More Options for Power Chair Driving

While evolving technology makes it possible for more clients to drive power chairs independently than in the past, Quantum Rehab’s Jay Brislin also points out that improving medical treatments for newly injured SCI patients is resulting in a higher percentage of “incomplete” injuries — patients who retain limited sensation, function and movement below the level of the SCI.

Brislin calls the development “great, because you may be able to find a little voluntary movement.” For instance, in a patient whose level of injury dictates no finger movement, “if they’re incomplete, you may be able to find one or two fingers they may be able to move. It can be very minimal; they might be able to move an index finger half an inch, or put a little pressure on it. But if they can, it becomes an access point for a switch. There are a lot of possibilities if you can find voluntary movement.”

Assessing for that type of movement, Brislin says, involves working “distally to proximal. So you’re going to look at somebody’s hand movement first, and then you’re going to start moving up their body, to see where they have functional, voluntary movement that’s repetitive and has some strength to it.

“Another distal place to look at is their feet. If they have any kind of foot movement, some ankle flexion that’s controlled and can be repetitive, then that can be a switch site.”

It’s an example of how medical intervention and assistive technology together can provide greater independence. “You’d love somebody to be a joystick driver, because that’s going to give the most access,” Brislin says. “But really what you’re looking for is a point of access for a switch site. When you find one that can be used on a regular basis, you have something to work with.”

This article originally appeared in the SCI Handbook October 2010 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at

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