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Driving Specific Considerations – Amputation

Driving Specific Considerations – Amputation

Foot Steering Wheelchair Van Massachusetts

Amputation

  • is the removal of all or part of a limb
  • can be the result of trauma or illness
  • or limb deficiency may also be present at birth
  • is not progressive but the advancement of disease can lead to additional amputation(s)

Potential Deficit Areas

  • loss of function at or above the amputation site
  • decreased range of motion and/or strength of the residual limb
  • decreased sensation at the amputation site
  • hypersensitivity at the amputation site
  • phantom Pain

Impact on Driving/Transportation

  • A modified vehicle, wheelchair lift or transfer seat may be needed for a person who now requires a scooter or wheelchair for mobility or has difficulty transferring into an unmodified vehicle.
  • The site of the amputation will determine if the person will need adaptive equipment to return to driving.
  • Adaptive driving equipment allow the person to compensate for an impaired ability to reach primary and secondary driving controls
  • Prior to driving with adaptive equipment, the person will need a driving evaluation.

Possible Vehicle Equipment Needs

Left Arm Loss
  • Automatic transmission
  • Power steering
  • Steering device
  • Directional cross over
  • Electric turn signal
  • Foot parking brake release modification
Left Leg Loss
  • Automatic transmission
  • Parking brake extension
  • Chest strap
Right Arm Loss
  • Automatic transmission
  • Power steering
  • Steering device
  • Electronic ignition
  • Crossover and/or gear shift extension
  • Wiper control modification
  • Console parking brake modification
  • Secondary/dash modification
  • Key extension
  • Electric ignition
Right Leg Loss

Possible Vehicle Equipment Needs

Loss of Both Arms
Loss of Three or Four Limbs
Loss of Both Legs

Accessible Vehicles And Adaptive Mobility Equipment Q&A

Accessible Vehicles and Adaptive Mobility Equipment Q&A

Rear entry vs. side entry. Buying online. Buying used. What do you need to know to get maximum benefit for minimum expense?

Good information is the key to saving money and getting the most value for the dollar when making a big-ticket purchase like a wheelchair-accessible vehicle.

With that in mind, Seek out and find experts who truly care for answers to some common questions about adaptive mobility equipment.

Q: Can I just go to a car dealer down the street or do I need a certified mobility dealer?

A: Certified mobility dealers help consumers buy the right vehicle and adaptive mobility equipment to meet their mobility needs now and in the future. Future planning is especially important for people with muscle diseases that get progressively worse over time.

“There are so many different products out there, and technology has improved so much. We just want to help people make the right decision,” says Jim Sanders, president of Automotive Innovations based in Bridgewater, MA for over 25 years.

“Many times, consumers will go to a car dealer and buy [a vehicle] that can’t be modified or one that doesn’t fit their needs. And once you buy a vehicle, normally it’s very difficult to return it.”

The National Mobility Equipment Dealers Association (NMEDA), a nonprofit organization that provides consumer guidance and ensures quality and professionalism in the manufacturing and installation of mobility equipment. Members include mobility equipment dealers, manufacturers, driver rehabilitation specialists and other professionals.

NMEDA member-dealers must follow the safety standards established by the National Highway Traffic Safety Administration (NHTSA), in addition to NMEDA’s own stringent guidelines.

Some dealers choose to enroll in NMEDA’s Quality Assurance Program (QAP), which requires them to adhere to national motor vehicle safety standards, and use proven quality control practices to yield the highest level of performance and safety. Automotive Innovations was the First Mobility Dealer in Massachusetts to enroll and exceed the safety standards.

“The QAP dealer is audited by an outside engineering firm to verify that technicians have been trained, make sure the dealer has insurance and make sure the facility is ADA-compliant,”

So it means the QAP dealer is going above and beyond.”

Other reasons to seek out a certified mobility equipment dealer include:

They provide a link to qualified service and repair, that it’s crucial to have done on a adapted vehicle serviced.

Some manufacturers of adapted vehicles sell directly to consumers, cutting costs by cutting out the middle man, says Jim Sanders, of VMi New England, based in Bridgewater, MA.

But expert assessment and “try before you buy” remain essentials for prospective buyers, with or without a dealer in the middle.

