Motoring after amputation (view report contents)
Products and techniques
You may well be able to continue driving an unadapted car, particularly if it has automatic transmission and power steering. However if your amputation means you have difficulty driving, consider the adaptations available. See below and our Car controls guide, but this is the time to get individual advice from a Mobility Centre.
If friends or family also drive your car, make sure your adaptations do not prevent them doing so or get in their way unreasonably.
Getting in and out
If your main car key is small but full of electronics, fit a chunky holder on a spare key for more leverage. They cost about £5 and are available from general aids suppliers.
Having the door hinges modified and the seat runners extended will give you more space to get in and out of the car. It may be possible to have an existing seat converted – to be higher, made height adjustable, swivel or to be powered. Costs start at about £800 from adaptation firms. If swivelling helps, there are turning cushions (mostly between £20 and £80 from general aids suppliers) and replacement swivel seats, mostly from £700 upwards, from adaptation firms. To get in, sit first then turn and bring your legs in, doing the reverse to get out.
Wheelchair users
If you have a manual wheelchair, you may be able to lift it into the back of the car and walk the few steps to the seats. However if you can’t, there is a range of devices and techniques for getting you and the wheelchair into your car. See:
Primary controls
There is a range of adaptations for drivers.
Steering
To steer one handed you are likely to need a steering ball or spinner fitted to the steering wheel, and probably power assisted steering. Both are particularly useful during parking and low speed manoeuvres.
Spinners come in several shapes to suit different types of grip and most cost between £30 and £80. Some can be used with an artificial limb to steady the steering wheel. Limb Centres provide arm amputees with a spinner (free of charge) that is controlled with a detachable device in their prosthesis, depending on the design of the prosthesis.
Whether you can use a spinner with an artificial hand will depend on the level of your amputation and your type of prosthesis. Some spinners can be used with prostheses for above or below elbow amputation and some device options, such as cup and stem or split hook and ring.
When driving, an electrically powered prosthesis should be switched off and must not be clamped directly on to the steering wheel or spinner. Cosmetic hands can be used for steadying the wheel but not for forceful actions. The fingers should not be wrapped around the wheel rim or spinner.
Avoid adaptations that could interfere with an inflating airbag, and any that protrude and could catch your knee, seat belt or clothing. Take care that any rim fitted device is securely clamped.
Changing gears
Most people opt for an automatic – which can be driven with the right or left foot. To stop the car rolling back on slopes, you need to be able to use a handbrake or have an adaptation such as brake assist.
An automatic could be all you need if your left leg is amputated or if
your arm is amputated below the elbow and you drive wearing a prosthesis.
Think about the condition of your other leg, as you are likely to need
automatic transmission and hand controls if you have
problems with ulcers, sensation or circulation or
if both your legs are amputated.
You may have difficulty feeling floor pedals with a prosthetic foot and there is a risk of jamming it under the pedal without realising it. There may be times when your stump is too sore to wear an artificial limb.
If you cannot use a mechanical gear selector, there are systems which electrically set the gear for you, but these can be costly. It might not be worth adding them to an older vehicle. A Mobility Centre will advise you.
Some cars have manual gears designed to be easy to use – such as nudging the gear stick – without having to use the clutch pedal.
Pushbutton clutches have a touch sensitive switch mounted on the gear stick (around £1,000 to £1,500+). As you touch it, a motor disengages the clutch.
There are also semi-automatic clutches varying from mechanical levers to servo-assisted systems but they require manual dexterity.
If you drive an adapted manual car but your driving licence is for automatic vehicles only, you must make sure the clutch pedal is removed.
Accelerating and braking
If your right leg is amputated, consider having an automatic car and a flip up left foot accelerator fitted on the left side of the brake pedal for around £300. You will need training to drive this way. The original accelerator can be flipped down for conventional driving.
Hand controls
Many people find hand controls fitted on an automatic car easier to get used to. There are different types of system which can be mechanical or electric. They vary in the amount of effort required. Have a pedal guard fitted which is easily removeable.
Tips
Here is advice from disabled drivers:
- Think about what you may need in the future as well as about what suits you now.
- Get an assessment or test drive a new car when you are your least able – at the end of the day when you feel tired.
- Make sure you get what you know you need and want and not what others think you should have.
- See as many controls as you can.
Combined controls
- steering column mounted - push a lever to brake and pull it towards you to accelerate, from around £350.
- floor mounted push-pull levers – the height, length and strength needed can be set to suit you, from around £500.
- clamp on controls simply bolt on to the pedals – can be used temporarily and cost around £350.
Separate accelerators and brakes
- accelerator rings need less effort than a push-pull lever and you can steer with both hands on the wheel, from around £1,000 to £1,600.
- hand operated floor mounted brakes, around £350.
- custom built accelerators to be worked by different parts of your body.
Parking brake
Bolt on attachments make using the brake easier. These include simple levers to take the effort out of pressing the release button and handles you pull to operate the whole brake. These mostly cost from £60. An alternative is electric brakes worked by push buttons. These vary in cost, from around £700.
Secondary controls
These are used for things like lights, indicators and horn and there are simple attachments to make them easier to use – such as extended indicator stalks.
Otherwise there are infrared systems for all secondary controls. They can be fitted and adjusted to meet your particular needs. Getting used to an infrared control can take practice as you need to find the right button by touch. Many do not have automatically cancelling indicators.
There are also bleeper and tone systems – you press just one button until you reach the function you want. Voice control systems work by spoken command and are programmed to act on only your voice.
Prices of these vary widely depending on how complex the adaptations are and on your vehicle’s wiring system. They start at about £750. Do check the potential cost of any adaptation you are considering and its compatibility with your car with an adaptation specialist.
Other ways of driving
Nearly all controls can be altered or adapted to suit you and complete systems built around you if necessary. Obviously the more equipment you need and the more it has to be adapted, the higher the cost. You will certainly need a thorough assessment at a Mobility Centre and specialist instruction for systems that involve driving in a very different way.
Report Contents
About
this guide
Driving
after amputation
Choosing
a car
Plan
of action
Products
and techniques
Getting
in and out
Primary
controls
Secondary
controls
Finance
Further
information
Helpful
organisations
