Tim, who was a commercial airplane and helicopter pilot and part owner of a helicopter charter service, was an active person before his spinal cord injury, and he still is to this day. His primary focus after his accident was getting mobile. Among his first thoughts were, “If I’m going to end up in a wheelchair and never walk again, then at the very least I want to be able to drive a vehicle.” His first attempt to drive his car was met with disappointment and frustration. He had purchased a folding wheelchair, which could be loaded into his pre-accident (but recently modified) hand-controlled, two-door car. After several futile attempts, he found the pain overbearing. On his final attempt, his sliding board slipped off the car seat and he landed on the gravel.
It soon became apparent to Tim that he would somehow have to walk to get into the vehicle if his life were to return to any remote form of his pre-accident state. He explained that everyone’s injuries are different and his injuries remain the reasons for his inability to load his wheelchair into his car. Walking to the vehicle, but how? Wishful thinking! Then he remembered his twenty-year-old neighbour Bob, who had suffered a similar spinal cord injury two years prior. Bob walks with braces and forearm crutches so he figured, “If he can do it, so can I.” Despite the fact that Bob is fifteen years younger, his inspiration would eventually become Tim’s answer to his looming million dollar question of how to get into his car.
Tim began gait training (brace walking), which consisted of four weeks in rehab, building up muscles in his arms and what little recovery he had in his hips and legs. “Walking,” he explained, “is extremely difficult in the beginning but things get better in time—you just have to stick with it, the rewards are tenfold. There is nothing more rewarding than breaking free from the wheelchair and not having to lug it into the car just to go to the corner store.” The only difference between Tim and Bob is that Tim uses a four-post walker and his younger counterpart uses the less cumbersome forearm crutches. Today, Tim combines the use of his car, wheelchair and his ability to walk with leg braces to overcome many mobility challenges. He and a friend have even designed and built a stand-up, motorized all-terrain standing frame vehicle, which was designed to help people to get around while removing the boredom factor from standing therapy for the SCI user.
Tim feels that while he was in the rehab centre, he learned a lot about available assistive technology, but also what was lacking to fulfill his needs. He also became concerned that the cost of specialized equipment was prohibitive. So Tim and his family and friends decided to design and build some of his personal equipment. They developed some products that were not otherwise available. Much of the equipment that they developed was not only less expensive, but was also much better suited for Tim’s environment and needs than the equipment available commercially.
Go directly to:
Around his house and around town, Tim combines the use of his car, his manual wheelchair and his leg braces for transportation. When deciding on what features he wanted for his equipment, Tim considered how each piece would work with other assistive technology he was going to purchase or build. He wanted his technology to work together as a system.
Tim chose a folding chair over a rigid chair in the beginning, primarily so that he could use it with an exercise bike: “I wanted to get my legs moving again, I knew from rehab that there are exercise bikes out there that work both your arms and legs together…. With that in mind, the only way to get to the exercise bike is to get your wheelchair nice and tight up against it.” Otherwise, your feet keep sliding off the pedals. He couldn’t get close enough with a rigid frame chair to be able to pedal from it, not to mention that his feet had a tendency to snag on the footrests of the rigid chairs, so he chose a folding chair with leg rests that swing away, “and then you simply lock the [wheelchair] wheels and away you go.”
Tim also preferred the folding chair because the armrests are sturdier than those on the rigid chairs he’d tried during rehab. This became an important feature later on when he began walking with braces. “You can’t do it with those flimsy, little metal bars, because sitting down requires that you put pressure on the armrest of the wheelchair I usually bent them or missed those flimsy armrest bars altogether…. The first thing you go to grab for is the armrest when you’re about to sit down.” The larger the target the better. He also wanted sturdy brakes for getting up and down into his chair. He found the brakes on rigid chairs to be “kind of second-rate.” He admits though, that if he used his wheelchair all of the time, “then I suppose I would have gone with, you know, more of a sports-type chair. Something that would get up and go…. In a folding-type wheelchair, you’re hard-pressed to get any speed out of them.” Folding chairs, in his opinion, are built for practicality not looks, ride or speed.
Tim keeps the anti-tip tubes on his chair primarily because they provide additional stability when he’s transitioning quickly from standing to the chair. He also says that all wheelchairs have a tendency to tip over due to their high centre of gravity. “It is even more pronounced when you’re using a chair under these circumstances because of the speed that you’re landing into the seat. Anti-tip tubes aren’t pretty to look at but they can really help stabilize the chair when using forearm crutches and braces.”
