Page 14 - Mobility Management, July 2019

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Making Tracks: Getting PWC Users Ready to Roll
Procuring a power wheelchair is a long process of assessing, fitting, trials and documen-
tation. But just as important as measuring seat widths is preparing your client to succeed at power wheelchair driving.
Here are ways you can help your client get ready to roll in a new power chair.
Drive-Wheel Configuration Matters
Drive-wheel configuration — front-,
mid-, or rear-wheel drive — has a
big impact on how the wheelchair
turns, and it will help to determine,
for instance, when the power chair
user should begin to turn to go through a doorway.1
If your client used a previous power chair, it’s important to know what its drive-wheel configuration was so you can help your client to adjust if needed. A user accus- tomed to a mid-wheel-drive chair turning in its own foot- print will need to practice maneuvering with the longer turning radius of a front- or rear-wheel-drive chair.
Identify Limitations that Could Impact Driving
To optimally prepare a client to operate a power chair, identify his or her visual or sensory disabilities.
Vision limitations or changes are common in clients with cerebral palsy, stroke or brain injury.2 Problems can include visual neglect, in which the client becomes unaware of stimuli in a certain direction — say, to his left. That client would be unaware of anything to his left and therefore won’t look to his left while driving. Other vision problems can include double vision or visual field cuts, which are “blind spots” in a client’s vision.
It’s important to note that visual or sensory limitations don’t automatically disqualify someone from effectively operating a power chair. By identifying limitations, the seating and mobility team can create ways to compen- sate. Strategies could range from additional practice and training time to sensors to alert wheelchair users to potential obstacles in their environment.
Practice Can Perfect Performance
Just as no one walks, rides a bicycle, or parallel parks a car perfectly on the first try, mastering a power
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wheelchair takes practice. Studies have suggested that plenty of power chair practice is especially important for pediatric users who are learning, and for those with complex or multiple disabilities.3
It’s also important to note that very young children and those with complex disabilities might need more time to demonstrate purposeful driving, such as driving to a parent when called. Very young children or ones who are first learning to maneuver
a power chair can spend a lot of time just turning the chair in circles, while ignoring a thera-
pist’s request to drive in a straight line. Independent mobility is a new experience to
someone who’s never had it before. So expect some seemingly random exploring at the start, and expect that a child who’s never been independently mobile will need time to figure out how to maneuver successfully through space.
Train in Realistic & Engaging Environments
Learning to drive on a perfectly smooth surface in a wide-open space — such as a clinic exam room or gymnasium — certainly gives the power chair user fewer obstacles to hit. But how realistic is that setting?
A power chair needs to move through much more cluttered, imperfect and interesting environments. So training in other settings, such as at home and at school for kids, can help new users to learn to navigate more crowded environments.4 Plus, practicing in a more intriguing location such as a park can motivate learners to use their power chairs to explore and engage. An interesting environment can be especially helpful in giving young children a reason to practice their evolving power chair driving skills. m
Sources: (1) https://mobilitymgmt.com/articles/2018/10/01/ drive-wheel.aspx. (2) https://mobilitymgmt.com/arti- cles/2015/03/01/vision-and-mobility.aspx. (3) https:// onlinelibrary.wiley.com/doi/full/10.1111/dmcn.12245.
(4) https://www.numotion.com/blog/april-2018/ training-methods-for-pediatric-powered-mobility
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