Driving After Spinal Cord Injury

 

Most people who have suffered a Spinal Cord Injury have the ability to drive an adapted car, however this does depend on the level of injury, their upper limb strength and balance and the amount of spasticity that they suffer. It is unusual for people with a complete C5 injury and higher to be able to drive, and normally only fit, strong people with a C6 injury area able to drive. Injuries lower than these normally have minimal difficulty returning to driving.  The biggest challenges are transferring into and out of the vehicle, loading their wheelchairs, balance while steering and in the higher quadriplegics they may have difficulty with steering strength.

Where there is paralysis or weakness in both legs the most common adaptations required are hand controls for the brake and accelerator which are fitted to an automatic car. It is important to note that any person who requires any form of adaptation to their vehicle to enable them to drive, is legally required to re-do their driving licence. Click Here to go to a summary of Licensing Procedure

Correct positioning in the vehicle can help to optimise the physical function of drivers who have limited body function as a result of a spinal cord injury. This can make the difference between having the physical ability to avoid an emergency situation, compared with finding that they are trapped and unable to escape as a result of not having the agility to manoeuvre their vehicle out of harm’s way.

Setting position

Paralysed trunk muscles result in poor balance in the vehicle, the severity of balance loss depends on the level of injury. This has a big impact on their ability to turn, particularly to the right, as both arms are raised onto the steering wheel and controls, and the momentum of the vehicle throws their body to the left. The impact of this can be clearly seen when working on the skidpan with drivers with weak balance. Their ability to manoeuvre through cones at speed or to do an emergency lane change is compromised by their body falling from side to side. When correctly positioned in relation to the steering wheel and by stabilising the pelvis and trunk, we have seen a large improvement in their performances and the speed at which they are able to tolerate major changes in direction without losing balance. This is very significant should they find themselves in a situation where they need to do an emergency lane change on the highway.

Most experienced drivers with spinal cord injuries have developed their own techniques of hooking an arm on the side of the seat or wedging their arm again the door in order to keep them stable. This is fine for general everyday driving, but should they need to respond to an emergency situation, they could find that the time taken to stabilise themselves in that moment was too long. Being correctly positioned from the moment they start driving is a safer option.

When driving with hand controls only one arm is available for steering and a lot more strength is required compared with driving with both arms on the steering wheel. Where the individual has a cervical injury and thus reduced strength in the arms and shoulders, being correctly positioned in relation to the steering wheel can make a big difference to the amount of strength that they can apply to the steering wheel, it also reduces shoulder fatigue when driving long distances.

CLICK HERE TO READ MORE ABOUT PRINCIPLES OF POSITIONING IN THE VEHICLE

Working on skid pan