Tim chose to replace the wheelchair’s standard backrest upholstery with a hard-shell, foam-lined backrest. The angle of both the backrest and its lumbar support are adjustable, which helped Tim reduce the pain and lack of balance he was experiencing while in rehab. If he were to buy a new chair today he would still look for a backrest that gave him maximum support. “The low backs, like you see a lot of guys with, don’t give a person much lumbar support in my estimation. I need the extra lumbar support because that’s where I broke my back, in the T12 to L1 region.”
Video:
See Tim move about his home using leg braces. Choose a format: |
Tim had trouble accepting that he was going to spend the rest of his life in a wheelchair. He became inspired to use leg braces to walk after a neighbour demonstrated to him that it was possible. His neighbour had a similar injury, although his neighbour was in his teens when his injury occurred and Tim is in his thirties, he figured it would be worth a shot. “No pain, no gain and if Bob can do it so could I,” he said. Tim notes that anyone wanting to try walking with leg braces has to wait at least six months after his or her injury. His injury was complex, so he had to wait even longer. Tim still can’t figure out why physiatrists don’t encourage people to strap on braces. According to many published documents he’s read, most paras are capable of brace walking and the benefits medically are enormous.
Tim didn’t want to sit idly, waiting for his first chance to try leg braces. He realized that he needed to prepare himself. He started by wheeling as close as possible to the kitchen sink, locking the brakes and standing, with his hands in the sink and a pillow in front of his knees to steady himself—what he calls a poor man’s standing frame. This exercise gave him confidence that he would be able to use leg braces. He also used his homemade exer-cycle to loosen and strengthen his arms and legs.
Tim started walking with rigid full-leg braces, called KAFOs (for Knee-Ankle-Foot Orthosis) on both legs. These offered maximum stability for the initial training period. He progressed to a semi-rigid KAFO, which eliminates support for the knee and allows muscles in that area to start working more on their own. He also notes that you can go a step further with braces that are hinged in the ankle as well. The foot is controlled by springs that raise the foot after a step is complete.
Therapists recommended that Tim use forearm crutches, as opposed to standard crutches that fit under the armpits, because standard crutches can cause problems with the shoulders, specifically an impingement of the rotator cuff muscles. He only experiments with the forearm crutches though, and prefers to use a walker to balance himself. “If a good wind comes along while using the forearm crutches it’s going to knock me over. So that’s why I like the walker.”
According to Tim, the benefits of walking with leg braces are nearly limitless. Aside from the workout he gives himself every time he walks, he says, “If you’re up on your braces all day you’ll never get a pressure sore. I’ve never got a pressure sore all the time that I’ve had these braces, but I was starting one when I was in a wheelchair all the time.”
Tim would like to be able to kneel down and get back up again while in his leg braces. He finds that it is difficult and unsafe with his current walker unless someone is bracing it for him, because he relies on it to pull himself up from the ground and finds that it is too unstable. There is currently no brace capable of performing such a task that he is aware of. He says that you can get to a lying position but not a kneeling position, which would be the ultimate. Since he has not seen a solution offered by any manufacturer, Tim plans to build extension legs on his own walker to increase the stability. He also intends to speak with an orthotist to see if there is any way to invent a brace with that capability.
Tim also chose a folding wheelchair because he thought it would be easier than a rigid chair to put in his car. A friend of his who works in the assistive technology field installed hand controls in his car soon after his discharge. His first attempt at transferring into his car was difficult: “I transferred from the wheelchair over to the car, and I got [the chair] apart, you know. I got the armrests out, I took the Velcro off it and the seat support and folded the wheelchair, basically lifted it up. And then the wheelie casters kept getting stuck in the seat belt. And I thought, ‘Well, I’ll pin the seat belt back.’ So I tried that, and right about then my trunk balance still wasn’t very good, and I went to lift the wheelchair up to get it in the back, and I had this huge pain overcome me. So I grabbed the wheelchair and I [pushed] it. I just said, ‘Screw it, I can’t do this. I need to walk—that’s all there is to it.’”
From that day on, Tim felt transferring from the wheelchair to the car was not worth the pain, grief and aggravation and focused all his efforts towards learning to walk with braces. Now Tim doesn’t even bring his wheelchair with him when he goes out with his car. “Most public places have wheelchairs available or scooter carts or stuff like that, and you can get [to them] with the walker and the braces usually quicker than the time it takes to reassemble a chair. Besides, it feels good to stand and walk after a long drive. I don’t bring my chair unless I’m going to a hospital, in which case my wife comes along with me. It’s a lot more comfortable to have your own chair than the old wrecks that collect dust in the hospital entrances. If you’re going to wait around in a hospital for hours, I recommend people bring their own chairs.”
