FRIDAY, Aug. 4, 2006 (HealthDay News) -- Two years ago, Daniel Strones' car crashed through a mountain embankment at almost 100 miles per hour.
Strones was not wearing a seat belt at the time and was in a coma for three weeks after the accident. When he came out of it, he had balance and perceptual problems.
This might not seem like the type of driver most people would like to see back on the road. However, Strones made the transition with the help of driver rehabilitation specialists, and he has not had any problems since he returned to the wheel.
"I was surprised at how easily driving came back," Strones said. "I started in a parking lot, then moved to neighborhood streets, then Central Avenue [Route 66]. I've been driving again about a year and haven't had any problems."
Despite considerable obstacles, many people with newfound disabilities, including neurological conditions, heart disease and stroke, are finding ways to navigate America's byways and highways safely.
"Driving is a complex skill, and the ability to drive safely can be affected by an illness, a disease or a mental condition or some physical decline as we get older," said Bella Dinh-Zarr, former national director of traffic safety policy at the American Automobile Association (AAA).
For the impaired person, the ability to drive symbolizes independence.
"Driving represents freedom," said Strones, who is 29. "Before, my mom would have to drive me everywhere."
"How well you reintegrate into a community has a lot to do with whether you drive or not," added Carol Spizman, an occupational therapist in Albuquerque, N.M. "People regard it as freedom."
"Not being able to drive is almost more crippling than not being able to walk," explained Stanley Vigil, 24, of Albuquerque, who was left paralyzed from the waist down after a surfing accident last year.
Vigil has passed vision and reaction tests, and has been approved by his therapist and doctor to drive again. He is now just waiting for adaptive equipment that will enable him to operate a car.
It's not always immediately clear who is a good candidate for driver rehabilitation.
"You cannot tell about a person until you thoroughly evaluate them," Spizman noted.
One man with a brain injury looked especially hopeless. He had bad ataxia (inability to coordinate or control movements), slurred his words, and had slow response times.
"You would think this guy should not drive," Spizman said. "But we set him up so he can transfer from his wheelchair into the vehicle, and gave him a steering knob for his good arm. We started him out in parking lots, and driving became his rehabilitation."
Another man who lost both of his legs now drives with his hands.
"People often correlate driving rehab with pulling licenses," said Elin Schold Davis, project coordinator for the Older Driver Initiative at the American Occupational Therapy Association. "We want to figure out as best we can, being mindful of the safety of our community and of independent rights for people, strategies to help them as much as we can."
The question is how to get these people back on the road in a way that keeps everyone safe. Regulations differ from state to state, and it's all too easy to slip through the cracks.
At the same time, driver rehabilitation programs, which require instructors with specialized training, are becoming few and far between.
"There is a sore lack of driver rehab programs out there," said Schold Davis. "We need more. Driving programs have difficulty sustaining their business because there are a lot of liability and equipment expenses."
The Adaptability School of Driving in Albuquerque, N.M., where Strones learned to drive again, is now closed. But a lack of such schools won't keep those who are disabled off the road, the experts noted.
"A great majority of people with disabilities who want to be driving are out there driving," Spizman said. "I heard about one person with a spinal cord injury who improvised a system of broomsticks for gas and brakes, and drove like that for years. Doesn't that give you pause?"
For more on driver rehabilitation, visit the Association for Driver Rehabilitation Specialists.