For example, We, a NMEDA QAP-certified member, send representatives to customers’ homes for assessment and test drives before they buy, and also offer unmatched service/maintenance to just about any modified vehicle including Rollx vans.

Q: Can I get a better price if I buy online rather than from a dealer?

A: As with any online shopping, the warning “buyer beware” rings true. Buying online without trying out different vehicles with different conversions can be a costly mistake. Furthermore there are many grey market converted vans being offered as quality conversions.

Online, clients are mostly shopping blind. Typically they have no idea how the vehicle they need will even work fro them, even if they have specific recommendations from a driver evaluator or occupational therapist.

“You definitely shouldn’t buy it online,” “There not trying to assess your needs by e-mail or over the phone. There just trying to sell you something.

Some online dealers even have a questionnaire on its Web site to try and give you the idea your getting what you need. But, it will never replace being able to go to a local mobility dealership and try the vans out first hand.

A mobility vehicle is probably the second-largest purchase after a house. You should see it, try it out, and make sure it’s something that will work for you. It’s horrible when people get something that they’re disappointed in.

Every vehicle is a little bit different — such as in the dimensions, electrical and fuel systems, or suspension modifications. “If you go online and buy [based] on price, you’re not really looking at the total package.”

While buying online maybe able to save money up front, it wont over the long term.

In addition to consumers missing out on the important local service contact that a mobility equipment dealer provides, these online deals or grey market vans are worth much less when it comes time to trade it in.

Where do you want to sit? If you plan to drive from your wheelchair, then a side-entry conversion is what you’ll need, unless you can transfer to the driver’s seat (rear entry). With a rear-entry conversion, the wheelchair user typically is positioned in the back or between two mid-row captain’s seats, while a side entry offers a wheelchair user multiple seating options in the driver, front passenger and middle sections.

Q: What are some common mistakes people make when buying a modified vehicle?

A: Manufacturers and mobility dealers agree that one of the most common — and costly — mistakes is buying the vehicle first and then shopping for the conversion or adaptive mobility equipment. Not all vehicles can be converted.

For example, If you purchase a minivan from a traditional car dealership you can hit a roadblock if it doesn’t meet specific requirements to have the floor lowered for a rear- or side-entry conversion.

Q: What are some good questions to ask a dealer or manufacturer?

A: Although buying a modified vehicle can be “a daunting experience,” says VMI’s Monique McGivney, it also can be “exciting and fun when you walk in armed with good questions and information.”

Prior to getting an assessment from a mobility dealer, evaluate your needs and try answering the following questions:

  • What vehicle will fit in my garage?
  • What kind of parking issues will I encounter where I live?
  • What is the size and weight of my wheelchair?
  • What is my seated height in the wheelchair?
  • How many people will ride in the vehicle?
  • In what part of the vehicle do I want to sit?
  • Will I be able to drive with hand controls?
  • Do I want a full-size van, minivan or alternative vehicle?
  • Do I want manual or power equipment?
  • Will an in-floor ramp or fold-out ramp meet my needs?
  • What is my budget, and do I have access to supplemental funding?

The first question mobility dealers usually ask a client is: “What is your seated height in the wheelchair?” From there, the dealer can advise whether a full-size or minivan is appropriate, and what kind of conversion is needed.

Be sure to ask the dealer about the warranty and how the vehicle can be serviced.

Q: Which is better: rear entry or side entry?

A: The most important difference between a rear- and side-entry conversion is that with a rear entry, wheelchair users can’t drive from their wheelchairs nor can they ride in the front passenger seat. From there, the choice comes down to personal preference and budget.

In recent years, because of quality, convenience and cost, there’s been a shift toward side entry vehicles. Rear entry is more of a frugal modification, involves a less of conversion process and is typically a little less expensive than a side-entry conversion.

Many people prefer side entry with a in-floor conversion for many safety reasons additionally because they can park almost anywhere and not worry deploying the ramp out into traffic. Also, side entry allows the consumer to ride in the passengers front position along with maintain the rear seats in a minivan because the conversion doesn’t affect that area.

Rear entry is harder to get out of compared to a side-entry.

Anyway you look at it side-entry vehicles are more versatile. For example, side entry allows someone with a progressively worsening condition to use the vehicle for a longer period of time. A wheelchair user can start out driving from his or her chair, and then move to several other positions in the vehicle when no longer able to drive.

