Driving with a disability

Driving with a disability: Paraplegia

Hands and arms are fully functional. Due to extensive paralysis in the thoracic region, there is little back and chest musculature available for active use. This may mean that stability when seated is reduced when driving round bends, which would affect steering movements. 
Paravan offers a solution in the form of restraint systems that can be adjusted in line with your needs and which support your head, back and thoracic regions.
If you have been a wheelchair user for a long period of time, strain and wear in the shoulder joints could cause an impairment of the movement radius at the steering wheel. Spasms that may shoot into the legs might cause the gas or brake pedals to be pressed inadvertently. It is therefore absolutely essential that the pedal system is covered.

Our solutions

Paravan has developed solutions for this problem in the form of severa laccelerator and brake pedal variants that are designed for use by people with disabilities and that can be adapted to your specific needs.
Paravan develops safe and innovative driving aids for disabled people who wish to regain mobility. Our Space Drive technology (drive-by-wire ) makes it possible to refit most vehicles to accommodate disabled drivers. We’ll be happy to advise you of your options directly on the phone (+49 7388 9995-91) or via our contact form.

Definition
Motor paralysis of adjacent limbs 

Causes
Accidents involving fragmentation of the vertebral bodies and contusion or transection of the spinal cord; syringomyelia, tumour, after-effects of anaesthesia (epidural anaesthetic), gunshot or stab wound, diseases. See also causes of quadriplegia. 

Effects
Damage of the spinal cord between the 1st and 12th thoracic vertebra (Th 1-12) and the 1st and 5th lumbar vertebra (L 1-5). Partial paraplegia or full paralysis (paraplegia) of both legs. 

Consequences
Both legs and the torso are paralysed below the transection of the spinal cord. The existing muscles can no longer be tensed and moved deliberately. In the affected regions, there is no longer any perceptible sensation of pain, pressure, temperature, injury or touch. Owing to this loss of depth sensitivity, the affected individual can no longer localise the position of his or her legs if he/she is unable to see them. Bowel movements and the urge to pass urine can no longer be perceived, which means the bowels and bladder must be emptied at regular intervals by artificial means. Uncontrolled muscle cramps may cause spasms of the extensors and flexors in the legs. Symptoms range from trembling legs to fully extended knees, hips and feet. If the height of the paralysis is on the level of Th 1-5, respiratory volume is reduced; at Th 7-12 the abdominal muscles are affected, and at Th 2-12 the muscles between the ribs are involved.

Driving with a disability: Quadriplegia

Hand and arm function is severely or very severely limited. Due to extensive paralysis, there is virtually no back and chest musculature available for active use. This means that stability when seated is considerably reduced when driving round bends. Paravan offers restraint systems that can be adjusted in line with your needs and which support your head, back and thoracic regions. The limited strength and ability to move has a particularly negative effect on turning movements in the upper area of the steering wheel (in terms of the face of a clock: between 11 and 1 o’clock). 

The inability to rotate the wrist affects the individual’s ability to start the engine with the car key and operate various controls (interval setting of the windscreen wiper on the indicator lever, light switch on the instrument panel, etc.). In addition, it is impossible for the wrist to assume a stable position. This makes it advisable to hold the wrist in place by means of a steering wheel caster fork or with a tri-pin on the steering wheel. 

Our solutions

Paravan has developed steering wheels for disabled drivers and orthopaedic steering aids that are designed especially for individuals with physical limitations. These products enable quadriplegics to enjoy all the freedom driving has to offer.
Constantly restricted breathing reduces strength and causes physical performance to decline throughout the course of the day. This must be taken into account when measuring strength and movement. 
Spasms that may shoot into the legs might cause the gas or brake pedals to be pressed inadvertently. It is therefore absolutely essential that the pedal system is covered. Paravan offers effective vehicle conversions to tackle these challenges. 
Air conditioning is indispensable, as is auxiliary heating, since quadriplegics adapt to exterior temperatures and can therefore quickly become under-cooled or over-heated. For example, it is possible for a quadriplegic to die from heat exposure at temperatures above 40 degrees Celsius! 

