One of the coolest things that is still possible after a spinal cord injury (SCI) is being able to drive a car. With hand controls, the open roads are still accessible to us. But don't worry, the controls aren't as difficult to use as you might think. With a little bit of patience and arm movement, you, too, can learn how to drive using hand controls. Read up on the basics below, so you can be prepared to drive yourself (and soon).
There are a variety of hand controls available that control the gas/brake for all levels of injuries. However, you still require a modicum of movement to drive. This means that anyone with an injury above C4 likely cannot drive, but if they have an incomplete SCI, there is still a chance that they can. For those with minimal arm movement, they are able to drive using a joystick.
They can drive while sitting in their wheelchairs as well, and after locking their wheelchair into the floor lock, they use their own wheelchair joystick to drive the vehicle. The system that runs this is quite expensive, however, and limits many from using it. And for those who can use their arms a bit more but are still a quadriplegic, a tri-pin electric hand control system is recommended.
This system controls both the gas and brake using just the wrist and arm without any finger dexterity required. It is all electric and connects to the gas/brake pedals. An electric hand-control system for a quadriplegic can cost a minimum of $30,000.
For quadriplegic drivers, it’s not as easy to do things like turn on the blinkers or lights while driving. Usually both of their hands are tied up, making it impossible to take their hands off the controls. In order to operate the blinkers, horn, lights, as well as other operations that are important while driving, many quadriplegics use an elbow-controlled system they can reach from where they are sitting behind the wheel.
This is usually a touch pad that’s glued to the driver's door or on a stand that is affixed to the floor on the other side of the driver. This touch pad will include all of the controls you would use that typically would be found by the steering wheel — the horn, lights, dimmer, blinkers, cruise control — and it will be said aloud on a voice system. When the voice says the operation you want, you hit the touchpad with your elbow again, and it activates it.
For drivers who can’t grip the wheel, a tri-pin is placed on the steering wheel. All they need to do a slide their hand into the tri-pin and they’re off. This device is fitted the first time a driver begins driving in order to ensure their hands fits appropriately. Others that have a little bit of hand movement usually opt for a steering knob. A smaller steering wheel can even be installed for anyone with limited arm movement.
For many quadriplegic drivers, and even some paraplegic drivers, they will stay in their wheelchairs while driving. In order to do this, an automated lockdown system is used. Two of the main companies that create automated lockdown systems for wheelchairs in vans/trucks/SUVs are EZ Lock and Q'straint. These automated tie-down systems have especially opened the roads to quadriplegics who can’t transfer, allowing them to finally drive on their own.
These systems have a sensor that senses when the wheelchair is over the lock. When you drive over it, a peg that has been previously permanently affixed to the bottom of your wheelchair will slide into the lock, creating a safe seal around it that is the just as safe as sitting in the vehicle seat. As for your seat belt, this is on its own separate stand, so you can drive right into it as you drive behind the wheel.
For many quadriplegic drivers, keeping their balance is something about which they need to be concerned. Typically a chest strap is used and that’s all that’s needed. There are other instances however where lateral support may also be required. Lateral side supports can be used to help the driver sit upright, placed along each side of the torso. As for drivers able to transfer out of their wheelchair and drive from the seat of their vehicle, balance is not a concern.
The takeaway: Hand controls are awesome. Please don't allow any fears you may have about learning to drive with hand controls prevent you from giving them a whirl. Many who have waited for years out of fear are blown away at how easy they are to use. Plus, you can’t beat being able to go anywhere at a moment's notice.