The following information is based on personal experience and a couple of sources that are stated below. I have never lived outside of the United States therefore the information contained in this writeup may or may not be valid for other countries.

I have been disabled since I was about three years old. This has created a life where I have to adapt to situations in order to be able to function in the same manner as other adults. One of the biggest days of a teenager’s life is the day they get their learner's permit. This can happen at various ages depending on your state and your parents. I was 15 when I received mine. The only difference between myself and every other 15 year old in Lawrenceville, GA was that I had to learn to drive using hand controls.

Just for reference, my disability means I can’t walk or use my legs in any way other than to move them around and maybe kick things by accident. Thus, the hand controls were necessary so that I could interact with the pedals. One of the first things that one finds out when attempting to install hand controls in a vehicle is that the vehicle must have an automatic transmission. No respected automotive shop that installs hand controls will install them on a manual transmission because it is rather dangerous and quite possibly illegal. Here is why: My standard driving position involves one hand on the wheel and one hand on the hand controls. Just for those with less imagination than others, that means both hands are occupied and even if you could rig up a system that allowed you to depress the clutch, you still need a free hand to shift gears. I’m not saying it is impossible. In fact, I saw a racecar one time that had been outfitted with hand controls and it was a manual transmission. I am simply suggesting that for the average person an automatic transmission will be much less trouble.

Hardware
Hand controls are generally limited to one configuration. There are two rods that run the length of the steering column. Each rod is attached to a pedal by a clamp and several screws. There is a junction box of sorts attached to the base of the steering column just below the steering wheel. This junction box is the termination point of the two rods. The rods run into the junction box where they are attached to several ball and socket joints. There is a handle that extends from the left side of the junction box which is about 10” in length. This handle is the means by which the driver will control the vehicle. There are several different versions of the handle and each has its own form of operation. The differences between them are the way in which one causes the car to accelerate and brake.

Types of Hand Controls
  • Push Pull Control – Brake: handle pushed toward the floor, Accelerate: handle pulled up.
  • Push Right Angle Pull Hand Control – Brake: handle pushed toward the brake pedal, Accelerate: handle is pulled down in the direction of the driver’s left knee.
  • Push Twist Control – Brake: handle pushed toward the floor, Accelerate: handle twisted back toward the driver.
  • Quad Hand Controls – These hand controls can work in the same manner as any of the above but are fitted with an extra L-shaped bracket due to the nature of the injury.
Another fairly common device that is installed along with hand controls is a steering knob. These are simply knobs attached to the steering wheel to assist with steering due to the fact that disabled driver can’t use both hands to make sharp turns. I don’t actually use one of these knobs because I found that it got in my way. However, most of the disabled drivers that I know do use the knobs and have told me that the only reason I can go without the knob is because of my upper body strength. These knobs come in all shapes and sizes and there is even one that is simply an open metal loop for amputees who have a hook prosthesis.

Tips and Suggestions
  • In general, ambulatory drivers will not have any problem driving your car. The rods follow the steering column and the pedals are not completely covered by the clamps. I have had many people drive my car and none of them have had any trouble using the pedals.
  • DO NOT try to drive your disabled friend’s car with the hand controls. If you have already learned to drive that means you have learned to react to emergencies with your feet and your reactions with the hand controls will not be fast enough. The only excuse for an ambulatory driver to be driving with hand controls is if they are doing it in the interest of teaching a disabled individual how to drive. My parents learned so that they could teach me but now that I can drive on my own they refuse to even touch the hand controls.
  • Find an installer that you trust. Don’t attempt to do installation on your own unless you are very familiar with things of this nature. You don’t want to be driving down the road and suddenly lose the ability to use your pedals because your hand controls aren’t working.
  • I am personally suspicious of the so-called "portable" hand controls, that can be taken from one car to another. They just don’t seem very sturdy. YMMV
  • Pick a car that you will be comfortable driving. This goes for anyone, but is very good advice for disabled people as well. You know your limits and therefore you should know whether you will be able to drive a big van or if you will be better off in a small car.
  • Keep an eye on the screws and bolts. They will need to be tightened on occasion and you will notice because you will start to feel the hand controls become less reactive. For instance, you will have to move the handle further before the car begins to accelerate.
  • Don’t tighten them too much. You will also notice if this happens because you will start your car and the gas will already be depressed.
  • Note: Being able to drive leads to increased mobility and can lead to fun and excitement.
The most important thing to remember is to have fun driving your new car. It will be kind of nerve-racking at first. Eventually, you will get comfortable with your car and the hand controls and you will find that you have certain preferences and ways of dealing with them. One of the things I have noticed is that when I am trying to mess with the radio I have a habit of holding the gas down with my left hand and reaching up with the thumb of the same hand so that I can keep the wheel steady. This is not really safe but it is things like this that will eventually become unconscious habits. If anyone has any further questions regarding hand controls please feel free to /msg me or make use of my contact information provided on my homenode.

Sources and More Information:
http://www.mobilitymotoringprogram.com/equipment_handcontrols.htm
http://www.wheelability.com/
http://users.actcom.co.il/~swfm/

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