Dan has always been an active person who enjoyed participating in sports. After his injury four years ago, Dan was unsure of what he was going to be able to do to occupy his time. “When you first get injured you’re like, you know, what am I going to do?” During his rehab, a recreation therapist introduced him to different activities that he could participate in, with the help of assistive devices. “At first it was kind of overwhelming, but then after everything was shown to me it was more like, ‘Okay, now it’s time to pick and choose. What am I going to try,’ and how do you learn, which one’s going to work for you … and the steps in doing that.”
At the time of his injury four years ago, Dan was the manager of a grocery store. Before that, he was an electronics technician with the United States Navy. Both occupations taught Dan useful skills for putting assistive technology to work for him. At the grocery store, Dan learned how to deal with all kinds of people and develop his problem-solving skills. In the Navy, he gained understanding of and comfort with technology. Because he had these skills, Dan became adept at researching and evaluating assistive technology early in the rehabilitation process, making it possible for him to choose the proper equipment for each task. He is now able to maximize his use of technology to maintain an active lifestyle.
Since leaving the rehab centre, Dan has tried numerous sports and has found many that he enjoys, including wheelchair rugby, tennis, snow skiing, jet skiing and hand cycling. He feels that participating in sports has many benefits. It gets him out of the house and enables him to be “more social and interactive with other people … it helps you spiritually, emotionally and it helps with your personal relationships. Now my wife and I can actually go out and do things with each other.” Participating in sports, “also adds to your motivation … it helps you to believe in yourself and you realize that you can do more than you think you can.” He also feels that involvement in sports contributes significantly to improvement in his functional abilities. “I’ve probably improved myself since I left rehab, I would say at least two hundred percent … because I just keep using my muscles.”
Dan found that sports gave him the stamina he needed to return to work. He says, “It just happened to be an unexpected byproduct and I found it helped, so I just used it to my advantage.” He now works part time as an advocate for people with disabilities.
Dan feels that, along with his increased strength, assistive technology has helped him to become more independent. He says, “Some things of course you will always need assistance with, but the more things they come out with, the easier it is because there’s not always going to be somebody there for you.”
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While still an inpatient at the rehab centre, Dan relied on an occupational therapist to recommend his first wheelchair. Dan feels that because he was measured for the chair while he still in a halo, he was fitted for the chair sitting too far forward. When the halo was removed he found it difficult to maintain proper balance. He went back to the vendor who sold him the chair and worked with them to solve the problem. “I told them you know, this is not working anymore and they helped me figure out how to adapt it. I actually put some adaptive blocks to raise the axle to get more dump [or seat angle], so I’m able to hold myself up going up and down ramps.” The angle also allows him to sit up without having to work at holding himself up.
Although he was able to achieve satisfaction in the end, his first experience with a poorly fitting chair encouraged Dan to become an informed consumer. Currently, Dan subscribes to an assortment of disability-related magazines and regularly uses the Internet to help him make appropriate equipment choices. As well as researching products on the world wide web, he says, “I would meet people and some would live out of state, and I was able to keep contact with them through email. So that was a way of sharing information.” Since Dan works as an advocate for persons with disabilities, the ability to disseminate information in this way is important to him. “The more I find out, the more I am able to share with others … so I pass it along.” In return, Dan finds that having a network of peers helps to keep him informed on the latest technology issues.
At this point, Dan is very clear on his criteria for choosing an everyday wheelchair. Dan explains that it must have the correct seat angle, it must be light so it is easy to push, and it must have the right centre of gravity. Also, Dan prefers his chair “a little bit tippy … so I am able to pop the front up, instead of hitting a bump and then coming to stop.”
He uses solid tires because he has experienced flats at inopportune times in the past. A disadvantage of this preference is that the ride tends to be rougher and it is harder for him to get over larger bumps and curbs. As well, Dan realizes that solid tires are harder to push than air tires on some surfaces. But because of durability and therefore dependability, he still prefers solid tires. Dan uses graphite wheels because he was routinely breaking spokes on regular wheels. “If you can’t change spokes yourself then it is costing ten dollars a shot for labour. So say you break a couple each week, it starts to get very expensive.”
Dan chose a special chair back that consists of a hard shell with a foam cover. Unlike a traditional fabric back, the hard shell gives better support. According to Dan, “The fabric back gives a little bit so when you push you kind of, sling back and forth, where in mine when I push it’s a solid push … and more stable.”
