Can a quadriplegic drive a car?

Driving After Spinal Cord Injury

The amount of time after your injury is a major factor in deciding whether and how you can return to driving. You may see many improvements in your abilities several weeks or months after your injury. With time, you may regain some functions that could make driving possible. With time, the amount and cost of any needed special equipment may be reduced. You should look for these important signs that you are ready to drive again:

• You do not need narcotics to control your pain while you drive.
• You have good vision, or your vision can be corrected.
• You can control the muscle spasms and muscle tightening caused by the injury.

Your doctor can refer you to a driving rehabilitation specialist for a full evaluation to decide if you are ready and able to drive.

A full driving assessment will evaluate:

• Medical data/driving history/driving goals.
• Vision
• Strength and range of motion
• Cognitive ability (if indicated)
• Ability to transfer
• Wheelchair or other mobility device loading
• Behind-the-wheel driving to try out equipment options

How to find out what kind of assistive technology I will need.

Your doctor can refer you to a Certified Driver Rehabilitation Specialist (CDRS) near you who can do a driving evaluation for you. You can find a list of specialists and their locations at http://www.aded.net/ or by calling ADED at 866.672.9466.

The CDRS can help you decide what special equipment you might need to drive a vehicle, and what type of vehicle would be best suited to your needs. The CDRS may also know about special funding to help you get the equipment you need. To be evaluated by a CDRS, you will most often need a referral from a doctor. If you live in an area where there is not a CDRS close by then we recommend you visit http://www.nmeda.com/, and use the dealer locator tool to find automotive mobility dealers closest to you. These dealers are specially trained to help with your driving equipment needs. They will know of professionals in your area that can best meet your needs. NMEDA’s phone number is (866) 948-8341.

What kind of assistive technology is available?

There is assistive technology for many activities associated with driving; your choice will depend on what you need:

Getting in and out of a vehicle:Two of the main factors to consider in the return to driving after an SCI are vehicle entry and exit, and loading and unloading the mobility device if you use one.

• You may be able to transfer from a wheelchair into the vehicle and then load the manual wheelchair on your own.
• If you cannot load your wheelchair, there are adaptive wheelchair loading devices like the one shown on the left.
• If you cannot safely and independently transfer from the wheelchair to the driver’s seat, you may need a wheelchair-accessible vehicle that lets you drive or push your wheelchair into the vehicle.
• Some modified vehicles let you drive while sitting in the wheelchair.
• Whichever device you choose, the wheelchair must be secured while the vehicle is moving.

An example of a wheelchair lift for a pickup truck. Photo courtesy of Shepherd Center.

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Operating the gas and brake controls: There are many different types of gas and brake controls; the most common are hand controls. Hand controls are available with many types of motion—push-pull, push-twist, push-rock, and push-right angle—so that drivers can use the one that suits them best. A CDRS can help you choose the best type for your injury or disability.

Controls can be mounted for the left or right hand. Pictured above is a right- floor–mounted mechanical hand control. Also a removable accelerator pedal block and steering wheel spinner knob can be seen. Photo courtesy of Shepherd Center.

Steering. Often a driver using hand controls will use only one hand for the steering wheel because the other hand is controlling the gas. A steering device like the one pictured here can help a driver steer efficiently with only one hand. The device can be placed on either side of the steering wheel, depending on which arm is strongest. The steering system can also be adapted so the driver can turn the wheel with less force using a smaller steering wheel, a separate electronic steering wheel, or even a foot-operated steering device.

Electronic Wheel to be used with right hand for steering.

Electronic Gas/Brake Lever used with left arm and Electronic Wheel used with right arm for steering.

A tri-pin steering device allows someone without finger function to turn the steering wheel.

How will I pay for this equipment?

• Your State’s vocational rehabilitation (VR) program might help you buy, equip, and learn to use a vehicle. VR programs usually are for people who plan to return to school or work and who need costly high-tech equipment and/or a wheelchair-accessible vehicle.
• Most vehicle companies offer a rebate (about $1,000) to qualified people who buy a new vehicle. These rebates usually limit what equipment can be purchased.
• The Crime Victims’ Compensation Program might help if you are a victim of a crime (such as gunshot, drunk driver, violence). For more information, go to http://victimsofcrime.org, or call (202) 467-8700.
• Your State might have a trust fund that could help you. (For example, The Georgia Brain and Spinal Injury Trust Fund Commission helps Georgia residents with uninsured costs related to disability, including buying or modifying a vehicle. For more information, go to http://www.ciclt.net/bsitf.
• HelpHOPELive helps organize community-based fundraising efforts to help cover the costs of uninsured medical expenses for people with tragic injuries. For more information, go to http://www.helphopelive.org/about/.
• The U.S. Department of Veterans Affairs, or VA, offers grants to veterans who become disabled due to disease or injury associated with their military service, or who become disabled as a result of therapy, rehabilitation, or medical treatments provided by the VA. For more information, go to http://www.va.gov/.

