Clinically Speaking

The Importance of Setting Specific Drive Parameters for Individuals

It’s never an easy task for anyone to try something new or to immediately excel in an area in which they have no prior experience. For many individuals, moving away from a personal comfort zone can cause stress, anxiety and fear. These situations can relate to many aspects of a person’s daily life, and they likewise ring true for many individuals, including those with assistive technology and mobility needs.

Rehab professionals are challenged daily to ensure that they are providing the most appropriate power mobility for their clients. It’s imperative that the client is not only physically comfortable with his or her power chair, but mentally comfortable, as well. In this area, programming a power chair’s drive characteristics is a vital part of the fitting process. The ultimate objective is to create an optimal level of mobility that best serves the client’s clinical, comfort and independence needs. Power chair handling plays a key role in all of these areas.

Setting Clients Up for Success

For a moment, imagine trying to get comfortable going from your own car to one that you’ve never driven.

You’d start by adjusting many aspects, like the seat, steering wheel and mirrors. It would still take you quite some time to get used to the overall handling. Based on this point, a client can have initial difficulty operating, maneuvering and maintaining safety with a new power chair. As rehab professionals, it is our responsibility to ensure that we provide proper power chair drive training for all of our clients.

Some clients may be quick learners, and the drive training can be simple. Others may require large amounts of time in order to feel comfortable and be able to operate the power chair safely. In all circumstances, however, setting the appropriate individual drive settings can be the difference between remarkable liberation or frustrating confinement for the client.

Although there are many variables associated with programming drive parameters for specific client needs, there are three client-centered aspects that need to be accomplished in order to get successful results.

Driver Education

The first objective during initial drive trials with your client should be taking 10-15 minutes at the beginning of the meeting to explain the general workings of a power chair.

Many clients become very anxious about the thought of operating a power chair. They can get scared if things do not go well, and if something happens that the client doesn’t like from the start, you may have a difficult time changing their mind as you move on. Talk to the client about his or her expectations of how the power chair should work and explain how the chair will react. Make sure to thoroughly explain aspects like what a “proportional joystick” means and how it will react when the client pushes it. When we know how a device works, we’re more comfortable with it, and your client will be too.

It is also extremely important to discuss with the client how to stop the chair. Many clients have the tendency to try to stop a forward motion by pulling back on the joystick — this situation can be dangerous, causing the client to lose balance and control of the chair. Educating the client to simply let go of the joystick to stop can be a valuable piece of knowledge that keeps the client comfortable with the power chair’s operation.

Start Out Slowly

The second objective is starting out slowly. The beauty of programmable electronics is that you can have the drive parameters turned down to a snail’s pace at the initial trial with the client.

It makes the operation of the power chair very safe, so that the client is not immediately intimidated when driving for the first time. It allows you room to increase parameters to the client’s liking. If the power chair is programmed too fast for the client at initial drive testing, they may become scared and not trust it. This is difficult to recover from. Performing this objective may take a bit more time in the beginning, but it may save you time by lessening repeat visits to a client who is not satisfied. And, once again, building a client’s trust and confidence is vital. Programming Speeds for All Environments The third and final objective is to ensure that you program through all speed modes for the client’s particular environments.

The client needs to understand speed modes and how they function. For example, if drive mode one is for the client’s indoor use, you need to make sure that the drive mode’s parameters fit that environment. To meet the client’s needs, this may mean adjusting the parameters multiple times while the client drives around his or her home until the drive performance is acceptable to them. This same action should be followed through all environment-based drive modes.

A Client-Centered Approach

As rehab professionals, surely we understand the technical importance of drive parameter programming. However, it’s vital that we also focus on the human side of the process — the client.

When we take the time to follow a client-centered method to programming, we see an amazing transition when the client goes from apprehension to confidence with the push of the joystick.

This article originally appeared in the February 2010 issue of Mobility Management.

About the Author

Jay Brislin, MSPT, is the director of Quantum Product and Clinical Development for the Quantum Rehab division of Pride Mobility Products (Exeter, Pa.). He can be reached via email at jbrislin@pridemobility.com or by phone at 800-800-8586.

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