Dan concedes that choosing the right equipment for some sports is just trial and error because of individual differences. However, one can minimize the likelihood of purchasing the wrong piece of equipment through some simple strategies. Dan started researching the equipment for the sports he plays by watching videos and reading articles in magazines that specialize in sports for persons with disabilities. After he had a general idea of what was needed, he experimented with borrowed equipment first before buying.
When selecting a chair for a particular sport and getting it set up properly, he says, “Some of it you can learn by trying other people’s chairs.… If you go to certain tournaments or certain clinics, you can try different chairs and different set-ups and see which one feels best for you…. Otherwise you can just talk to other people that are in whatever sport it is you’re looking at and ask them what their version is and look at their ability versus your ability and your function.” He feels that it is best to try equipment that belongs to those with similar abilities, “and then see if they work, seeing what you might change to make it more comfortable, and taking notes on that.”
Dan also believes that one should be able to sit as comfortably in a sports chair as in an everyday chair, and to be able to stay in it for a long period of time. As well, an overriding concern is the ability to transfer from his everyday chairs into his sport-specific chair. Dan bought two rugby chairs before he found one that suited him properly, “which was kind of expensive before I got the right chair to take.… I should have tried other people’s chairs at tournaments instead of [going] ahead and being so enthusiastic.… I just wanted to get into the sport … that one I learned the hard way.”
Dan’s primary sport is quad rugby. “That’s a contact sport … it’s played kind of like football and hockey and demolition derby all mixed into one.” Each player is assigned a number of points on a scale from 0.5 up to 3.5. Points are based on the function of the player. For example Dan says, “a 0.5 is somebody that doesn’t have any use of hands, probably no triceps or biceps and no trunk control.” Players with the most points assigned to them, “like maybe even can stand but maybe not walk real well but still [have] some [dysfunction] in their legs and in their hands.” A team can only have a specific number of “points” on the court at one time, so all get to participate.
The task of the “low pointers” typically is to block opposing team members, while the “high pointers” move the ball (a leather volleyball) up the court. The ball has to be passed or bounced at least every ten seconds or the play is stopped and the ball turned over to the other team. A point is scored when a player with the ball crosses the defending team’s line with at least two wheels.
Players use manual wheelchairs specifically designed for the sport. Due to the level of contact, the chairs have protective side bars on them and players are strapped in to prevent injury. Most chairs are made of titanium or steel to handle the hits that they sustain. In addition, the low pointers have a high camber (angle of the wheels) so that they can turn fast, as well as “red push rim covers so they can actually stick to the other person’s chair and hold them.” The high pointers have armor on the front of their chairs resembling a cow catcher so that they can push through the other players without getting stuck.
Dan purchased a manual chair for tennis that was designed for all court sports. It allows the user to adjust the wheel camber, centre of gravity and seat angle, or dump, to suit the specific activity. Since he also has a rugby chair, he leaves this chair it set up specifically for tennis. He learned how to set up his chair properly by watching videos of people playing tennis and observing what the have done with their chairs. Compared with his rugby chair, Dan says, “It’s set up a little bit different because there’s no contact in that sport, it’s more just quick turns and being able to push fast enough.” He adds more wheel camber, “because you want to turn a lot faster to be able to get to the ball.” As well, the seat angle is more shallow. “You want to be able to lean forward to reach for the ball … so I sit more flat than my rugby chair.” He also uses a chest strap to keep himself stable and a single rear anti-tip caster.
In order to hold on to the racket, Dan puts on a baseball batting glove and tapes the racket to his hand. “I can grasp it, it’s just that I tape it because after a while my hand will fatigue and I’ll end up dropping the racket. So I’ll tape it just to keep it in there, to be able to last the whole match.”
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See Dan demonstrate and use his handcycle. Part 1
Part 2 |
Dan also has a low profile hand cycle that he uses outdoors on paved trails or roads. He started off riding six to eight miles and can now pedal up to 28 miles, and with seven gears at his disposal he can reach speeds of 23 miles an hour. Dan learned which hand cycle was right for him by trying out the various configurations at cycling clinics held by his city and the nearby rehab centre.
