Page 12 - Mobility Management, September 2019

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Alternative Driving Controls: New Possibilities
To paraphrase a
popular proverb, there
is more than one
way to operate a power
wheelchair. Even better,
the alternative driving
controls niche is expanding
and putting independent mobility within reach of more clients than ever. But with a wider range of product possi- bilities comes a question: Which driving control is best for my client?
It Starts with a Joystick (Regular or Mini)
The standard power chair control is a joystick, a propor- tional control mounted on an armrest. A joystick is like a car’s gas pedal: Step on a gas pedal slowly and gently, and the car accelerates gradually. Stomp on the pedal, and the car takes off. Applying more force to a joystick makes the power chair go faster, and that concept — more input = greater result — is intuitive to many power chair users, particularly those who have experienced independent mobility before.
When a conventional joystick requires too much strength and stamina to operate, or its armrest location
is inconvenient, a mini joystick can be a great choice. Mini joysticks drive proportionally, but can be operated by the chin, for example, or whatever body part — knee, foot, etc. — the user can control well. Mini joysticks typically require less “throw” and force than a traditional joystick, making minis a popular choice for users with less strength. Joysticks can also be mounted midline, nearer the center of the body, if a user has more proximal than distal strength and control.
Switching to Switches
In contrast, switch systems are like simple light switches: on or off. If a switch is activated, the chair moves. If the switch isn’t activated, the chair doesn’t move.
All-or-nothing operation can be an easier concept to grasp for someone who’s never moved independently, such as a young child. Creating a scenario of either moving or not moving can help a child to learn quickly: When I press this button, I go!
Switches can be mounted on a tray or at different locations on the wheelchair. Or switches can be unified into a single control apparatus, such as a head array or sip-and-puff system.
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Switches are also used by power chair users who don’t have the ability to manage the nuances of a joystick. When a client has a progres- sive condition, such as ALS or muscular dystrophy, it’s
crucial for the mobility team to understand how the user’s abilities will likely change, and to select a power chair that can accommodate the driving control changes that will be needed.
A New Generation of Driving Controls
The world of power chair driving controls used to be as simple as switch vs. proportional. Not anymore.
This year, Evergreen Circuits introduced Independence Drive, a switch system operated via eye gaze; the user drives by looking at directional icons on a tablet. The system began as a challenge from Steve Gleason, a former pro football player living with ALS who wanted to navigate his power chair using just his eyes.
The driving control landscape also includes “propor- tional switches” — switches designed to respond proportionally to input. These choices join a myriad of other options, including systems that use fiber optics, and those that employ proximity sensors that activate when a user’s hand or other body part moves into the prescribed zone. These systems can be helpful to users who have limited motor control, such as those with cere- bral palsy. Even joysticks have evolved: a new selection of micro joysticks now requires even less force to use.
Choices like these can offer independent mobility to power chair users or preserve it as a disease progresses. What’s next on the driving controls horizon? Look for more convergence, as expanding electronics capabilities make it possible for power chair users to communicate, operate household electronics, and manage their envi- ronments with greater ease than ever. m
Sources & Resources: Power Wheelchair Drive Controls, https://mobilitybasics.ca/wheelchairs/drivecontrols; Alternative Driving Controls & ALS Clients, https://mobili- tymgmt.com/articles/2019/05/01/alternative-driving-controls. aspx; Imagining New Possibilities, https://mobilitymgmt.
c o m / A r t i c l e s / 2 0 1 9 / 0 8 / 0 1/ D r i v i n g - C o n t r o l - I n n o v a t i o n s . a s p x ; A Hierarchy of Driving Controls, http://www4.mobilitymgmt. c o m / A r t i c l e s / 2 0 17/ 1 0 / 0 1/ D r i v i n g - C o n t r o l s . a s p x
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