When is the best time for me to get started?

Timing is everything. Take your time and get all the facts. Your body might need time to adjust to the effects of your SCI. For example, your motor functions might be different 1 month after your SCI than even a few to several months later. We urge you to take the time you may need after your SCI to be evaluated by a CDRS. The CDRS will evaluate your skills and help you decide what vehicle and equipment you will need. If you use a wheelchair, it will be important to coordinate your new chair with any plans for driving and also to have your own chair available before you purchase a vehicle so that the vehicle choice can support you and your chair.

Remember, an adapted vehicle can be expensive. It is important to truly understand your needs before buying anything. Do not feel pressured to make quick decisions. Rushing into a purchase will almost always make an appropriate vehicle more expensive than when a full evaluation is made at the proper time. When a purchased vehicle cannot be adapted to meet your needs, money and time are wasted in selling it and then buying a well-matched vehicle.

Authorship

Driving after Spinal Cord Injury was developed by John Anschutz in collaboration with the Model Systems Knowledge Translation Center.

Source: Our health information content is based on research evidence and/or professional consensus and has been reviewed and approved by an editorial team of experts from the Spinal Cord Injury Model Systems.

Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. The contents of this fact sheet were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DP0012-01-00). The contents of this fact sheet do not necessarily represent the policy of Department of Health and Human Services, and you should not assume endorsement by the Federal Government.

Copyright © 2015 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.

Can a quadriplegic drive a car?

FOUNTAIN, Colo. (CBS4) – The revving engine of a race car outside Fountain Wednesday morning was the sound of a major breakthrough in a technology that could one day change the lives of people who are mobility challenged. The man behind the wheel of the 850 horsepower NASCAR Cup race car was German Aldana Zuniga of Miami. Despite being paralyzed from the waist down, he used a microchip implanted in his brain to drive lap after lap. «It’s an amazing experience. Since my accident, I don’t have mobility below my waist, so this is my first time driving a car,» Zuniga said.

Nine years after a life-altering car wreck, Zuniga used his thoughts to drive Wednesday. It’s a technological breakthrough pioneered by a team led by Dr. Scott Falci, a Colorado neurosurgeon with Health ONE’s Falci Institute for Spinal Cord Injuries. The group also included electrical engineer Dr. Harry Direen, and Kevin Davis with the University of Miami Miller School of Medicine’s Miami Project to Cure Paralysis. For more than a year, they, along with others, worked tirelessly so Zuniga can communicate between a microchip on his brain and a computer in the car. «The electrical changes get picked up on that electrode, travel down a cable underneath his skin to a little computer processor,» Falci said. «When the computer recognizes that particular fingerprint, it knows to send the signal to the computer in our race car and that computer knows to send it to the throttle and to actuate the throttle,» said Falci. For now, the technology allows Zuniga to use his thoughts to start the throttle and keep it at a steady pace. He can steer with a specialized helmet that registers his head movement, as well as slow down using a tube attached to the helmet known as a sip-n-puff input.

Because of all that, a task that was once unthinkable is now possible with focus and practice. «It’s unbelievable to think about being in the car, especially that fast. To be in it and watch how you go through the track smoothly and it responds to what you think, it’s just incredible,» Zuniga said. According to Falci, the future possibilities for this technology are just as exciting. «Our goal is not to make race car drivers out of spinal cord injured patients, it’s really to apply this to real-world situations,» said Falci.

«We can use this potentially for driving an electric wheelchair, a golf cart, control a robotic arm, control an exoskeleton device, control implanted medical device. Once we develop that science, that science can be used for all types of systems,» he said. It’s a finish line Zuniga can’t wait to help cross. «Technology is advancing, so we have to help do our part in it and make it become available for everyone,» Zuniga said.

Quadriplegic Driving: Hand Controls 101

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).

Adapting the Gas and Brake

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.

Operating the Blinkers, Lights, and More

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.

Steering Adaptations

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.

Locking in Safely

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.

Keeping Your Balance

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.