Side-entry conversions typically are a little more expensive than rear-entry because they’re more intrusive and labor intensive. For example, with a minivan, the entire floor and frame must be removed and replaced with a lowered floor and new frame.

Q: What’s the difference between a fold-out ramp and in-floor ramp?

A: This decision comes down to safety, aesthetics, convenience and cost.

A fold-out ramp folds up into the vehicle, takes up valuable space in the passengers front area and must be deployed whenever the door is opened.

The in-floor ramp slides under the floor, so it safer for anyone seated in the passengers front position, mid-ship position, there’s no obstruction to the door, and other passengers can enter and exit without deploying the ramp. In-floor ramps only are currently only available for side-entry minivan conversions, and there is even a manual (unpowered) option.

In-floor ramps in addition to being safer will generally provide more room in the vehicle because there’s nothing blocking the doorway. The ramp is “out of sight, out of mind and may last longer because it doesn’t have to be deployed each time the side passenger door opens.

Fold-out ramps generally cost a little less than in-floor, and consumers can select from manual and power versions; a power fold-out ramp still costs less than an in-floor ramp.

If an in-floor ramp system breaks down or the vehicle loses power, VMI’s in-floor ramp systems have a backup system (sure-deploy) that bypasses the vehicle’s battery.

A lot of people just feel more secure knowing there isn’t a fold-out ramp next to them in the event of a accident.

Q: I use a wheelchair, but a van or minivan just isn’t “me.” Are they my only options?

A: You have some choices.

Lowered-floor conversions with fold-out ramps can be done on the Honda Element, Chrysler PT Cruiser and Toyota Scion. The conversions are small and don’t fit as many people.

Due to them being built on a much smaller scale, the ones we have seen have not been built with the same level of quality of mini van conversion. Parts availability and repairs have been a problem, some of the companies that converted them are out of business and or have no support for “something they used to build”

For those who prefer to keep their standard car rather than purchasing a modified vehicle — and who can make the transfer from a wheelchair to a car seat — the answer may be as simple as a set of hand controls or a left foot gas pedal

Turning seats can be used in a wide range of vehicles, from sedans to SUVs and pickup trucks. A way to transport the wheelchair (like a rear lift) also is needed.

The rate at which your disease symptoms are worsening is one thing to consider when looking at turning seats — is it likely you’ll be able to transfer and ride in a car seat for many more years? Also, be sure to check with a mobility dealer to determine if your vehicle can accommodate a turning seat and a wheelchair lift.

Q: Why are modified vehicles so darned expensive?

A: A vehicle conversion can cost consumers upwards of $27,000 — and that’s just the cost for the conversion, not the vehicle. The total package can run between $45,000 and $80,000 — or more.

Besides the cost of the components, the reason it’s so pricey is that basically there is a lot of work involved to build a quality vehicle.

Modified vehicles from certified manufacturers and dealers must meet NHTSA’s Federal Motor Vehicle Safety Standards (FMVSS). That means all modified vehicles must be properly crash tested. (To learn more, visit www.nhtsa.dot.gov.)

It’s quite a labor-intensive process because of the customization. When you make structural modifications to a vehicle, you have to go through all of the crash testing, and you have to show that the vehicle is compliant again, and those tests are very expensive.

Most of the time lowering the floor in a minivan requires replacing or moving the fuel tank. Once the conversion is finished, the vehicle still has to meet the original requirements for evaporative emissions, in addition to NHTSA requirements.

Q: How can I pay less?

A: Consumers have some options.

Many consumers cut costs by purchasing pre-owned vehicles with new conversions, typically saving around $10,000 to $12,000.

The previous van owner already has absorbed the depreciation hit on a new van, which essentially occurs right after you’ve driven off the dealer’s lot.

Buying used can be beneficial for first-time buyers who want to try out a vehicle for a few years before buying new.

But if you plan to buy used, do some research and make sure the vehicle is structurally sound including the conversion. Ask for a vehicle history (CARFAX) report, and get the vehicle inspected by a mobility dealer to ensure it’s in good shape and was well taken care of.

Q: How do people manage to pay for it?

A: Many consumers used home equity loans to purchase a vehicle and adaptive equipment. But with home values decreasing.

