Since his discharge from rehab two years ago, Matt has concentrated most of his efforts on learning to live independently at home and engaging in physical fitness and sports-related activities. Matt’s strategy is to use these activities to maximize his functional capabilities, while enjoying their social and leisure benefits. Although Matt uses assistive technology to accomplish many of his daily activities, he feels it’s “not natural” and prefers limiting his use of technology whenever possible. However, for fitness and sports, Matt does consider assistive technology an important facilitator, and readily uses a variety of devices.
Matt recalls that much of the assistive technology that he received during rehabilitation to accomplish self-care tasks turned out not to be practical or efficient “in the real world.” Matt acknowledges that some of the aids had useful features, however, the nuisance of carrying them around and his desire to do things on his own, gradually led him to discard almost everything. In fact, “Most of the stuff sits unused in the closet.” For Matt, the practicality of an assistive device—is it simple, unobtrusive and portable?—most often influences his decision to use it or not. Once he was living at home, Matt gradually learned to do many things for himself, with as little assistive technology as possible.
From Matt’s perspective, one of the most important things that rehabilitation provided was the opportunity to come into contact with other persons with spinal cord injuries. Through observation and direct discussions, Matt became increasingly aware of all the possibilities that were open to him, in particular in relation to self-care and recreational activities. These interactions provided considerable encouragement, and motivated him to rigourously pursue preparing himself to return to a similar lifestyle he enjoyed prior to his injury. Today, consulting peers is an important strategy for Matt when it comes to choosing appropriate assistive technology. Matt regularly uses a network of peers to seek out feedback and advice regarding the type and brand name of technologies that he chooses for exercise and recreational activities.
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Matt’s first wheelchair was electric and he hated it! He recalls, “My first goal was to get out of that and get in a manual chair.” Matt’s perception of the electric chair was that, “It just made me feel more handicapped than I was.” He felt that, “It was huge, it was clumsy.” In addition, an important goal for Matt was to rebuild his strength and get out doing things. For Matt, pushing a manual wheelchair was the best way to feel more comfortable with his injury and regain his strength and stamina. He worked diligently with weights, doing mat exercises and swimming in order to become strong enough to perform independent transfers, maintain his balance and manually push his chair for extended periods of time. Matt remembers that his first attempts at manoeuvring a manual chair were quite shocking. Because he thought the chair was only 36 pounds, he did not anticipate the difficulty associated with pushing himself around for long periods of time. Eventually he got used to it, and he moved into a manual chair permanently.
Matt’s first manual chair was a demo that a vendor brought to the rehab centre for him to try out. Matt felt it was kind of implied that after using it during rehab, he would have to purchase it when he was ready for discharge. As a consequence, Matt feels he was never properly measured to fit the chair, and really did not have much choice in the matter. However, he points out that the chair was a good deal in terms of cost and it has served its purpose, “It’s okay for now,” but he plans on being actively involved in purchasing his next chair. Based on discussions with peers and a good understanding of his own functional needs and lifestyle requirements, Matt has a clear idea of the chair that he wants. Matt points out that because the wheels of his first chair are cambered, it’s too wide and therefore difficult to manoeuvre in some enclosed spaces. He also does not like the front casters on his chair; he would prefer something with better suspension. In addition, Matt wants a chair with easily removable wheels so he can get the chair in and out of his truck with limited difficulty. Ultimately, he is looking for something that is “compact, manoeuvrable, and easy to transport.” Because of his active lifestyle, Matt is also looking for a wheelchair that is durable, so it will survive his various recreational pursuits.
In addition to his everyday manual chair, Matt has a wheelchair that he uses specifically for wheelchair rugby. Matt got the chair from one of the other players on his team and he says it’s a great chair. The wheels are cambered and the frame is low to the ground. The chair is fairly heavy and as a consequence he does not go very fast, but because of the position he plays (a low pointer) this is not necessarily a problem. The chair is equipped with a metal protective apparatus that surrounds his legs and feet. Matt is content with this chair and he will likely continue to use this type for playing rugby.
Matt spends a significant amount of time following a rigourous exercise program, in order to maximize his functional capabilities. He considers it very important to keep joints, ligaments, tendons and muscles moving, and his exercise routine serves this purpose for him. He has also recently started taking Yoga.
