Transportation Options for People with Disabilities

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Transportation Options for People with
Disabilities

• Kathy Norton, MClSc (OT)

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Options

• Cars
• Trucks
• Vans
• Taxis
• Handidart
• Bus (City, Greyhound)
• Plane

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Car Considerations

• 4-door vs 2-doors
• Seat options bench vs bucket height
• Types of transfers required vs abilities
• Folder vs rigid frame w/c

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Truck Considerations

• Better in snow - clearance and 4WD
• Transfers required vs abilities
• Bruno EZ Rider and Cab Sider
• Twin or extended cab required
• Must be indep. with transfers!
• e.g. Ford F150

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Van Options

• Full-sized vs Mini van
• Tie-downs vs EZ Lock
• Consider wheelchair/seating needs size and
  wheelbase
• Ramp location In floor, Under vehicle (UVL), or
  inside
• Driver vs passenger.
• Overall client height for head clearance!!!

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Car vs Truck vs Van

• Power vs Manual
• Chair type seating needs
• Transfers
• Energy Expenditure
• Time Requirements
• Skin Integrity

• Injuries (temporary overuse)
• Environment / weather
• Family, social, and work requirements
• Financial issues
• Maintenance

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Conversion Options for Vans
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Conversion Options for Vans
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Van Conversions

• VMI -
• VanAction -
• Vantage -

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Driving Modifications

• Primary and Secondary Driving controls
• Primary gas, brakes, steering
• Spinner Knobs, T-handle,Tri-pin,
• Zero-Effort Steering
• Toggle/Switch Control
• Secondary remote start, voice activations,
• climate control, stereo, lights, washers etc

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Driver Assessment Rehab
Driver Rehab Ctr Vancouver 604-322-8335
Robertson Rehab Vernon 250-558-4584
Glenrose Rehab Hospital Driver Rehab Program,
Edmonton 780-471-2262
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Vehicle Dealers

• CanAm Cruisers PG Surg-Med
• Kelowna Prince George
• 250-491-0003 Lift installation only
• www.canwill.com 250-562-2240
• Shoppers Home Health Care Others
• Edmonton 780-562-4002 -SideWinder Chilliwack
• Vancouver 604-326-1117 (all vans and
  conversions)
• craigt_at_oakhill-labron.com -Tom Harris
  Vancouver Is
• (GM Dealer)

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Flying!

• In own w/c until last minute loading
• Transfer to narrow aisle chair
• Own w/c gets taken to luggage
• At risk of damage to w/c, esp. powerchair
  controls
• Pressure relief and positioning in seat!
• Contact airline ahead of time for assistance or
  to book a practice session

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SCI HANDS Form and Function

• Assessment
• Tenodesis training
• Splinting Protocols
• Deformity prevention
• Range of Motion and exercise
• Tendon Transfer Surgery (Maura)
• FES

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Hand Assessment

• COPM clients occupational goals!!
• grip and pinch strength
• AROM / PROM
• dexterity and fine motor assessments
• Functional hand assessments /observation
• Sensation pin prick, light touch, temperature
• Edema control
• Spacticity / tone issues

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C4/5 level

• Shoulders and biceps only
• Doral Wrist Support - with wrist extension
• Pocket or cuff on palm
• Long opponens
• ?tendon transfers
• Resting splint and passive ROM (ice/wax)
• Self feed, teeth, sign name etc

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Tenodesis C6-8 level

• Active wrist extension passive finger flexion
• Passive ROM
• Wrist strengthening
• Splinting resting splint, boxing glove, short
  opponens, universal cuffs
• ?tendon transfers
• See Handout package for program
• Feed, groom, write, type, wash, toilet, cook

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Why splint?

• Functional hand vs flat hand, claw hand
• Prevent deformity
• Maintain functional hand position
• Maintain good alignment of thumb in relation to
  index finger
• Enhance Function short opponents, thumb CMC or
  thumb post splint
• Clients often prefer no splint at all

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Types of Grasps in tetraplegia

• Key grip (lateral grip) paper, tv remote
• Palmar grasp - joystick
• Cylindrical grasp - glass
• Interdigital or interwoven writing, cutlery
• 2 handed cooking, drinking, lifting
• Wrist hook technique dressing
• Use of thumb to hook mug, u-cuffs
• Use teeth to assist opening containers

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Gadgets.!!!

• Self Care / ADLs
• U-cuffs toothbrush, hairbrush, cutlery,
  writing, typing, shaver, make-up
• Bathing / toileting routines
• Kitchen / cooking safety and independence
• Reading
• Writing / typing
• Phone

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Hands contd.

• Have client learn self-ROM program
• Wax or flax bags (heated) very popular
• Focus on clients specific goals
• Call us here!
• Internet SCI resources see handout!
• BCPA / Peers best ideas come from those living
  with SCI

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Contact Info

• GGF Strong Occupational Therapy Dept.
• 604 737-6286
• GFS Toll-Free
• 1-866-906-1888