ATP Series: Case Study

Ingenious! Power Chair Case Studies Rising to the Occasion

Client: Gabe Adams, 17 years old.
Diagnosis: Four-limb Amelia.

Four-limb Amelia Case Study

PHOTOS COURTESY GABE ADAMS & FAMILY/ ANGIE KIGER, SUNRISE MEDICAL

Gabe Adams drives his new Quickie QM-710 with his shoulder.

I’ve chosen my own happiness. That’s a phrase Gabe Adams of Utah recently wrote to caption a picture of himself he posted on Instagram. Finding joy in the little things and being able to smile through incredibly difficult situations are things many people struggle with throughout their entire lives. However, 17-year-old Gabe seems to already be a master of both. His positive attitude, determination and radiating smile have inspired everyone he has encountered, including his complex rehabilitation technology team.

“Awesome Gabe Adams”

In May 2015, one of my colleagues at Sunrise Medical, Account Manager Roger Serzen, sent me an e-mail with the subject line “The Awesome Gabe Adams & the Advantage of Assignable Buttons.” As someone who has dedicated much of my career to helping clients gain independence through power mobility, I love learning about creative solutions fellow industry members have come up with to provide a client with independent mobility. Roger’s e-mail included a video featuring a young man driving a Quickie QM-710 power wheelchair with a standard joystick, independently transferring in and out of the wheelchair, and operating the seating functions via a switch.

So what was so cool about that?

Gabe, the young man in the video, was born with four-limb Amelia — he has no arms or legs. From the moment I saw that video, I knew I had to meet Gabe and learn about his team’s journey to success with identifying the best power wheelchair.

Re: Gabe

Q: Gabe previously drove with his head, but was adamant about driving his new chair with his shoulder. Why?

Angie Kiger: He didn’t like the way the head array blocked his vision and the pads got in his way when he was trying to interac t with people. He stated that he already looks different enough, so driving with a standard joystick makes him look just a little bit less different. Also he believes he has better control for precise movements, thus can go faster because according to Gabe, “Speed is everything!”

Gabe, born in Brazil, was adopted at 9 months old. When his parents, Ron and Janelle, brought him home to Utah, the only way he was able to move around his environment was by rolling. Shortly after arriving, Gabe began going to Shriners Hospital in Salt Lake City for outpatient therapy services. It was at Shriners Hospital that his family was introduced to Ken Kozole, ATP, BSME, OTR/L, and Matt Lowell, MPT, from the wheelchair and seating department. Throughout the years, Ken and Matt have worked closely with Gabe and his family to provide him with wheelchairs that not only meet his unique needs, but also provide him with the most independence.

Last year, when it came time for Gabe to be evaluated for a new wheelchair, his family naturally turned to Ken and Matt for assistance.

Evolving Needs & Goals

By this time, Gabe was an active 16-year-old, so what he desired and needed in a wheelchair was different from when he was in elementary school. To determine what Gabe needed in a new wheelchair, it was essential that the team first determine what was working well on his old wheelchair and the areas that needed to be improved.

Positive aspects of the old wheelchair included power capabilities that enabled Gabe to drive and transfer in and out of the wheelchair independently. Areas of improvement for Gabe’s next wheelchair included simplifying the electronics, as well as providing better suspension, increased speed capabilities, a smaller footprint for better maneuverability in a variety of settings, and an alternative to using his head for driving.

Four-limb Amelia

PHOTOS COURTESY GABE ADAMS & FAMILY/ ANGIE KIGER, SUNRISE MEDICAL

Gabe with author Angie Kiger.

Historically, Gabe had driven his power wheelchairs with his head via head arrays and RIM controls. The team decided to explore whether or not Gabe could functionally, efficiently and safely drive a power wheelchair using the residual musculature in his left shoulder. To accomplish this, a joystick was mounted directly beside his shoulder. Gabe was able to successfully utilize the standard joystick and was excited to drive his chair without using his head.

The obstacles surrounding the desire to decrease the footprint, increase the speed, improve suspension and maintain Gabe’s ability to get in and out of the wheelchair independently posed an entirely different set of obstacles. The Shriners wheelchair and seating team of Matt and Ken had an epiphany one day when they were discussing Gabe’s needs. If they were able to transform an elevating legrest system into a chair-to-floor mechanical assist accessible via a switch, then Gabe could have the other benefits of a mid-wheel-drive base (smaller footprint, turning radius, and maneuverability), increased speed and better suspension. Ken and Matt contacted Roger (Sunrise Medical) and the complex rehabilitation technology supplier, Bryon Cheney, ATP, Intermountain Homecare, to brainstorm solutions for making everything work.

To provide Gabe with a wheelchair that had better maneuverability, decreased footprint, increased speed capabilities, and better suspension, the team decided to go with the Quickie QM-710. The QM-710 is a mid-wheel-drive power wheelchair with a much smaller turning radius than Gabe’s previous wheelchair, thus allowing for better maneuverability in smaller spaces. In addition, the QM-710 features SpiderTrac suspension, which provides superior traction and handling across all terrains. Through the use of the assignable button/switch jack feature available on the QM-710 and a power-elevating center-mount legrest system, the team was able to create a chair-to-floor mechanical assist that Gabe can control via a switch programmed as a latched button.

In addition, a switch was mounted on the back of the wheelchair set to power the wheelchair on and off. This rear switch enables Gabe to independently turn his wheelchair on and off when he is on the ground. When Gabe is in his wheelchair, he is able to use a standard joystick to drive and control the power functions with the residual musculature in his left shoulder. The efforts of the team were evident the moment Gabe transferred into his new QM-710 independently and sped off with a grin on his face.

Four-limb Amelia

PHOTOS COURTESY GABE ADAMS & FAMILY/ ANGIE KIGER, SUNRISE MEDICAL

Gabe, shown here with one of his dance instructors, has competed on his school dance team. His dance videos have taken YouTube and social media by storm.

Need for Speed

Last October, I traveled to Salt Lake City and was privileged to have the opportunity to meet Gabe and his mother, Janelle. For a little over an hour, Gabe, Janelle and I traded stories. Janelle recalled the very first moment she and her husband learned about Gabe. They knew instantly that Gabe was born to be a part of their family, and he has provided them with tremendous joy. Gabe candidly shared stories from his childhood and his perspective on life, including where his internal drive comes from and his dreams for the future. He was vocal about the important roles his family, friends and faith have in his life. Gabe also shared his passion for music and love of dance.

When the conversation shifted to talking about the role power mobility has had in Gabe’s life, he and his mother raved about the life-changing impact of the complex rehab team.

Gabe revealed that his goals surrounding his power wheelchair have always been relatively simple: a system that allows him to be completely independent in his mobility, is Gabe with author Angie Kiger. designed to encourage people to see him first as opposed to his wheelchair, can maneuver wherever he wants to go, and, most importantly, enables him to live at the speed of life. Gabe informed me that he “loves” his QM-710… it’s his speedy racer.

Determining the best mobility system requires an incredible amount of teamwork. In this case, Gabe, his family, therapists, complex rehab technology supplier, and equipment manufacturer all pulled together to come up with the perfect solution. According to Matt and Ken, clients such as Gabe are a constant reminder to never say never and to always listen to your client! After meeting him, I can assure you, Gabe Adams is a world changer who motivates everyone he encounters!

This article originally appeared in the June 2016 issue of Mobility Management.

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