Video:
See Tim demonstrate the use of his motorized all-terrain vehicle. Choose a format: |
Tim was trained as an aircraft mechanic, and he wanted to put his knowledge to good use by helping friends with engine repair and other projects. He recognized that he needed to be able to elevate himself high enough to provide advice that would help other mechanics troubleshoot problems on large vehicles. He also realized that he had problems walking on rough or soft surfaces, so he and his friends and family designed and built a six-wheel powered vehicle. It not only gives him an elevated platform to stand on, it goes over all kinds of terrain.
The vehicle consists of a metal platform mounted above 10-inch go-kart wheels, on top of which sits the electric motor from an old wheelchair and three large batteries. A walker is attached in the middle of the vehicle. Tim modified the walker with knee braces and belts, similar to what you would see on a standing frame. All controls are attached to the walker as well. All six wheels are powered to make sure that Tim doesn’t get stuck. Tim and his friends took about eight months to complete the project, and they were fortunate to keep the costs low because they worked mostly with used or donated parts.
Tim’s friends would like to market the creation. In fact, he demonstrated it on a television show. But he found that not many people want to stand as he does. He admits that he could mount a chair to the vehicle but he and his friends would “rather see it stay as a power walker.” When he looked into the number of approvals from various agencies that he would need to bring it to market, as well as the cost of insurance, he started to appreciate what the manufacturers of medical equipment go through, and why they charge so much for their products.
Video: See Tim demonstrate his homemade exercise bicycle. Choose a format: |
Tim knew that he had to get in shape to be successful with his leg braces. “I told my brother if I’m ever going to get on braces or back to walking that I’d need to get my legs moving. My legs hurt a lot if I don’t move them.” And he knew that the exercise bike at his rehab centre helped him when he was there and he wanted one like it, but didn’t want to pay the “totally outrageous” price of a specialized bike that is designed to be used from a wheelchair.
Tim wanted a bike that was compact, so it could fit into the small house that he and his young family were renting after his discharge from rehab. He also wanted to be able to pedal with his hands, which would propel the foot rests and move his legs. His brother started by gathering neglected standard exercise bicycles from friends and family members. He welded two together so that Tim would have access to a set of pedals at leg height, which his brother modified to keep Tim’s feet in place, and a set of pedals at arm height, which were modified so he could grasp them with his hands. Both sets of pedals are interconnected with a bike chain and connected to a wheel that has adjustable tension. The apparatus is mounted on a plywood base. It could also be lagged to a floor or placed against the wall for additional stability but that has not been necessary.
Tim credits their invention with helping him to walk. He also says, “if I move [my legs] … I feel better in mind and spirit, and physically too. I mean you can get tuckered out on it, because it really works your cardiovascular system…. And if you’ve got frustrations, you can crank up the tension and really pull on it. It beats destroying property that you worked so hard for before the accident you know.”
Tim still uses his exercise bike as often as he can, and now he can cycle using only his legs. He believes that all people with a disability should use one. “It’s really inexpensive, and it’s really easy to build, and I think every person with a spinal cord injury should have one. Even someone with quadriplegia can use it—I mean if you can use your arms at all, you can run this thing.”
Tim hired his business partner, who is also a home-building contractor, to build him a barrier-free home. Since it was the first time that either of them had built an accessible home, they relied on information from a community agency, as well from as the Internet, to design the home. He requested wide doorways in case he needs to use a power wheelchair in future. And he used pocket doors, which slide out of the way into an opening in the door frame. As a result, the doors “don’t have to swing out, and they don’t take a lot of space, and they’re easier to open and close.” They also installed ceramic tiles throughout, instead of carpet, to make all floors easy to wheel on. Tim wanted to make the home as accessible as possible because, if he decided to sell, he could market it as a barrier-free home. At the same time, he didn’t want their home to look like it was designed for a person with a disability, so he left some items standard.
Tim specified that the counters be installed at standard height, “because I felt while I was cooking or helping my wife, it was better if I stood, because it hurts a bit less than sitting, besides, it promotes standing.” In hindsight though, he wishes that he’d lowered the counter. “Let’s face it, it would be nice to be able to get over to the sink and do certain things. To wash whatever instead of going all the way to the bathroom to wash…. The other reason why you probably should have lowered counters is the first thing in the morning when your wife’s not there, and there’s nobody there to help you, … then if you have a lowered counter, you can get closer to things. And you can get certain things that would normally be out of your reach if you had normal counters.” Tim uses a reacher for items he cannot get to on his own and finds it an indispensable item for his kitchen. I definitely made a mistake when planning for the kitchen but I was working on the premise that I’d have more recovery than I did.
To enter and exit his home, Tim has a ramp with two purposes. One is a straightforward ramp, and the other has steps that were built to accommodate his walker. He admits that he rarely uses the ramp because using the stairs is much quicker when he uses his braces and walker, but he may need the ramp more in the future.