Many dealers and manufacturers work with lending institutions that offer extended-term financing, including 10-year loans, allowing consumers to make lower, more affordable monthly payments. The downside is that consumers are locked into the vehicle for 10 years, and end up paying more in interest.

If you finance for 10 years, and you’re not going to keep the vehicle for that amount of time, you’re going to lose money when you try to sell or trade it because you haven’t paid off much of the balance.

When you buy a new vehicle, many car manufacturers offer mobility reimbursement programs (up to $1,000) to help offset the cost for the purchase and installation of adaptive equipment.

Amputee Driving Controls South of Boston, MA

Amputee Driving Controls South of Boston, MA

2013 GM Equinox Hand Controls Boston Amputee Driving Controls

VMi New England and Automotive Innovations promotes full implementation of the Americans with Disabilities Act, and other legislation which guarantees full participation in society for all people, regardless of disability. We are dedicated to helping with motor vehicle modifications to meet the needs and concerns of amputees.

Support:

We will do our best to provide motor vehicle mobility solutions and resources for people who have experienced the loss of a limb and those involved with their lives. We are a supplier and installer of handicap and amputee driving devices.

Driving after Amputation: Automotive Mobility Equipment for Amputees
Driving after amputation is possible with the right equipment and vehicle modifications

After a limb has been amputated, for any reason, a person is typically not able to drive an automobile the same way they did before. However, there are several adaptive devices that can enable an amputee to continue driving and maintain his or her independence. The site of amputation(s) will determine exactly what type of vehicle an amputee is able to drive, and what other types of adaptive mobility equipment will be necessary. Here is a general overview of the various amputations and what equipment might be necessary with each one:

VMi New England and Automotive Innovations Bridgewater, MA has installed the following amputee driving equipment for over 25 years:

Hand Controls Boston, MA

RIGHT LEG

•Amputee Left foot gas pedal
Hand Controls 
•Automatic Transmission
•Power Braking

BOTH LEGS

•Hand Controls for brake and accelerator
•Amputee Spinner Knob
•Automatic Transmission
•Emergency Brake Extension
•Chest Strap

EITHER ARM

•Automatic Transmission
•Amputee Steering Device
Reduced Effort Steering
Zero Effort Steering
Zero Effort Brake
•Modified Gear Shifter
•Electric Gear Shifter
Electric Parking Brake
•Modified Secondary Controls (turn signals, dimmers)

Not every vehicle can be modified appropriately, and if the amputee is also a permanent wheelchair user a lowered floor minivan or mobility van may be their only option. That is why it is necessary to first be evaluated by a driver rehab specialist and then follow up with a certified mobility specialist to look at all of your adaptive equipment options as recommended by your driving evaluator.

2012 VW Van Left Foot Gas Pedal

VMi New England and Automotive Innovations sells and installs all of the above equipment.
Set up an appointment to meet with a mobility specialist today and let us help you regain your independence after amputation.

From the Department of Veterans Affairs: Automobile Adaptive Equipment (AAE)

The Automobile Adaptive Equipment (AAE) program permits physically challenged persons to enter, exit, and/or operate a motor vehicle or other conveyance.

Veterans are trained, through the VA Driver’s Rehabilitation Program, how to safely operate their vehicle on our nation’s roadways.

The VA also provides necessary equipment such as platform wheelchair lifts, UVLs (under vehicle lifts), power door openers, lowered floors/raised roofs, raised doors, hand controlsleft foot gas pedalsreduced effort and zero effort steering and braking, and digital driving systems.

Additionally, VA’s program provides reimbursements for standard equipment including, but not limited to, power steering, power brakes, power windows, power seats, and other special equipment necessary for the safe operation of an approved vehicle.

PDF application for adaptive equipment

Automotive Innovations has a substantial inventory of wheelchair accessible vans in Bridgewater, MA, and would be happy to set up a time for a demonstration. Every day is a Abilities Expo just south of Boston with access to factory direct inventory of hundreds of wheelchair vans in every make, model, and color available.

The Left Foot Accelerator, like model 3545S, is an accelerator pedal for persons with limited or no use of the right leg requiring them to drive with their left leg. It is equipped with a guard to prevent the driver from inadvertently resting their right foot on the accelerator pedal. The Left Foot Accelerator incorporates a quick release mechanism and is easily removable without tools.