The principal parts are similar to a bicycle, but their configuration is much different. First, a hand cycle has three wheels instead of two, with the single front wheel being propelled by a chain attached to crank arms. The crank arms, gear changing levers, steering and brakes are all combined together in front of the rider’s sitting position. The seating position, as well as the exact location and style of crank arms, is determined by the functional level of the rider. “There’s one that you actually sit just like in a regular manual wheelchair … mine’s a low-profile where you actually lay back a little bit and my feet are … just above the ground and strapped in.” His feet are secured to plates so they stay in place if he has a spasm or hits a bump. He has his bike set up so that he pulls both hand cranks toward him simultaneously to propel himself forward. His crank arms are “angled so I can just stick my hands in and use my palms to pull and push.”
Dan wears a weightlifting belt to stabilize his torso and hold himself up in the chair. Also, he straps a soft water canteen to his back that incorporates a long flexible plastic tube that can be used like a straw, to keep himself hydrated while riding.
Dan emphasizes that using a hand cycle takes a lot of practice. A rider has to know when to pedal, when to turn and how to shift, since all three are controlled by the hands simultaneously. Also, he says, “Sometimes you have to lean towards your turn in order for you to stay comfortable in the turns. Some chairs actually have a swivel … the seat actually swivels so you can get more of a turn, but those are harder to control.”
Besides increasing strength and endurance, Dan finds is now able to participate in common activities with his wife. “She has her regular bike and we go out and you know, ride bikes together. Or if I’m in my regular wheelchair she can ride in her skates alongside.”
Dan also enjoys skiing at a local ski resort as well renowned ski resorts in Colorado. He chose to use a mono-ski instead of a bi-ski because he can turn and control his own descent down the hill. “Bi-skis are for people … that need assistance. And they have people that go with them and they call it tethering and they have straps that are connected to the ski to help them control the speed. I can personally control my own speed by turning, just like normal skiing … so I’m off the tether.”
Dan is held securely in place in a special seat with a deep pocket that is called a bucket. This is attached to a single ski “on a shock so it picks up some of the shock, instead of going through your spine.” He uses special poles, called outriggers, that have small skis on them. “Those are the ones that help you balance yourself and help you turn the ski itself.” The outriggers also have shock absorbers built into them to reduce the impact of bumps in the snow.
When he’s skiing, the bucket is positioned just above the ski for the best balance. However, Dan can raise the bucket to lift height, so he can get on the ski lift on his own. “You flip a lever that and that releases the locking mechanism, and then you take your outriggers and you push yourself up and it locks the seat up in a high position and then you ski up to the lift. And then when the lift comes you kind of give another push and lean back and the [seat of] the lift goes right underneath.”
Dan has also tried downhill mountain biking through the adaptive aids program at the same resort where he skis. Two types of chairs have been developed for people with disabilities: one is used to go down the hill and the other is used to push up the hill. The downhill version “is a chair that has four mountain bike wheels and it has four disc brakes and it has an actual bike handle in front of you, and you sit in a bucket again with your feet almost like a regular wheelchair.” Where the downhill chair relies on gravity for propulsion, the uphill chair uses smaller wheels and push rims for climbing. Dan says though, “usually what [the program operators] do is they’ll take you up on a bus to the top of the mountain and then you take some trails around and some of it’s downhill … so you can get going pretty fast.”
He has also used an automatic cocking pool cue to play billiards. “It has a button on it that you push down to cock it and it’s spring loaded so you can push it down a certain amount of pressure for whatever shot you want. And then it has these little buttons so you can just hold it and push the button and it shoots out and hits the ball.”
Dan has a standing frame at his home, which he uses to help with hip flexibility, controlling muscle spasms, and blood circulation. He chose a model that he could use without any assistance. “The netting, I can put behind me, kind of scoot forward in my chair and put it under my rear end and then sit back in it. I hook on the netting support and then it has this hydraulic lever and it pulls me up. Once I get fully standing, there’s a safety latch that goes around me and I hook that on.”
He used it regularly when first purchased it, starting off with half-hour sessions and working up to an hour and a half. However, the busier he got, the less time he found to use it. Now he uses it twice a month on average. He would like to use it more because of the benefits he receives.
Dan has a wheelchair roller that he uses every other day, from between a half an hour to an hour and a half, to increase his wheelchair pushing endurance by building his cardiovascular system and strengthening his arms. He noticed great improvements in a very short period of time, and these have led to greater independence. “I could tell the difference after probably two weeks … as far as even getting up the ramps in my house.”
Using either his everyday chair or his rugby chair, he backs up the ramp of the rollers until his rear wheels are resting between the two rollers, which are a few inches apart. He locks his casters in place so that the chair stays secure. He can then push the chair on the rollers against steady resistance. He started out pushing for short periods of time, resting, then repeating. Newer models of rollers, he says, have the ability to change the resistance, so those who are new to them can start with minimal resistance and increase it as they get stronger.