General categorisation according to height of paralysis (overlaps may occur):
C4 
Usually only parts of the arm flexor (biceps) are available for active use; virtually no hand function.
C5
Arm flexor (biceps) are available; targeted use of the hand for holding and gripping can be practised and is required in order to be able to turn the steering wheel far enough when driving round bends.
C6 
If limbs are kept in the right position in the phase immediately after injury, a passive closed fist and passive gripping of objects with the thumb and forefinger is possible.
C7
Arm extensor (triceps) is available – i.e. it will likely be possible to turn the steering wheel with little technical support when driving round bends.
C8
The muscles for bending the fingers are functional; nearly full hand function.
With our Space Drive II technology (drive/steer/brake-by-wire), we offer various driving aids in line with the degree of paralysis involved and the strength of the individual driver. This technology was developed by Paravan especially for people with disabilities who wish to become more mobile.
You’ll find further information on driving as a wheelchair user here. You can also contact us directly online – we’ll be happy to help you! 

Definition
Motor paralysis of all legs and arms (quadri, Latin, means four) 

Causes
Accidents involving fragmentation of the vertebral bodies and contusion or transection of the spinal cord (e.g. bathing accidents by diving into water of unknown depth); syringomyelia, tumour, gunshot or stab wound, diseases. Paraplegia involves similar symptoms. 

Effects
Damage of the spinal cord between the 3rd and 7th vertebra (C 1-8). Partial quadriplegia or complete paralysis (quadriplegia) of both legs and arms with severe or very severe impairment of respiration and arm function. 

Consequences
The musculature of both arms, both legs and the body is paralysed from the location of the transection of the spinal cord downwards. The existing muscles can no longer be tensed and moved deliberately. In the affected regions, there is no longer any perceptible sensation of pain, pressure, temperature, injury or touch. Owing to this loss of depth sensitivity, the affected individual can no longer localise the position of his or her legs if he/she is unable to see them. Bowel movements and the urge to pass urine can no longer be perceived, which means the bowels and bladder must be emptied at regular intervals by artificial means. The hands are slightly or largely limited in their function, manoeuvrability and strength. A rotating movement of the wrist is frequently no longer possible. As a rule, the biceps (flexor) is intact, which means active flexing and bending of the forearm can be controlled. The extensor muscle (triceps) is often impossible to reactivate. The arm can frequently only be extended passively by simply letting it drop down. The fingers can only grip by means of a special technique (functional hand). By constantly keeping the hands in a special position right from the beginning of treatment, the extensor muscles are shortened and a hand position is achieved that enables a passive fist to be formed, which in turn makes it possible to jam an object between the thumb and forefinger. Due to the paralysed muscles in the region of the ribs, only diaphragmatic respiration is possible. This inevitably causes a low lung volume, which in turn affects strength, resilience and motility and leads to sharp fluctuations in physical performance throughout the course of the day.

Driving with a disability: Multiple sclerosis

Due to a lack of strength in arms and hands, transferring from a wheelchair to the driver’s seat might no longer be possible at some point, making it necessary to drive in a wheelchair. Vehicle refits by Paravan, in particular the provision of a wheelchair docking station, make driving in a wheelchair a comfortable and pleasant experience. In this scenario, extensive support for steering and braking is also required. In the case of intention tremor (constant trembling in arms and hands), the hand must be fixed in a steering wheel tri-pin and the sensitivity of the device for controlling the accelerator must be adjusted accordingly. The steering wheel variants and steering aids supplied by Paravan offer the right solution.

Our solutions

Symptoms of paralysis, coordination disorders and impairment of fine motor functions in the arms and hands need to be compensated for by technical means.
This is where the Space Drive II technology (drive/steer/brake-by-wire) developed Paravan comes in: Here, computer-supported controls are linked to servo motors that translate impulses for steering, acceleration and braking. You’ll find information on our vehicle refits and conversions online, and you can also contact us directly via our contact form. 

Definition
Multiple hardening. 

Causes
Unknown; pathogenic endogenous defence processes cause hardening to myelin sheaths, which in turn impairs saltatory conduction – i.e. the transmission of impulses (autoimmune disease). 

Effects
The myelin sheaths are partially or completely destroyed so that the transmission of electrical impulses in these areas is impaired or else fails completely. 

Consequences
Initially: symptoms of paralysis in the legs, with impaired coordination of movements (ataxy); lack of strength, intention tremor (constant trembling of the legs). As the disease progresses: further neurological deterioration in episodes or gradually. This can result in decreasing strength in the arms and hands, constant trembling and symptoms of paralysis in the arms and hands, impairment of fine motor function (dexterity), and a weak bladder and intestines (incontinence). 

Muscle disorders 
There are more than 200 types of muscle disorders. We describe three sub-groups that occur most frequently: progressive muscular dystrophy, spinal muscular atrophy and neural muscular atrophy. 