LFA The (LFA) was designed for the driver that has lost control of only his right foot.

Left Foot Accelerator By Automotive Innovations is a  leader in design & quality. The (LFA) is extremely adjustable allowing it to be used in virtually any vehicle. The (LFA) is also equipped with a quick disconnect allowing (LFA) to be released and removed from the vehicle when not in use. Only the mounting plate is permanently mounted to the floor.

2012 Toyota Camry Left Foot gas Pedal

A left foot accelerator pedal device which allows persons lacking sufficient functionality of the right foot or right leg to operate a motor vehicle accelerator pedal using their left foot. The device incorporates an accelerator pedal activator which engages the motor vehicle accelerator pedal and is operable attached by a main shaft to a left side accelerator pedal. The main shaft is supported by a base unit which is removable attached to a base plate affixed to the vehicle floor. By depressing left side accelerator pedal a person lacking functionality of the right foot may operate the vehicle while the device may be easily removed from base plate allowing a person of normal functionality to operate the vehicle.

Automotive Innovations is New England’s premier mobility controls dealer. A Quick Release Left Foot Gas Pedal with Pedal Guard allows the driver to accelerate with the left foot. This pedal is installed on the left side and is mechanically linked to the original manufacturers pedal. The Pedal Guard shields the original pedal thereby making it inoperable. This quality crafted pedal is fully adjustable. The lightweight design of the pedal along with its quick release feature makes it quick and easy to remove and install, as the Left Foot Accelerator Pedal with Pedal Guard slides in and out of a base that is bolted to the floor. This makes the a Left Foot Accelerator Pedal with Pedal Guard is a smart choice.

Pedal Extensions

Automotive innovations gas and brake pedal extensions adjust to allow 6″ to 12″ or longer if necessary of extended reach. Made of durable lightweight aluminum or steel, Pedal Extensionsprovide comfortable driving after installation. Pedal Extensions fold down out of the way to allow other persons to operate the vehicle. Pedal extensions must be installed by authorized dealers. They fit most American cars and vans. Call now for more information on price and available appointment times.

Left Foot Gas Pedal

Designed for people with limited or no use of their right foot, the quick release left foot gas pedal enables those drivers to utilize their left foot for gas operation. The pedal can be installed in any vehicle with an automatic transmission. No adjustments are necessary after installation, and the unit can easily be removed to allow other drivers to operate the vehicle. A pedal stop is part of the unit, and will not allow the right foot to inadvertently apply throttle.

Block Pedal Extensions

Our pedal extensions are fabricated from structural aluminum tubing with a non-skid surface. They have adjustable slots for two stainless steel clamps that go around the gas and brake pedals (can also be modified for clutch pedal extensions). Standard sizes range from 1″ to 4″ high. This is a semi-permanent installation.

Custom Foot Pedal Extensions

Automotive Innovations carries a full line of custom gas, brake, and clutch pedal extensions for all driver’s needs.

Left-Foot Gas Pedals:
Your vehicle can be modified to allow you to use your left foot to control the gas pedal. This modification is designed for quick installation and removal so your vehicle can be shared with other drivers not in need of this adaptation.

508-697-6006

info@VMiNewEngland.com

How to adapt your new or pre-owned vehicle to meet your needs after a stroke

How to adapt your pre-owned vehicle to meet your needs after a stroke

Easy Car Makeovers for Adaptive Driving

 CAN I DRIVE AFTER A STROKE newenglandwheelchairvan.com

Driving after a stroke is often a major concern for survivor’s and their loved ones. It prompts many questions about ability, safety and vehicle options. Often times, the physical disadvantages that result from stroke can compromise a survivor’s ability to operate their vehicle.

Advances in the vehicle modification industry have introduced new driving controls that are giving independence back to stroke survivors that want to drive. They allow them to get back behind the wheel in their own vehicle to go where they want to go, when they want to go.

Innovative vehicle modifications such as hand controls, left-foot accelerators, lifts and mobility seating can transform your personal vehicle into a vehicle that give you more freedom.

Mobility equipment dealers strive to remain at the forefront of the vehicle modification industry by providing cutting-edge technology and a full selection of adaptable equipment for your pre-owned vehicle.