Video:
See Tim demostraate his homemade shower chair system. Choose a format: |
Tim also realized his need to have a wheel-in shower installed, which includes a swing-type shower chair built by his brothers. The area can also accommodate a wheel-in commode chair. “I suppose when I get really old and I can’t lift myself up or if somebody else wants to come to visit, and they’re used to the commode chair idea, they bring their commode chair; the bathroom is set up to accommodate either shower method. Or let’s say we move out of here. At least the home is equipped with a wheel-in shower.”
Having lived in the home for a while now, Tim says he would have done a few more things differently in addition to lowering the kitchen counter height. He had difficulty visiting the site while it was under construction: “Back then I was in the electric wheelchair, and of course, the house was built in the spring and this was one big mud hole back here, and I couldn’t get on site to see how things were progressing. As you’ve probably gathered by now it’s easier for me to demonstrate and show people than it is for me to explain it in words.” He wishes he had installed windows that were taller with sills that were closer to the floor, then it would be easier to see outside without having to stand up or prop up on the wheelchair armrests. And he would have made sure that all door thresholds were level with the floor, so that they don’t slow him down when he is in his chair. Also, the thermostat was overlooked and set too high by the heating and cooling crew. For the most part they are all little things, but these little things sure can make life easier if a little forethought and overseeing goes in.
Tim also had difficulty getting into his basement. He only has to go down there if there is a problem with the electricity or if the basement floods, but he has figured out a low-tech solution. He had handrails installed on both sides of the stairs leading to the basement, so he can use his arms to lower himself down to the bottom, where he has a walker waiting for him. He admits that getting up is a workout, but he can use his legs a little to help. He will find a mechanical solution in time, like a stair climber, but he feels he doesn’t go down there enough currently to justify the expense.
Tim wanted the assistance of a mechanical device to transfer in and out of bed on his own. He looked at commercially available lifts and devices that were used at his rehab centre and decided that they were either too costly or didn’t do the job properly for him. He took ideas from different lifts he had seen and created his own to suit his transferring style. Tim had a ceiling track installed, which his brother made from half-inch pipe. He machined some old hydro phenolic insulators to the contour of the pipe to act as idler pulleys, and he also welded the trolley itself from flat iron. Then they simply attached two padded triangular handles on chains to the sliding mechanism on the track. He pulls himself upright with the handles, and then, with very little weight on his legs, he is able to ambulate to his destination along the track. He says that it is safer than similar products he has seen that are fixed above the bed. Because the chains are always directly above his head, there is less of a tendency to injure the shoulders. Also, it didn’t cost nearly as much as a commercial track lift.
Tim feels that to make informed decisions after a spinal cord injury, people should exercise a lot of self-discipline. “You need to know what’s going to work for you, read a lot about the subject and try to concentrate on your specific situation. I know it’s an extremely difficult time, but if you’re wallowing in self-pity, your brain’s not working, and you’re not focusing. You have to focus—the distraction will do you good. Try to exercise self-discipline. I was fortunate and learned a lot about that subject in aviation. It’s kind of like the first time you fly in clouds on instruments at night with a thunderstorm nearby, you wished you were on the ground, holding your mother’s hand, but you’re up there and it’s happening to you and you have to deal with the crap that life has sent your way. The fact is that you have to make many decisions early on to get what you need to make your life a little bit better from this point on.”
He suggests tackling one barrier at a time though. Setbacks are common, simply because the spinal cord injured community have lost so much. “Just try to clear your mind and the ideas will come to you. Do whatever it takes, but above all, don’t give up. Tell a friend what you need, and they’ll come up with the ideas as well. It’s time to call in those favours that you did for friends in years gone by. Don’t be afraid to lean on them now, you would do the same if the situation were reversed. We did not ask for this to happen to us!” He also suggests that, “If people want to help you out in the beginning, let them. Tell them what you want. They’ll help you build it in the beginning … but as time progresses, everything gets old. The injury becomes old, and they feel that you probably should have asked earlier, because now [they’re] … not interested in helping as much. It’s just that everybody wants to help in the beginning.”
Once you start to figure out what you need, and want to build some equipment for yourself, he recommends that, “you go on the Internet and you look and see what’s out there.” He also says, “Basically I’ve gotten ideas from the manufacturers. I’ve just modified them a little bit.” Finally, from his training as an aircraft mechanic and as a pilot he learned that, when inventing something, it is best to keep it simple.
 |
 |
 |
 |
|
- - - - - - - - - - - - - - - - - - - - |
Home © 1999 - 2008 All Rights Reserved |
