Chris recalls that when he was first injured he went through a tumultuous adjustment period. He considers himself fortunate, however, to have connected with a peer who helped him come to terms with his injury and move forward in a positive direction. He says, “Once it happens then you can’t turn back the clock. You’ve just got to take all the best, all the positives you can out of it.” Since then, it’s been a busy 25 years for Chris, completing a Master’s degree and building a career in recreation therapy, while maintaining constant involvement in athletic activities. Chris’s active lifestyle includes travelling, wheelchair rugby, water skiing, jet skiing, tennis and hand cycling.
Chris identifies assistive technology as an important facilitator in his chosen lifestyle. However, the value that he places on assistive technology depends a great deal on the task at hand. For day-to-day activities, Chris prefers to do as much as he can without technology, and when equipment is necessary, he chooses simple and dependable devices that require little or no maintenance. On the other hand, for athletic and recreational activities, Chris has the complete opposite opinion: he regards technology as the primary mechanism that allows him to participate.
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It has taken Chris a long time to get to the point where he is completely satisfied with his wheelchair. Living in a chair for 26 years has taught him exactly which features he needs to keep up his busy lifestyle. Because he travels regularly, his chair must be compact and portable; these characteristics allow him to enter and exit both airplanes and motor vehicles with little trouble. He has chosen a chair with a very short wheelbase and without too much camber in the back wheels. These features make the chair less bulky, which improves manoeuvrability and transportability. Chris has chosen a squeeze frame, where the seat rail angles down as it goes toward the back of the chair. This gives him more of a bucket to sit in, which helps his balance. However, Chris points out that someone straight out of rehab should avoid this seating feature because balance takes some time to evolve.
On the other hand, the specific type of wheels that Chris uses on his wheelchair are something he would recommend for everybody the first time out. They are solid, fiber-covered, rubber wheels that provide shock absorption like air tires, but never go flat. Since he got them three years ago, these tires have required zero maintenance—a very important feature for someone who is quadriplegic and travels a lot. Another feature that Chris feels is very important is the ability to adjust the centre of gravity by altering the position of the axles back and forth, and up and down, making it easier to push.
Chris uses “scissor” brakes that tuck underneath his chair so that they don’t catch on anything. He only uses these brakes for getting in and out of the shower or if he is making an unfamiliar transfer, because the potential for slipping is greater. Otherwise, it’s easier for him to stabilize himself by holding the wheel as he transfers. He feels that bracing oneself is a technique that is not taught thoroughly enough—certainly not by wheelchair companies. Chris learned this and other techniques from fellow wheelchair users. “I grew up with all paraplegics. You know, when I was first injured there weren’t any quads who were being active and so I played basketball. And they taught me how to do wheelies.”
Some of Chris’s most useful devices are little bags that he uses to carry items such as his keys and his wallet, as well as a simple net bag strung under his chair. The net bag is useful for carrying all sorts of things that he needs, such as a water bottle or a sweatshirt. “It’s just the ultimate. I mean I throw everything in. If you see me at work that thing’s full.” To access this net, Chris takes advantage of his tri-spoke wheels, which he can reach right through. These simple things, he feels, should be standard features on wheelchairs but are never recommended.
Until recently, Chris has chosen to use minimal adaptive technology in his motorized vehicles. This preference has been influenced by his desire to avoid complicated technology that he considers costly, unreliable and prone to untimely breakdowns. Chris would rather transfer himself in and out of vehicles than be dependent on automatic door openers and motorized lifts. In his experience, only a small number of people—such as someone with a C5 or higher injury who uses a power chair—really need a full-size van with all the bells and whistles.
Chris is now putting his “less-is-better” viewpoint to the test. He recently took advantage of the opportunity to purchase a used adapted van at an exceptional value. The van has an automatic door opener and lift, as well as a six-way power seat. He purchased the van only recently, so his final evaluation is not yet complete. Although satisfied to this point, he notes that the van is big and it takes up a lot of room when he parks. He is also somewhat tentative about reliability and concerned about the possibility of high maintenance costs. Chris explains, “I’m using it, but man that stuff breaks down, and if it breaks down at ten o’clock at night when I’m out by myself, and the lift’s stuck open, what do you do?” For Chris, the jury is still out on accessible vans.
Like many people with an injury at C6-7, Chris initially used a shower chair for bathing. However, he never really liked it because he found it awkward to use. Because of his hand dexterity, he often dropped the soap or washcloth onto the shower floor and then found it extremely difficult to retrieve. It used to drive him crazy. Chris’s solution was to discard the shower chair and replace it with a sixteen-inch square, four-inch deep foam pad that sits on the bathroom floor. Now, he says, “If you drop the washcloth or the soap it’s right there.” Chris points out a side advantage: his wife doesn’t constantly have to move a shower chair out of the way when she’s in the bathroom.
Chris prefers simplicity and less reliance on technology in his everyday living, but with sports and recreation, “it’s a whole other world. Then I’m totally gung-ho flipped over the other way.” With the right adaptations, he can participate and enjoy sports and recreation as much as he wants to, which is to say, a lot.
The biggest issues that Chris faced for jet skiing were back support and leg positioning. For a back support, he took the seat cover off (which normally comes off to access the engine) and screwed a back onto the seat. Now Chris says, “if I owned a jet ski, I’d put on the seat cover that has the back on it and I could go ride. If my wife went out with her friends, she’d just put the regular seat cover on and ride that way.” Chris uses a foam pad in front of each leg to keep them from moving around. He positions his legs bent at the knees, with his lower legs pointing toward the back of the jet ski. The foam pad fills in the spot underneath to stabilize his leg. It is covered so that the foam does not get soaking wet. For safety reasons, the pad is not screwed down, so that it would also come off if the rider fell off.
