by Robert Spitzmesser, ATP
Every once in a while we come across that one custom wheelchair application that is extremely difficult or almost impossible. I recently came upon one of those that the clinicians as well as I thought would just not work. But, having a “never say never” attitude I started looking for what I needed to make it happen. That’s when I was introduced to the new “MicroPilot” proportional joystick by one of my factory reps. Switch It has always been the “go to” company for really tough drive applications for PWC’s but they have really out done themselves this time! This device, I believe is the best thing to come along in several years as far as drive input devices go.
The MicroPilot is a extremely compact, very durable, proportional control that works off of pressure as opposed to movement. This is amazing in the fact that as little as 10 grams of pressure is all that is required. It is all metal construction and much more durable than the “mini joystick” which has a plastic housing and is prone to breakage.
The beauty with the MicroPilot is it can be mounted literally anywhere because of its size. It also only needs a minute amount of pressure to activate it. If an individual has simple control of a single digit on their hand but no fluid movement capability then this would be a perfect application for the MicroPilot. Here is an example of how I used it to allow an individual that was considered absolutely a non candidate for power. For privacy reasons we will call her Kim.
Kim is a 21 year old female that suffered a severe allergic reaction to a medication which left her with severe neurological deficits. She presents symptoms very similar to somebody with severe spastic cerebral palsy. Kim burns about 15k to 20k calories a day because of the severe spasticity and uncontrolled movements. She has to have injections and oral medications every hour to two hours to help control the spasms and severe hypertonic muscle tone. She is very bright and intelligent and communicates with eye movements to yes and no questions. She had actually used a PWC several years back with a head array but had trouble controlling it and injured a playmate and was reluctant to ever use it again.
Upon physical examination I noticed she was held in place in her manual wheelchair by several straps, supports, padding and positioning harnesses. But, even constricted as much as she was I noticed she had a very steady left hand even though it was in a severe fixed posterior wrist contracture which was rotated inward toward her midline torso area. I thought to myself “this is going to be impossible!”. A head array was out of the question due to limited movement only to the right and her reluctance to use it again. The only way this would work was if I could figure out a way to get a control mounted directly in front of her ring finger on her left hand, but her hand was so badly contratured and rotated that it would take something I had not ever seen. Walla, in comes the MicroPilot!
I began assembling a Quantum Q600 with the proper supports and straps to hold Kim in place to perform an evaluation with the MicroPilot. After 14 padded straps, laterals, and other numerous supports, we were ready. I originally mounted the MicroPilot in the Bullet Tray from Switch It on the left side flush with the arm pad trough. The Bullet Tray allows you to mount the MicroPilot flush with the half circular cut out so that it is not exposed for accidental input by a random spasm. At first we strapped down Kim’s arm very snug to keep it from moving but she could not reach the tray properly to make contact with the MicroPilot. So, to compensate for her severe rotation in her wrist, I used the “multi axis 360 degree” mount to position the Bullet Tray with MicroPilot perpendicular to the armrest and at a 45 degree angle to the arm tough in toward midline of her torso. Bingo! Kim did not have to struggle to reach it! It actually allowed her to rest her palm on the Bullet Tray and insert her ring finger into the cutout to make contact with the MicroPilot. That is all you need! Just contact and the ability to apply pressure not movement! The first thing that happened was she went in a circle, like all first time users of something new! But then she was able to follow commands such as forward, left, right reverse and stop. The only issue we had was she became so excited she couldn’t control her spasms! We worked a little more to find the optimum position for the MicroPilot and discovered she could actually use her palm as well! What was amazing is her dad could not believe she was driving because her hand nor finger were actually moving! I had to show how the system worked off pressure and not movement and he was totally amazed (as was I!) on how efficient it actually was!
I believe Switch It has hit a home run with this input device. I believe this will allow so many more applications for individuals that would otherwise not be considered for power wheelchair applications. Like any device it will take a lot of training but in the long run it has opened the door for us ATP’s to create mobility where it would have never been before.
For more information on this new and revolutionary device, please contact Switch It or visit their website at http://www.switchit-inc.com/ for more information.
You will not be disappointed!
For more information contact Active American Mobility at 888-734-2207