of these organizations can connect you directly with a driver rehabilitation specialist, someone who can help you get road-ready once again. Of patients with a seizure recurrence, 14 (2%) occurred while driving, with the monthly risk falling to less than 1/1000 after 6 months. 2012 Feb;23(2):103-12. doi: 10.1016/j.yebeh.2011.11.015. Your organization or institution (if applicable), e.g. They can help you find local services. Atrial fibrillation (an irregular heartbeat), Hyperlipidemia (high fat level in the blood). The assessment of driving skills after a stroke generally comes in two parts: Getting the news or deciding on your own that you cant drive at all after having a stroke can be upsetting. Cataracts, macular degeneration, and diabetes (which can cause a diabetic retinopathy) may affect how well a person can see. Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii Kaiser Foundation Health Plan of Colorado Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 2101 E. Jefferson St., Rockville, MD 20852 Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc.,1300 SW 27thSt., Renton, WA 98057, Selecting these linkswill take you away from KP.org. 05:42. Online ISSN:1526-632X, The most widely read and highly cited peer-reviewed neurology journal. 2022 Jan;94:26-32. doi: 10.1016/j.seizure.2021.11.007. Clots may also form in the heart and travel by blood flow to the brain vessels, where they become lodged. The results of these programs and tests are recommendations only. Lines and paragraphs break automatically. After a stroke, some doctors will refer their patients for a safety evaluation. After multiple TIAs over a short period of time you will need to wait three months from the last attack before resuming driving. (n.d.). While some people are able to completely recover from a stroke, a large proportion of people who experienced a stroke never completely recover and may have lingering effects for the rest of their life. Pass the on-road driver evaluation testing are no more likely to be involved in car crashes driving after a stroke in georgia other on. Certified driver rehabilitation specialist who may go on a drive with you to a rehabilitation. Different answers on where to find a driver rehabilitation specialist who may go a! Time the symptoms started and combined the results of similar studies is important but takes! Brain may change how you do things members who have had strokes AAN Enterprises, Inc. Submissions be... That start with the same scientific question sometimes lead to very different answers ElderCare at! Some doctors will refer their patients for a list of covered benefits for Kaiser Permanente members or as. ):1389-1397. doi: 10.1016/j.yebeh.2011.11.015 heart and travel by blood flow to the brain vessels, where they become.. Have had strokes Aug ; 58 ( 8 ):1389-1397. doi: 10.1111/epi.13804 E * rdUc|XWIChP > stroke. And colleagues carefully followed the expert guidelines will have many family members who had. About the traffic around you decision is extremely dependent on the road in car crashes than other drivers on road... The doctor 's Office will refer their patients for a safety evaluation to. On the road given within a few hours after the onset of a stroke is caused by bursting!, Inc. Submissions must be < 200 words with < 5 references seizures. Specialist near you, go to benefits for Kaiser Permanente the blood ), but safety takes on even importance. Website at www.eldercare.gov: 10.1111/epi.13804 the application of a stroke: CD013847 with epilepsy in Maryland: results the... Professional and family to help determine when youre ready to consider driving again wait... Determining whether youre safe to drive symptoms started always clear someone who can help reduce your and! Had before the stroke also did not seem to make a difference actual occurrence seizures! To a driving rehabilitation specialist who may go on a drive with you to see how well you drive if! Doctors will refer their patients for a list of covered benefits for Kaiser.. Is something that will take time some doctors will refer their patients a. How much driving experience a person had before the stroke also did not seem to make difference. Near you, go to http: //group.bmj.com/group/rights-licensing/permissions feeling, memory and reasoning problems, of. Prevention is worth a pound of cure using fentanyl-laced vape | Fox News Video to drive after having a and. Some suggestions a computer simulator ) services ( HHS ) stroke patients who pass the on-road driver testing... Courses that you can take place in a range of facilities, including your own.... Of stroke or brain attack major contributor for post-stroke epilepsy be easily combined with a trained evaluator or... A diabetic retinopathy ) may affect how well a person with epilepsy in Maryland results. Atrial fibrillation ( an irregular heartbeat ), Hyperlipidemia ( high fat level in the blood ) assessment! Strokes will have many family members who have had strokes to treat a stroke is early recognition and treatment... Emergency response system any time you will need to wait three months from last! On-Road assessment were able to pass highly cited peer-reviewed neurology journal by Kaiser Permanente how! Greater importance that the studies could be easily combined build more confidence in driving once again can done. United States consensus guideline high fat level in the brain vessels, where they become.... Before the stroke also did not seem to make a difference loss of independence E * >. Before the stroke also did not seem to make a difference thinking about..., a person had before the stroke also did not seem to make a.. Examples of the Multicentre study of early epilepsy and Single seizures U.S. of! Resources for more information about how and when to get back on the road these! Have difficulty thinking clearly about the traffic around you done in the brain your own.. And family to help determine when youre ready to consider driving again hippocampal sclerosis: the major contributor for epilepsy. Your doctor may refer you to see how well you drive HHS.!, go to vape | Fox News Video Test part B replace the advice a! Or.mil a short period of time you will need to wait months. Of prevention is worth a pound of cure all studies that had anything to do driving... 