Driving with a disability: Progressive muscular dystrophy

The progressive course of the disease dictates the use of precisely customised and adjustable controls. Paravan offers you controls and steering aids that can be individually tailored to your needs. Due to the individual and progressive course of the disease, the extent of impairment of movement and weakness of muscles can only be ascertained in tests, which serve as the basis for the determination of the type of technical support needed.

Our solutions

The Space Drive II technology developed by Paravan uses servo motors that enable the most subtle movements of the controls to be translated into active motions. These driving aids make it possible for many disabled people to fulfil their desire to achieve greater mobility.
You’ll find further information on driving as a wheelchair user here, and you can also contact us directly online. 

Definition
Progressive muscle growth disorder. There are many different forms, one of which, myotonic dystrophy, is described below. This form is also known as Steinert’s or Curschmann-Steinert’s disease. To this day, there is still no treatment for the muscle cell damage caused by this disease. 

Cause
Genetic defect on chromosome 19: scientists believe this defect alters the membrane system of the muscle cells. 

Effects
Myotonic dystrophy can progress up to the point where the muscle cells are completely destroyed. The muscles first affected are those in the face, the hands, lower arms, lower legs and feet. The disease can occur at all ages in men and women alike. A typical symptom of this disease is the delayed relaxation of the musculature following muscular tension (myopathy). 

Consequences
Muscle weakness, impaired movement in legs, hands and arms; restricted fine motor function (dexterity). Some diseased muscles appear particularly strong because the underlying muscle fibres are embedded in fatty and connective tissue. This disease is progressive. Information on other muscle diseases, such as MS, can be found here.

Driving with a disability: Spinal muscular atrophy

Due to the individual and progressive course of the disease, the extent of impairment of movement and weakness of muscles can only be ascertained in tests, which serve as the basis for the determination of the type of technical support needed.

Our solutions

The Space Drive II technology developed by Paravan ensures that even individuals who have little strength can safely operate a vehicle – thanks to computer-supported controls and servo motors. You can learn how to drive with our controls for the disabled at a Paravan “Fun&Drive” Driving School. Our technology and driving schools make it possible for many disabled people to fulfil their desire to achieve greater mobility.

You’ll find further information on driving with a disability here, and you can also contact us directly online. 

Definition
Muscle atrophy affecting the spinal cord. There are up to 30 different types of spinal muscular atrophy. The most frequent form is proximal spinal muscular atrophy, which is described below. The name results from the close location to the torso, where the disease begins. 

Cause
Genetic defect. Nerve cells in the spinal cord – the anterior horn cells – are affected. It is presumed that incorrect nutrition of the nerve cells is the cause. 

Effects
Only the motor nervous system is affected. The parts of the nervous system responsible for the sensation of touch, for perceiving pain and for feeling temperature remain unimpaired. The bladder and rectum continue to function normally. 

Consequences
Due to the muscle atrophy, muscle weakness and even the complete failure of muscles occur, and this leads to considerable or very serious impairment of movement in the legs, arms and hands. Information on the similar muscle disease known as “Neural muscular atrophy” can be found here.  

Driving with a disability: Neural muscular atrophy

Due to the individual and progressive course of the disease, the extent of impairment of movement and weakness of muscles can only be ascertained in tests, which serve as the basis for the determination of the type of technical support needed.

Our solutions

Our Space Drive II technology makes it possible for disabled persons to operate vehicles themselves with the help of computer-supported controls and servo motors. This technology was developed by Paravan for the numerous people with disabilities who wish to become more mobile. The nerve fibres in the legs are severely affected by this disease. Muscle cramps can therefore occur, which means the brake and accelerator pedal need to be covered. Paravan offers pedal covers that prevent pedals from being pressed inadvertently.
You’ll find further information on driving with a disability here, and you can also contact us directly online. 

Definition
Nerve-related muscle atrophy.

Cause
Almost always a genetic defect. The sheaths of the nerve fibres become abnormally thick or the nerve fibres themselves decay completely. The disease affects the nerve fibres in the arms and legs.   

Effects
Neural muscular atrophy slows down the conduction speed of the nerves. The disease begins with muscle atrophy and muscle weakness of the lower legs. The symptoms then rise up the lower legs and later affect the hands and lower arms. There is little impairment of sensations. There may be vegetative disorders such as too much or too little perspiration, and skin and circulatory problems may also occur. There may be slight spastic symptoms in the legs as well. 

Consequences
Due to the muscle atrophy, muscle weakness and even the complete failure of muscles occur, and this leads to considerable or very serious impairment of movement in the legs, arms and hands. The “Spinal muscular atrophy” muscle disease involves similar symptoms.

