Transportation
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Transportation Presentation Transcript

  • 1. Transportation Options for People with Disabilities Kathy Norton, MClSc (OT)
  • 2. Options
    • Cars
    • Trucks
    • Vans
    • Taxis
    • Handidart
    • Bus (City, Greyhound)
    • Plane
  • 3. Car Considerations
    • 4-door vs 2-doors
    • Seat options: bench vs bucket; height
    • Types of transfers required vs abilities
    • Folder vs rigid frame w/c
  • 4. Truck Considerations
    • Better in snow - clearance and 4WD
    • Transfers required vs abilities
    • “ Bruno EZ Rider ” and “Cab Sider”
    • ‘ Twin or extended’ cab required
    • Must be indep. with transfers!
    • e.g. Ford F150
  • 5.  
  • 6.  
  • 7. Van Options
    • Full-sized vs Mini van
    • Tie-downs vs ‘EZ Lock’
    • Consider wheelchair/seating needs – size and wheelbase
    • Ramp location: In floor, Under vehicle (UVL), or inside
    • Driver vs passenger.
    • Overall client height for head clearance!!!
  • 8. Car vs Truck vs Van
    • Power vs Manual
    • Chair type + seating needs
    • Transfers
    • Energy Expenditure
    • Time Requirements
    • Skin Integrity
    • Injuries (temporary overuse)
    • Environment / weather
    • Family, social, and work requirements
    • Financial issues
    • Maintenance
  • 9. Conversion Options for Vans Lowered Floor (Ford Only) 4” or 6” Raised Roof (sport top) 6-8” Back or Side Lift Power Door Removable Seats Power Front Seats All Tie-Down Options All Driving Modifications Lowered Floor Raised Roof Side or rear Ramp (manual fold-out vs power) Power Kneel Power Side Door Removable Seats Power (4 or 6 way) Front Seats Tie-Downs vs EZ lock All Driving Modifications Available Conversions & Modifications Ford E150 / E250 (3/4 or 1 ton) GM/Chevy 4WD Full size GM Chevy Venture (Silhouette) Ford Windstar Chrysler Plymouth Voyager (Grand Caravan) Commonly Converted Vans FULL-SIZED MINI
  • 10. Conversion Options for Vans New Van: $38-45,000 Just conversion:$63,000+ Van + Conversion $25-33,000 Used Van + Conversion: $5,000 – $20,000+ New Van + Conversion: $55,000 - $60,000 Just conversion: $18,000 - $25,000 Used Van + Conversion: $25,000 – $40,000 Cost 53” with lowered floor, may need raised roof also 54-56” (side door) Door Height Can be more space for larger wheelchairs Great for those with less confidence and skill Less space for wheelchair maneuverability inside Inside Space Better clearance Have to be aware of height Less clearance under van, not appropriate for all terrain, snow Clearance Bigger to drive and park Drives like a Car Handling FULL-SIZED MINI
  • 11.  
  • 12. Van Conversions
    • VMI -
    • VanAction -
    • Vantage -
  • 13. Driving Modifications
    • Primary and Secondary Driving controls
    • Primary : gas, brakes, steering
    • Spinner Knobs, T-handle,Tri-pin,
    • Zero-Effort Steering
    • Toggle/Switch Control
    • Secondary : remote start, voice activations,
    • climate control, stereo, lights, washers etc…
  • 14. Driver Assessment & Rehab Driver Rehab Ctr Vancouver 604-322-8335 Robertson Rehab Vernon 250-558-4584 Glenrose Rehab Hospital Driver Rehab Program , Edmonton 780-471-2262
  • 15. Vehicle Dealers
    • CanAm Cruisers PG Surg-Med
    • Kelowna Prince George
      • 250-491-0003 Lift installation only
      • www.canwill.com 250-562-2240
      • Shoppers Home Health Care Others:
      • Edmonton 780-562-4002 - SideWinder – Chilliwack
      • Vancouver 604-326-1117 (all vans and conversions)
      • [email_address] - Tom Harris – Vancouver Is
      • (GM Dealer)
  • 16. Flying!
    • In own w/c until last minute loading
    • Transfer to narrow aisle chair
    • Own w/c gets taken to luggage
    • At risk of damage to w/c, esp. powerchair controls
    • Pressure relief and positioning in seat!
    • Contact airline ahead of time for assistance or to book a practice session
  • 17. SCI HANDS: Form and Function
    • Assessment
    • Tenodesis training
    • Splinting Protocols
    • Deformity prevention
    • Range of Motion and exercise
    • Tendon Transfer Surgery (Maura)
    • FES
  • 18. Hand Assessment
    • COPM – client’s occupational goals!!
    • grip and pinch strength
    • AROM / PROM
    • dexterity and fine motor assessments
    • Functional hand assessments /observation
    • Sensation: pin prick, light touch, temperature
    • Edema control
    • Spacticity / tone issues
  • 19. C4/5 level
    • Shoulders and biceps only
    • Doral Wrist Support - with wrist extension
    • Pocket or cuff on palm
    • Long opponens
    • ?tendon transfers
    • Resting splint and passive ROM (ice/wax)
    • Self feed, teeth, sign name etc…
  • 20. Tenodesis: C6-8 level
    • Active wrist extension = passive finger flexion
    • Passive ROM:
    • Wrist strengthening
    • Splinting: resting splint, boxing glove, short opponens, universal cuffs
    • ?tendon transfers
    • See Handout package for program
    • Feed, groom, write, type, wash, toilet, cook…
  • 21. Why splint?
    • Functional hand vs flat hand , claw hand
    • Prevent deformity
    • Maintain functional hand position
    • Maintain good alignment of thumb in relation to index finger
    • Enhance Function – short opponents, thumb CMC or thumb post splint
    • Clients often prefer no splint at all
  • 22. Types of Grasps in tetraplegia
    • Key grip (lateral grip) – paper, tv remote
    • Palmar grasp - joystick
    • Cylindrical grasp - glass
    • Interdigital or interwoven – writing, cutlery
    • 2 handed – cooking, drinking, lifting
    • Wrist hook technique – dressing
    • Use of thumb to hook – mug, u-cuffs
    • Use teeth to assist – opening containers
  • 23. Gadgets….!!!
    • Self Care / ADLs
      • **U-cuffs: toothbrush, hairbrush, cutlery, writing, typing, shaver, make-up…
      • Bathing / toileting routines
      • Kitchen / cooking – safety and independence
      • Reading
      • Writing / typing
      • Phone
  • 24. Hands cont’d….
    • Have client learn self-ROM program
    • Wax or flax bags (heated) very popular
    • Focus on client’s specific goals
    • Call us here!
    • Internet SCI resources – see handout!
    • BCPA / Peers – best ideas come from those living with SCI
  • 25. Contact Info
    • GGF Strong Occupational Therapy Dept.
    • 604 737-6286
    • GFS Toll-Free:
    • 1-866-906-1888