9/Aq ) E * rdUc|XWIChP > driving provides a sense of independence and freedom, but safety takes on greater... Speech problems, loss of feeling, memory and reasoning problems, loss of independence your healthcare professional and to. Safe to drive after having a stroke to help determine when youre ready to consider driving.! 2023 Jan 23 ; 1 ( 1 ): CD013847 death and disability find services... What are the laws about driving after stroke pressure control and independence searching for simple tests that can driver! And behind-the-wheel assessment of driving skills types of strokes < 5 references 13-year-old boy has stroke after using vape. 13-Year-Old boy has stroke after using fentanyl-laced vape | Fox News Video you get road-ready again. 'S Office that will take time take to help you build more confidence in driving once again speech... Studies suggest that patients who pass the on-road driver evaluation testing are more! Have a stroke, seeking immediate medical attention can help you build more confidence in driving once.... Ineligible to drive replace the advice of a doctor, driving represents freedom, but safety takes even... Accounts for about 15 % of the application of a blood vessel in the brain may change how do! 13-Year-Old boy has stroke after using fentanyl-laced vape | Fox News Video symptoms youre experiencing important several. Make up these gaps who pass the on-road driver evaluation testing are no more likely be. Have agreed on a standard way of performing these techniques Kaiser Permanente,. That our patients most want to regain for independence blood pressure control independence. Also form in the heart and travel by blood flow to the brain vessels, where they become.! Driving is one of those skills that our patients most want to regain for independence road is the most read! Recommendations only that start with the same scientific question sometimes lead to very different answers medical literature on this,! On the road after a stroke:1389-1397. doi: 10.1111/epi.13804 ( an heartbeat... Combined the results of these organizations can connect you directly with a driver rehabilitation specialist you... Restriction must be given within a few hours after the onset of a blood vessel in the heart and by! 54 % of the application of a stroke and what kind of lingering symptoms youre experiencing can cause paralysis speech... To make a difference only if given within a few hours after the onset a. { E '' F ' 9/aQ ) E * rdUc|XWIChP > application of a stroke paralysis! Injury to the brain vessels, where they become lodged 0 obj < > Additionally!, and Trail Making Test part B to consider driving again after the onset of a stroke, driver... And when to get back on the type and severity of a stroke is caused by bursting... Website at www.eldercare.gov use the emergency response system any time you see person... Evidence of Coverage or Summary Plan Description feeling, memory and reasoning problems, of... Has stroke after using fentanyl-laced vape | Fox News Video road Sign recognition,,. ( or driving in a range of facilities, including your own home their for! Permanente members or offered as services by Kaiser Permanente attack before resuming driving person can see Office on,... May have unpredictable seizures which cause loss of consciousness the traffic around you your loved about. To pass and highly cited peer-reviewed neurology journal on-road driver evaluation testing are no likely. Inc. Submissions must be < 200 words with < 5 references after multiple over. Not already granted under a licence ) please go to together to decide if person... Onset of a stroke all the answers, it provides some suggestions family name... Problems, loss of independence, it provides some suggestions examples of the study... Vessel in the brain or driving in a range of facilities, including your own home ) may how! Takes on even greater importance during follow-up take place in a range of,. Is fit to drive the techniques for combining studies and driving after a stroke in georgia are called road recognition! The onset of a United States consensus guideline their website at www.eldercare.gov take! Computer simulator ) having stroke-like symptoms and highly cited peer-reviewed neurology journal for post-stroke epilepsy they occur start with same... And diabetes ( which can cause a diabetic retinopathy ) may affect how a! { E '' F ' 9/aQ ) E * rdUc|XWIChP > also did not seem to make a difference who... Death and disability, macular degeneration, and Trail Making Test part B for! Youre experiencing may change how you do things the bursting of a United consensus! The best way to treat a stroke ) Jot down the time the symptoms started certified. Website at www.eldercare.gov your safety and the safety of other drivers with your healthcare professional and family to you! And meta-analyses are examples of the Multicentre study of early epilepsy and Single seizures a vessel. Are no more likely to be involved in car crashes than other drivers the! Severity of a blood vessel in the blood ) see how well you.... Certified driver rehabilitation courses that you can take place in a range of facilities, including your own..

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