On the Road Again Part 2: Equipment and accessories for driving

If you haven’t read Part 1 of this segment I recommend starting there. In this segment I am going to discuss examples of accessories and modifications that can be made to a vehicle to make it more accessible and to compensate for impairments such as difficulty transferring, needing to remain in a wheelchair or bring it with you, hand or leg weakness and more. 

As mentioned in Part 1, there are several websites that can help you get connected with a mobility equipment provider in your area and a Certified Driver Rehabilitation Specialist (CDRS). The CDRS will not only test your fitness for driving but will also make recommendations for adaptive equipment, provide opportunities to train and practice with the equipment and connect you with a local vendor. 

adaptive driving
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Keep in mind, the photos and links below are meant to provide an example of what is available to you but is not promoting any specific brand or manufacturer. Additionally you should always consult a licensed mobility dealer to install, train and select appropriate adaptive equipment for your vehicle.

Wheelchair Van/SUV/Truck

A wheelchair van or vehicle is a vehicle purchased from a dealer that is converted to be wheelchair accessible. These vehicles may provide side entry or rear entry and typically involve a lift or ramp to access the vehicle. In this instance the wheelchair is meant to stay inside the vehicle during transportation either in the passenger or driver position. 

Scooter/Wheelchair Lift

These are mechanical lifts that raise your wheelchair or scooter off of the ground for either storage inside or outside of the vehicle during driving. Several options are available to transport the vehicle just behind the trunk to allow for full use of the interior space while others will actually transfer the chair inside the vehicle. There are even lifts that will hoist a chair into the back of a pickup for transport.

Check out the Mobility Works website for visuals and in depth information about these different types of lifts

Wheelchair Ramps

Wheelchair ramps extend out from the back or side of the vehicle to allow the driver to enter the vehicle in their chair or for someone to assist by pushing the chair, sans passenger, into the vehicle for transport.

Tie Downs

The main purpose of tie downs is to secure a wheelchair in place inside the vehicle and allow an occupant to safely ride as a passenger or drive the vehicle from inside their chair. There are 3 main types of tie downs: manual, retractable or automatic and should be installed by a certified mobility dealer. The manual and retractable tie downs consist of a 4 point strapping system (2 in front, 2 in back). These two options require the wheelchair user to have a companion or assistant present to attach the tie downs to the proper position on the chair and then ensure that the straps are tight and secure. The automatic tie downs consist of an attachment on the bottom of the chair that allows the user to simply drive their chair into a channel locking system installed in the floor of the car which locks it into place. A button is then pressed later on to allow the user to disengage. Not every chair can be utilized with this type of system. Because of the dangers of serious injury in the case of a car accident or unexpected movement of the car it is vitally important that proper training by a certified professional be undertaken for anyone who will be involved in using these or installing these devices. 

Mobility blogger Katie Cummings writes an informative piece comparing different tie down systems in this blog.

Hand Controls

Hand controls allow a driver to accelerate and brake using their hands instead of their feet and are available in left and right hand controls. These devices are great for anyone who has fair to good dexterity in their hands and arms but poor sensation, coordination or strength in their lower body. 

Extension Controls

Extension controls allow the driver to better reach foot pedals, turn signals, gear shifters, parking breaks or any other levers needed to operate the car. If you think about where in your car these levers are typically located you can imagine it would be difficult if you could not use the hand on that side to operate the lever or could not reach far enough to access it easily. These accessories can provide better access to each of these mechanisms

Mobility Innovations is one company supplying a variety of extension controls to adapt your vehicle.

Left Foot Accelerator

As a physical therapist in a neurologic rehabilitation setting I have come across many people who have had a stroke or brain injury, for example, that affects their right leg making it difficult or impossible to access the accelerator and break. Sometimes these folks take it upon themselves to switch to using the left foot. If you’ve ever tried to hit even the break with your left foot while driving you will quickly realize, if you have been driving for some time, that your left side often is not nearly as coordinated for this task until you have had a lot of practice. Additionally, reaching across to the accelerator on the right side is difficult and frankly, unsafe. So in this case the left foot accelerator may be the hero of the day. With the accelerator on the left side one can easily use their left foot in place of their right. The good news with this is that is does not eliminate the right foot accelerator and a toggle or other mechanism can be utilized to switch back and forth which allows another driver to use the car in its traditional set up.

