Gary is a 58-year-old gentleman with C4-5 spinal cord injury resulting in quadriplegia. Gary uses a power wheelchair to access the community and get around in day to day life. Gary came into the clinic to have a splint fabricated to allow him to independently control his wheelchair. The customisation of a joystick to an individual can have a significant impact on the individual’s ability to control the wheelchair, and therefore improve their engagement in daily life. Appropriate mounting is critical to functional operation of a power wheelchair, and thorough clinical assessment is required to determine the best access or control points for the controls. Some joysticks have built in hand rest for stability, or the shape of the stick is different to accommodate the individual’s upper limb during control.
Occupational therapists play a significant role when working with individuals who have sustained a spinal cord injury, in addressing activities of daily living and community reintegration. Occupational therapists have skills in fabricating splints, that can not only provide support to different parts of the upper limb (e.g. wrist/fingers, but can also allow an individual to engage in activities of daily living (e.g. splint built onto comb, dressing stick).
Our OT, Dominique worked closely with Gary to assess what he didn’t like in his old splint and what changes could be made. She then fabricated a splint that was personalized and made specifically to assist Gary’s needs and requests. The splint constructed for Gary strapped his forearm in the splint, in a comfortable position and allowed him to use the proximal strength and control in his shoulders to push the splint attached to the joystick and independently drive his wheelchair. Gary reported the splint gave him much better support in comparison to his old splint and it was “perfect”!