Hand Controls For Stroke Survivors with Limited Use of their Feet

Automotive Innovations is New England’s  #1 hand control installation facility  manufacturer of hand controls and driving aids for the disabled. Hand control systems are specifically designed to give drivers the benefit of controlling a vehicle with both hands on the wheel making for a safer, smoother driving experience.

Unlike other manual and or servo hand control installers in Massachusetts, Rhode Island, Connecticut, Vermont, New Hampshire and Maine, we have the ability to offer a custom fitment to your vehicle and you, for everything from a Fiat 500 to a Lamborghini Aventador no one else has the master craftsman, machining equipment and facility capable of performing a custom installation the way we can.

Push Rock hand controls have a handle in a vertical position; accelerating by rocking back in an arching motion using the fingers and/or the palm. There are several additional options to choose from:

  • Spinner knob: Attached to the steering wheel to allow controlled steering with use of one hand.
  • Single Pin: As an alternative to the spinner knob, this hand control was designed for clients that cannot open their hand fully.
  • Tri Pin: Great for an independent driver. It requires minimal gripping strength and/or reduced wrist stability.
  • V-Grip: This attachment is intended for drivers with moderate gripping strength.
  • Steering Wheel Extension: This device is individually customizable, so you can pick a diameter and height that best suits your needs. The easily removable device is completely compatible with any OEM steering wheel.

Servo electronic mobility controls offers driving control products that are safe and provide piece of mind every time you are on the road.

Servo Steering Servo gas brake

  • Lever  A gas/brake input with adjustable levels of force and travel from the full gas to the full brake position. It is designed for customers that have a wider range of motion and a larger effort level.
  • One handed steering and gas brake  A input that you can steer that is available in a two-axis configuration for gas/brake and steering It has a adjustable range of motion and very low levels  of force to operate. It is designed and custom build for each customers specific range of motion and abilities.
  • Wheel  A steering input that can be adjusted to less than 2 oz of force at the proper orthotic position of 3 3/8” from center. It is also able to be adaptable for customers that have a wider range of motion.

Left-foot Accelerator

Automotive Innovations offers the best left foot gas pedals with unmatched installations.  Left-foot accelerator are designed to offer a left foot gas pedal which acts exactly like your vehicle’s existing gas pedal. Our Left foot gas pedals are removable with features like a quick-release base so the entire assembly can be removed and re-installed quickly and easily.

Lifts for Stroke Survivors that use Wheelchairs or Walkers

Automotive Innovations can offer more solutions for the transportation of your mobility device than any other dealership in New England.

” Its worth the drive, I live in the western part of Massachusetts and will never trust my van with anyone other than Automotive Innovations. They have been taking care of me and my vans since 1996. When a company comes through for you time and time again whats that worth? For me it’s priceless and the drive is irrelevant.”

Chris P Whately, MA

  • Scooter & Wheelchair Lifts while are not always practical they do work in all types of vehicles. These fold-down wheelchair and scooter lifts make lifting and storing your manual folding wheelchair or scooter possible.

Mobility Seating

The mobility transfer seat is an innovative system for lower vehicles which can provide easer  access to an automotive seat. The seat power rotates out over the doorsill, bridging the gap for a safe transfer onto the seat. These seats are not always practical for every type of vehicle

Our goal is to match your lifestyle and your vehicle with equipment that will deliver independence.

Finding a Dealer That’s Up to Standards

Hand controls, left-foot accelerator, lifts and mobility seating offers opportunities for the stroke survivor to regain their mobility freedom in their pre-owned vehicle. You have just found the best mobility dealer in all of New England that offers a ever evolving selection of adaptable equipment.

It is important to select a reputable dealer to provide the adaptable equipment and installation for your pre-owned vehicle.

  1. Are they members of the National Mobility Equipment Dealers Association (NMEDA) or another organization that has vehicle conversion standards?
  2. Are they Quality Assurance Program (QAP) certified?
  3. Do they provide ongoing service and maintenance?
  4. Do they provide 24/7 emergency service?
  5. Do they provide training on the adaptable equipment?
  6. Can the equipment be transferred to a new vehicle in the future?

Adapting pre-owned vehicles provides stroke survivors with mobility freedom in the vehicle they love and are familiar with.

By: Jim Sanders, VMi New England