Spinner Knobs and Steering Wheel Accessories

If grasp is an issue for you there are ways to adapt and change the steering wheel to ensure a safe and secure grip. These accessories mount onto the steering wheel and provide alternate ways to secure the hand to the steering wheel. For example, an amputee driver ring provides a place for an amputee to secure a hook prosthetic onto the steering wheel while a Tri Pin consists of 3 pins in a triangle formation that one can slide their hand into allowing for stabilization of the hand and wrist onto the steering wheel. Once again, a certified mobility equipment provider or CRDS is the best person to help you decide which accessory is best for you. 

Turning/Swivel Seats

Imagine if your car seat could turn 90 degrees out the door of the car and then simply lower down until your feet hit the floor. Picture being able to simply turn and sit right down onto it without having to try and scoot inside the vehicle. Helpful right? Well this convenience actually exists in the form of turning or swivel seats. These are car manufacturer specific and need to be installed by a trained professional but can make transfers into and out of the car exponentially easier. 

Check out the Turny Evo by BraunAbility as a great example of this car modification.

Electronic Driving Aids

This is where the magnificence of modern technology meets the adaptive driving world. Electronic driving aids allow a user to perform tasks such as acceleration or brake, turn signal operation, gear shifting, operating wipers, fan controls, ignition and lights with the touch of a button. Gas, brake and steering can even be controlled with a joystick in some instances. As you can imagine, this specialized equipment can open up driving to almost anyone that has the cognition and desire to gain independence in driving.

Once again, Mobility Works has a great list of available Electronic Driving Aids for you to look through.

Photo by ThisIsEngineering on Pexels.com

On the Road Again: Options for driving adaptations

For many, cars are their primary mode of transportation. Whether you are a driver or a passenger, being unable to access your vehicle can be a huge hit to your independence. Examples of issues that may prevent someone from driving easily or at all include having difficulty grasping and manipulating a traditional steering wheel, being unable to use the right foot on the gas/brake pedals; need for more trunk support than a traditional car seat provides or difficulties transferring into a car seat. As a passenger, being unable to transfer and to sit in the car are two possible roadblocks for using personal transportation versus an accessible ride service. 

Whether you are a teenager learning to drive for the first time or a seasoned driver hoping to stay or get back behind the wheel, there are many options to adapting a vehicle to make it more accessible. 

A great first start to this process is seeking out an Occupational Therapist or Certified Driver Rehabilitation Specialist (CDRS) that can assess your fit to drive. Vision, cognition and neuromotor control are some of the areas that will be assessed and the tests administered will give an indication if you are ready to hop behind the wheel in a regular car with no modifications, undergo training and assessment for appropriate vehicle adaptations or if remediation efforts such as additional therapies or other practice needs to be implemented first. 

Options for driving adaptations
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To locate a Certified Driver Rehabilitation Specialist or mobility equipment dealer in the United States, The Association for Driver Specialists website (ADED.net) is a great resource.

Insurance does not often provide coverage for these items but some programs like Workman’s Comp, Vocational Rehabilitation or the VA may. Some car manufacturers offer Manufacturer Rebate Programs if you buy or lease a new car from them which will provide money to fund vehicle modifications to that car.  Additionally, you may find small grants to be available through disease or injury-specific organizations and associations. 

Below is a list of examples of different modifications and adaptations that can be made to your vehicle. Check out On the Road Again Part 2 for more details about the equipment.

Wheelchair lifts


Tie downs and locking mechanisms to ride in or drive from wheelchair 

Hand controls to operate the gas/break 

Swivel seats for transferring into/out of car

Parking brake extension

Turn signal crossover

Spinner wheel

Left foot accelerator

Electronic driving aids

**The Adaptive Driving Alliance provides a list of consumer resources to assist you in your mobility product decisions.

***Bonus! Take a listen to the Rehabilitation Reimagined Episode 6 with Lea Bertoni, OTR/L, CDRS from Driving to Independence to learn more about working with a Certified Driving Rehabilitation Specialist!