Chris uses the base of his thumb to push the throttle. He wraps his left hand around the handle bars to push and pull the throttle, while pulling back with the other hand to steer. He doesn’t need an adapted throttle control, but he knows someone who made a round cylinder that could be placed around the throttle. This particular adjustment is still evolving because his hand keeps slipping off while the jet ski is still accelerating. Chris is working with rehabilitation engineering students to develop a new design that would solve the problem.
Chris describes how water skiing has evolved to the point where someone who with quadriplegia can participate. He himself uses a ski board (about four feet long by 20 inches wide) with a big groove in the front through which he slides the water ski rope; the rope is knotted so that it’s not necessary to hold on to it. There is a metal cage that goes halfway up his back mounted to the board, and a bucket sling for sitting. His feet slide under a little flap that keeps them in place—unless he falls off. Chris stabilizes himself by holding down on the bottom of the cage, down by his calves.
Chris knows another skier with a C4-5 injury who had been a serious surfer. He went to a surfboard manufacturer and had a board made out of fibreglass, which was more buoyant, although it was wider than 20 inches. Because he lacked stability, his cage was made to go all the way up to his shoulders and included a headrest. He stabilizes and steers himself by gripping onto two lateral supports—“like a half moon with the open part down”—by looping his wrist on either side and then by using his biceps to pull left or right. Chris says, “He just water skis me to death … nothing thrills me more than to see what he does.”
Another water sport that Chris enjoys is rowing in a modified single scull. Rather than row with the seat sliding back and forth, his legs are locked in and the seat does not move. To hold on to the oars, he wears gloves with Velcro, which attach to Velcro on the oars. However, this does not work very well because the Velcro tends to give as the oar moves through the water. He is considering a hard cuff, such as the one he uses for tennis; it would be screwed right onto the oar and would supplement the Velcro glove.
Chris played competitive wheelchair tennis for many years, but some time ago he experienced episodes of serious heat stroke during a few matches. For this reason, he decided to stop playing. However, he still considers tennis an excellent sport and recommends it as an enjoyable recreational past time. As part of his job as a recreation therapist, he explains and demonstrates how the sport works to people with recent injuries. An important piece of equipment is an adapted cuff that is worn on the wrist and holds the racket. Two Velcro straps stabilize his wrist in the cuff so that the cuff doesn’t go flying when he hits the ball. In turn, the cuff clamps onto a racket and holds it in place. With it, the player can grip the racket firmly, and with enough strength to successfully volley the ball across the net.
According to Chris, hand cycling is taking over from wheelchair road racing, which requires a huge amount of effort and commitment. Hand cycling is easy in comparison. There are many different brands of hand cycles, but all are basically the same: a chair with a big front wheel and two back wheels. Chris says there are two basic models. One has you sitting with your legs straight down in almost the exact same position as in a regular wheelchair. This type is especially suitable for people who don’t transfer well, because it’s easy to get in and out of, and for those who are not quite as physical. They are also suited for persons with a higher level of disability. In the second type, you sit lower to the ground with your legs stretched out. This position provides more stability, and so higher speeds can be reached.
There are also two types of steering designs. On some models, the rider uses the hand crank assembly to turn the front wheel to the right or to the left. On other models, the front wheel is held stable; you lean back in the seat either to the left or to the right, which causes the chair to pivot and turn. However, the latter steering method requires good hip balance or else it is easy to lose control at high speeds. To help with control, this type of hand cycle also has stabilization bars, which come out of the bottom of the seat. The rider holds on to the bars when necessary, when going downhill, for example. A brake handle is also attached to one of these bars.
In both types, a brake handle is located directly in front of the chest, just below the hand pedals, so that it is easy to drop your hand and reach it. Although a range of gears is available for hand cycles, Chris believes that a high-end, expensive gear system (i.e., 27 gears) is generally unnecessary for the recreational user. The simpler seven-gear system that he uses is sufficient and can save a lot of money.
While he has been told that his high level of activity, including hand cycling, might wreck his shoulders, Chris counters that proper exercise and conditioning, including warm-up stretches for ten minutes and cool down for ten minutes, prevents injury.
Chris uses a standing frame strictly for maintaining his health a couple of times a week. He considers it helpful for improving his circulation and countering osteoporosis. Once in it there is no way for him to move, so he stands in the corner and uses that time to watch hockey on TV or do his bills. “I try and make it functional. If I was going to sit on the couch and watch hockey, why not stand there and watch.”
Chris points out that his perspectives and experiences are not necessarily applicable to others with similar functional impairment, and he would never challenge someone else’s decision to rely on adaptive technologies that help make daily routines easier and improve quality of life. However, he feels strongly that for him, day-to-day living requires very little assistive technology. From this position, heavy reliance on technology would have created an uncomfortable dependency that he was not willing to put up with. At the opposite end of the spectrum, he acknowledges that he exploits technological adaptations tremendously for recreation so that he can lead an active lifestyle. From these contrasting viewpoints, Chris explains that choices associated with assistive technology are highly individual in nature. Each person must make his or her own decisions based on lifestyle preferences.
Chris believes wholeheartedly in the value of recreational and leisure activities for facilitating full and active community participation. Getting involved in sports and other recreational endeavours provides an excellent opportunity for peer support, enhanced physical functioning and improved mental health. He often encourages others to take advantage of available technologies and recreational programs until they find their particular niche. Chris recalls that it was a year and a half before he ran into someone who motivated him to get himself going. Once he got started, he jumped on the bandwagon, got things under control and never looked back. He often wonders, “What if I would have met that guy like a year and a half before?” That’s why Chris now puts himself in the position of being that person to others.
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