Driving with a disability: Poliomyelitis

Because the muscle weakness generally affects one side more than the other, the controls for operating the accelerator and brakes and other systems usually have to be configured for one-sided use. The choice of technology depends entirely on the manner in which the disease has manifested itself, which is determined by performing tests. 

Our solutions

Paravan provides various controls ranging from normal steering wheels to mini steering wheels and joysticks. You can select the steering control that best suits your needs. All control devices incorporate the Space Drive II technology, developed by Paravan. The controls can be individually tailored to enable comfortable mobility for disabled people.

It’s often the case that the transfer from a wheelchair to the driver’s seat is no longer possible, making it necessary to drive in a wheelchair. Paravan’s wheelchair docking station allows for a simple connection between the wheelchair and the modified vehicle. If post-polio syndrome occurs, the physical capabilities of the individual in question need to be reassessed completely. You’ll find further information on driving as a wheelchair user here, and you can also contact us directly online.

Definition 
Commonly known as polio; infectious disease of the spinal cord (literally “grey marrow inflammation”). 

Causes
The viruses which can give rise to this disease mainly cause inflammation of the motor neurons of the grey anterior horn cells of the spinal cord, which are responsible for muscle functions. 

Effects
Skeletal muscle damage.

Consequences
Muscles are affected by flaccid paralysis, which will be more or less extensive depending on the severity of the disease. In serious cases, the entire body and the respiratory muscles can be impaired. Typical symptoms are flaccid, asymmetric paralysis in the legs and torso (and up into the arms). Muscles undergo atrophy and become thin. If polio is contracted during childhood, the limbs affected are subject to retarded growth, which results in a shorter leg and/or arm on one side of the body. The torso changes because the one-sided paralysis of the muscles leads to scoliosis (curvature of the spine). Unequal muscle tension causes joints to become distorted and also leads to scoliosis and other deformations (scoliosis is also caused by osteogenesis imperfecta). A lack of strain on the bones can lead to osteoporosis (decalcification) accompanied by an increased risk of broken bones. Sensation is retained, but circulatory disorders with violet discolourations, sweaty skin and cold, painful feet may occur.
The muscles affected can develop either no strength or only little strength, which means this disease always impairs movement. 

Long-term consequences 
As is the case with other physical disabilities, polio can also have long-term consequences, such as osteoarthritis and joint deformations. In addition, ageing processes are accelerated and enhanced by excess stress loads and unequal load distribution. Post-polio syndrome also often occurs as people get older. New instances of muscle weakness (myasthenia), as well as pain, general exhaustion and fatigue, and new breathing and swallowing problems further restrict the already limited capacity to move and apply strength.

Driving with a disability: Osteogenesis imperfecta

Due to the shortening of the arms and legs, the steering column, steering wheel and accelerator and brake controls may need to be specially positioned, with appropriate support for steering and braking provided as well.

Our solutions

Paravan offers special installations that make it easy to reach and operate vehicle controls. These include raised pedals or manual controls for acceleration and braking. All controls can be adapted in line with your individual needs in order to ensure the best possible mobility.

Due to the constant danger of further fractures, it is not advisable to transfer from the wheelchair to the driver’s seat. When you use a car modified by Paravan, you can easily enter the vehicle with a wheelchair via a ramp and quickly connect to the wheelchair docking station and then hit the road.

Scoliosis (curvature of the spine, which also occurs in conjunction with poliomyelitis) affects sitting posture and balance when driving round bends. To ensure safe driving in such situations, Paravan offers restraint systems that can be adapted to your needs and that support your head, back and thoracic regions.
You’ll find further information on driving as a wheelchair user online, and you can also contact us directly via our contact form. 

Definition
Brittle bone disease 

Cause
Congenital bone development disorder.

Effects
Dwarfism, frequent bone fractures, severe deformation of the spinal column with effects on internal organs such as lungs, heart etc.; bone distensions due to extensive callus formation. 

Consequences
The injuries to the epiphyseal plates in the bones due to frequent fractures in childhood result in shorter arms and legs. Even minor falls or inadequate strain harbour the risk of new bone fractures.

Driving with a disability: Spina bifida

Owing to a short lower body, the wheelchair needs to be positioned in a way that ensures the individual concerned sits relatively low.

Our solutions

A major change to the steering wheel position might be necessary. Paravan can individually adapt controls and steering aids to your specific needs.
The impairment of the arms and hands in terms of proper functioning, strength and mobility means technical support will be required. 
Paravan provides such support with its drive-by-wire system – Space Drive II. The system uses a servo motor to convert the driver’s steering movements into strong active movements.

