Sustaining Independent Mobility and More – the story of Ryan
Ryan is a busy 25 year old man who is getting his Master’s degree in psychology. He likes to go out to eat, claiming his favorite food is whiskey! Ryan also plays video games, even programming the system so that he can control the functions he needs to. Ryan has limited motor control and strength due to a diagnosis of spinal muscular atrophy, type II.
Ryan was diagnosed with this progressive muscle disease at age 6 months. He was able to drive a power wheelchair for many years using a standard joystick, though this became more and more difficult as his muscle strength deteriorated. A standard joystick requires about 250 grams of force to use. More than 5 years ago, he began using a game controller that was adapted as a driving method for a power wheelchair. The small joysticks on this controller only required about 50 grams of force to activate, however the entire assembly tended to slide around and off of his lap. As a result, this driving method often broke.
It was time for a change. Ryan needed proportional control, if possible, that required less force and activation distance. His hand and forearm needed to be well supported to facilitate this small movement and provide the stability he needed. Finally, Ryan would need access to a Mode switch to control other features of the power wheelchair through the driving method, including power seating. Mike Freehill, a representative for Quantum Rehab and Stealth Products, met with Ryan to discuss options.
Ryan now drives with a mo-vis Micro mini proportional joystick using his right thumb. This driving method provides full proportional control without requiring undue force or effort – only requiring about 10 grams of activation force. As a result, Ryan can use his power wheelchair throughout his day. The Micro is embedded in a Stealth Products hand pad at the optimal height for his control needs, about ¼” above the surface. The hand pad, in conjunction with the arm pad, provides postural support and stability to the wrist, and hand. He grips the edges of the hand pad with his right fingers to keep his thumb aligned with the joystick and to provide stability. Ryan does not use a handle – he prefers to just use the stem (see photo). The hand pad is mounted just inside the right armpad to a swing away joystick bracket so this can be moved for transfers, as needed. The hand pad also protects this fragile joystick from collision.
Movis Micro mini proportional joystick in handpad, no handle. Mounted to inside of armpad.
The Micro, when used with a Mode switch mounted at his lateral knee (see photo), provides Ryan full control of his power seating, including tilt, recline, elevate, and elevating leg rests. He can also move the joystick to the left twice to emulate a Mode command. He has a second switch by his other knee for power. These are Twister switches, highly sensitive mechanical switches, and are mounted to the seat rail. Ryan drives a red Quantum Rehab Edge 2 power wheelchair, stating “It serves me well.” He particularly likes the independent suspension.
Ryan states that the Micro joystick has made an immense difference in his life. He could no longer activate other driving methods and the Micro provides him what he needs – independent mobility and control of his power seating. When asked what else he wishes his power wheelchair could do, he states “climb stairs and fly!” Fly true, Ryan.
Ryan stabilizes his hand by grasping the edges of the hand pad. This also keeps him aligned with the joystick. Note the Twister switch mounted on LocLine by the right knee for Mode.
Michelle L. Lange, OTR/L, ABDA, ATP/SMS