Page 282 - Handbook of Electronic Assistive Technology

Chapter 9 • Powered Mobility 271

• Most likely not need to travel seated in the chair in a vehicle, and so will not need to
consider a chair that is suitable for occupied use in transportation.
• Typically, transfer to an alternative seat at their chosen destination (e.g., their place of
work or a leisure activity).

Method of Driving Access

The joystick controller can be mounted on the left or right; a swing-away mounting can
also be selected to allow the individual to access a table or work surface. Whichever option
is chosen, adjustment is usually required to enable the person to use the controller with
least difficulty. This will entail an assessment of hand function and driving capability. It is
more difficult than it may first appear. In some cases a standard controller will be unsuit-
able and other options should be explored.
It is important to note that while some people are able to drive a powered chair
instinctively, it is found to be much more difficult by others, often regardless of previ-
ous vehicular driving experience. As such, it is imperative that adequate time is given to
the person to allow them to learn what for many will be a completely new skill (Nilsson
and Durkin, 2014), particularly for children, taking into account their developmental
needs. This not only may take more than one appointment, it also requires engagement
with others such as family, carers and schools. A powered chair may be the only means
of independent mobility available to the person; without it they may become entirely
dependent on others and may have longer-term clinical, psychological and cost impli-
cations. There are a multitude of driving access methods available and these should be
explored fully.

What Powered Functions Will Be Required?

The term ‘powered functions’ relates to the different articulations a chair can achieve. Not
all of these features are essential and not all chairs can perform every one. While there will
be clinical reasons for specifying certain functions, some will be selected to meet lifestyle
and independence needs, which can be just as important for the individual.
The following list shows the powered functions which are available. Within some limits
they can be used in combination and will often complement each other. A more advanced
control system will be required when a higher number of features are specified:
• Tilt-in-space (i.e., the seat, back and leg supports move as one unit, maintaining hip
and knee flexion angles).
• Recline (i.e., only the back support moves, which opens the hip flexion/extension angle).
• Elevating leg supports (i.e., the knee is extended).
• Seat riser/elevator (some chairs focus on gaining height, whereas others are designed
to lower the person to floor level, usually a small child to allow them to interact with
their peers; a very small number of chairs can achieve both).