Matt works out at a fitness facility that has adapted equipment for people with physical disabilities. For part of his exercise routine, Matt requires little adaptive technology. For example, when he is working out on his floor exercises, on the mat, he requires nothing more than the usual spotter. When lifting weights, Matt uses cuffs that are attached to his legs and/or arms, depending on the exercise, which can be secured to the weight lifting equipment. This allows him to complete repetitive weight lifting routines. However, he does make use of an arm crank and wheelchair roller in order to build his strength, stamina and respiratory capacity. The arm crank and wheelchair roller are fairly simple technology—they merely supply resistance that can be lowered or raised depending on his preference. As Matt accomplishes proficiency at low levels of resistance, he gradually increases it.
Matt also uses a leg bike in order to maintain the muscle mass in his legs. To use this piece of equipment, he rolls up and straps his legs onto either side, so they are firmly secured on both sides of the bike wheel. The leg bike has a motor that provides the energy to rotate the wheel of the bike, which in turn moves his legs in a circular motion. The bike has a speed dial that allows the user to monitor speed as well as distance traveled.
Matt also uses a standing frame apparatus. He likes this piece of equipment because he feels it stretches out his muscles, helps him with his balance and improves his circulation. He also considers it “important for maintaining bone density in the legs and with keeping feet and calves healthy—no foot drop.” Finally, Matt enjoys the sensation of being vertical. “It’s a good break from always sitting in the chair or lying in bed.” Matt has a standing frame at home and he also uses one at the fitness facility. The standing frame at the fitness club is especially convenient for getting in and out independently. To use it, he positions himself directly in front of the frame, as closely as possible, then using a strap, he secures himself to the standing frame. Once secured, he engages a motor that lifts him gently into position. At this point, he locks himself into standing position. Once he is ready to return to his chair, he releases the locking mechanism, engages the motor and is slowly lowered back into his chair. Then he just removes the lifting strap and wheels away.
Matt’s first vehicle was a van, which he got because he was using an electric wheelchair. The floor was not lowered so he could not drive it himself, and while that was okay at first, he wanted a vehicle he could drive on his own. Matt also felt that vans were fairly expensive and he wanted something more affordable. Once Matt started using a manual wheelchair he felt ready to make a change. Today, Matt’s primary mode of transportation is a four-door, half-ton truck, with an extended cab. Matt enjoys the image of driving a truck as opposed to a van and is extremely pleased with this truck.
Matt’s truck comes equipped with a remote control crane that is used to lift his wheelchair into and out of the truck box. In order to transfer in and out of the truck, he opens the door and wedges his chair between the door and the driver’s seat at an angle. He then transfers himself onto the seat of the vehicle. At this point, he removes the cushion of his chair and stows it in the back of the club cab (within easy reach). A hook is located on the chair, underneath the cushion, which he then attaches to the crane and proceeds to lift the chair into the back of his truck. Matt uses a remote control to move the crane around. In order to exit the truck, he just reverses the process. Matt considers the remote control crane an ideal mechanism for accessing his vehicle, and he finds it dependable and easy to use.
Matt has a computer that is set up on a workstation conveniently located in his bedroom. For the most part, Matt uses the computer for surfing on the Internet. This tends to be an activity he engages in for personal enjoyment. He also uses his computer to stay in contact with friends. Occasionally, if the need arises, he will also use the computer for word processing. He has a speech recognition program, but as yet he is not proficient. He finds the program hard to use, and does not feel the amount of word processing he does is worth the time and energy to learn the program. As a consequence, for him it is easier to use the hunt-and-peck method of typing. Although he does not use his computer much at present, he plans to use it more in the future when he is ready to return to work.
Matt uses a trained service dog for assistance performing everyday tasks. For example, the service dog can retrieve objects, pick objects up off the floor as well as open and close cupboards, drawers and doors. Matt notes that companionship is an added benefit. Matt explains that there is a lot of work involved in completing the training that is necessary to achieve a productive working relationship with a service animal. However, if one is willing to make the commitment, the end result is well worth the investment of time and energy.
Matt strongly recommends getting involved with peers, people that have been injured for five to ten years or longer. He points out that they have experienced most of what the newly injured person needs to learn, so they can provide valuable assistance in explaining how to go about living on your own. From Matt’s perspective, it is difficult for professionals, without disabilities, to really understand the circumstances associated with living with a spinal cord injury. So it is best to seek out peers, as a source of information and encouragement. Matt says, “All might not work for everybody, but you can take bits and pieces, and do what works for you.”
Matt also suggests getting involved in social activities with people with disabilities. He points out that it is a good way to build a network of peers and provides an excellent opportunity to learn about living with SCI. While Matt’s advice applies to all aspects of adjusting to life with
SCI, he points out it is particularly valuable in relation to assistive technology. Once a person gets to know their new functional capabilities and identifies lifestyle goals, it is possible to rely on others with SCI for advice on assistive technology to meet those goals.
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