Dan uses an electronic muscle stimulator (EMS) after his exercises to loosen and relax his muscles. “It helps get rid of the lactic acid after working out … I put it on whatever area I’ve been working out on and set it to a slow pulse rate … it keeps the muscle tight for a little bit. It’s almost like a cool down session.”
He uses the EMS on his upper body only. “I’ve tried it on my legs, but I’ve found it’s a little small for that.” He is aware that larger units are made for the legs but finds them too expensive. He originally purchased his EMS to build muscle but found that it was much more effective at easing pain and helping to reduce spasms.
The first vehicle Dan used after his accident was a car with long doors. To get in, he needed to be able to get his chair close enough to transfer into the driver’s seat. This was not in ideal solution for him though. He found that, at his functional level, “having to break down my chair … and actually lift it over my chest and put it in the passenger seat was taking a toll on my left shoulder…. So I found that I needed to go to a van with a lift.”
Through research, Dan realized that in order to get into most vans, either the roof had to be raised or the floor lowered. Looking to cut costs, he kept trying out different vans to find one that was compatible with him and needed no major modifications. He found it by “going to dealerships and asking them to open it up, actually transferring into the van … pulling my chair in, transferring into the seat and then back into my wheelchair and seeing if I could sit in there.” By using this method he found a van needed only a lift and hand controls.
Currently he is looking for a device that would allow him to load items, such as his sports chairs, into the van independently.
Dan’s involvement in sports has given him the strength, confidence and motivation to live as independently as he possibly can. “You keep trying things that are even hard at first and pretty soon you learn how to compensate and either work through it or work around it.” He also has many strategies to help him achieve his independence. For example, he says, “Since my injury is a C6 incomplete, I have pretty good hand function … I can get dressed myself. The only thing I had to learn was to set things up first, organization, it’s mostly that.”
He has also obtained many items that help him with day-to-day activities. He has a rolling table in order to safely retrieve hot pots from the stove and then transfer them to an eating surface. He did not have the cabinets and countertops altered to suit him better, but instead he uses a reacher to retrieve items from shelves. If he can’t reach something, he gets a family member to assist him before he needs the item.
Dan chose to buy a laptop computer over a desktop version due to the size of the keyboard. “I don’t have to stretch my hands because my fingers don’t open vertically…. [It has] a smaller keyboard and everything’s really compact and it’s easier to use.”
He has a speakerphone with a remote operating switch so he can access the phone in an emergency situation. The remote has “come in handy a couple of times because not every time I fall out of my chair I can get [back] in by myself … so [I’ll] call neighbors…. “ Having the emergency phone gives him a sense of security. He also carries a cellular phone for the same reason.
To find vendors that are right for him, Dan says, “That again is doing some research. Some vendors are very easy and will do anything for you.” He looks for vendors that will mail him brochures and product lists and are able to tell him the weight and size of wheelchairs and parts. He prefers vendors that put most of the information he needs on their website. He also looks for “somebody that’s not just interested in selling their product, but interested in making sure the product fits you.”
Once he finds a vendor that suits him, then he usually sticks with that company for subsequent purchases, “because once you find somebody, if they don’t have what you’re looking for and you’ve dealt with them, they’ll actually help you find it.”
Dan is a strong supporter of active participation in sports. He sees real benefits in sports participation on a variety of levels: social, spiritual, emotional, motivational, physical, functional and for stamina. Dan has also learned that in order to enjoy sports after a spinal cord injury, one has to try as many as possible. “Go to as many different clinics as you can, even if you are not interested in that sport at the time, because it might help you in determining some other facet of what you want to do…. Be open to ideas and be ready to try them. Some of them aren’t going to work you know, but don’t let that discourage you. Keep trying different ones and you will find something that works for you.”
Through experience, Dan has learned the importance of choosing the right piece of equipment and setting it up properly for a particular task. In order to build this knowledge, he says, “The first thing would be to ask questions. Don’t be afraid to talk to people. Not just people that are in chairs but also people who are in the business.” In addition to this direct contact with others, Dan puts a lot of effort into research through magazines and the Internet. His familiarity with technology from his work as an electronics technician in the Navy gave him the background he needed to use the computer as a research tool when he started looking for assistive technology. Finally, Dan exploits email to keep in touch with peers around the world.
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