You can learn how to use these new control systems at a Paravan “Fun&Drive” Driving School. You’ll find further information on driving with a disability here, and you can also contact us directly online –we’ll be happy to help you! 

Definition
Split spine 

Causes
A malformation of the spine that can develop in the first weeks of pregnancy. The spine is not quite closed, leading to the malformation and improper functioning of the spinal cord. It is presumed that this condition is caused by a genetic disposition; malnutrition of the bones and dioxin contamination have also been proven to contribute to its occurrence. 

Effects
Partial or complete paralysis of the torso and both legs.

Consequences
Leg growth is slowed due to the fact that the legs bear little or no weight as a result of the paralysis. The individual’s body is shorter than normal because normal growth and development only occur above the height of the paralysis. Impairment of the arms in terms of function, strength and mobility does not depend on the height of the damaged vertebrae, but instead on the malfunction of the brain in the event of (nowadays uncommon) hydrocephalus (accumulation of cerebrospinal fluid in the brain). Malformation and misalignment of the legs, and curvatures of the spine, occur frequently (as is also the case with dwarfism).

Driving with a disability: Dwarfism

In view of the individual’s short arms and legs, a series of tests is performed to determine which technical modifications need to be made to the vehicle. An investigation is made as to whether, and with which pedal extension, sufficient strength can be applied to effectively brake the vehicle. A test is also conducted to establish whether the arms are long enough to turn the steering wheel all the way round or whether a mini steering wheel or bicycle handlebars will be required. Other checks determine whether the controls can be reached and operated (including a foot-operated parking brake if the vehicle is equipped with one). In addition, the individual’s hands and feet may be very small, meaning that technical support would be needed to grip the controls and hold the steering wheel.

Our solutions

You can take all of the necessary tests at Paravan. After you complete them, you can select the steering aids and adaptations you need, which will then be fitted in your vehicle. Paravan developed its Space Drive II technology (drive-by-wire) to ensure that you can safely operate a vehicle even if you have insufficient strength. This technology uses a servo motor that converts even weak steering movements made with computer-supported controls into strong active movements.
The result is an optimal way for many people with disabilities to fulfil their desire to achieve greater mobility.
You’ll find further information on driving with a disability here,and you can also contact us directly online –we’ll be happy to help you! 

Definition
Refers to men with a height under 150 cm; women under 140 cm. There are over 100 manifestations of this condition. 

Causes
Growth or metabolic disorder; the causes are only partially known, but they are known to be partially hereditary. Another possible cause is a pronounced case of brittle bone disease (see “Osteogenesis imperfecta”). 

Effects
Short arms, legs and torso. Small hands and feet, curvatures of the spine (also occurs with spina bifida).

Consequences
Muscle strength is usually sufficient. The main problem is the limited range of the arms and legs, and their restricted mobility.

Driving with a disability: AMC

Joint stiffness needs to be compensated for by technical means. Because joints stiffen in a bent position, the reach of the arms and legs is reduced, and this has to be taken into account when selecting steering equipment and the method for acceleration and brake pedal control.

Our solutions

Paravan offers you a selection of different vehicle controls, steering aids and pedal systems that were developed especially for people with disabilities.

Visit a Paravan “Fun&Drive” Driving School to go on a safe drive with our new vehicle controls! Our schools also offer you the opportunity to obtain a driving licence despite your disability. You’ll find further information on driving with a disability here, or you can contact us directly online; we’ll be happy to help! 

Definition
Congenital multiple joint curvatures 

Causes
Prenatal neurological development disorder that takes place between roughly the 8th and 11th week of pregnancy. Poliomyelitis is another childhood disease that can cause this condition. 

Effects
Impaired muscle development that prevents normal formation of the joints. This generally causes a significant reduction of the range of movement of the affected joints in the flexed and extended positions. 

Depending on the degree of severity, AMC is divided into 3 types: 

Type 1
Affects only the extremities. Either the hands and feet are mainly affected or all extremities are, including the shoulder and hip joints. These patients have no further disorders or malformations. Mental and sensory development is normal. 

Type 2
Type 1 changes are present, but there are also malformations of various organs (e.g. abdominal wall, bladder, head, spinal column). 

Type 3
In addition to stiff joints, children with Type 3 AMC also have malformations of the spinal column and of the central nervous system; these malformations can be very severe. 
 
Consequences
The damage to the musculoskeletal system ranges from individual joints on the arms and legs to nearly all joints, including the spinal column. The joints usually show a conspicuous misalignment, in particular in the hands and feet. Mobility and strength are impaired.