Sidewalk travel is very intimidating to some students yet no big deal to others. Before an instructor starts a lesson on block travel, he should make sure the student is able to detect and react to drop-offs on either side of the chair and to the front of the chair. Students should also have experience in navigating tight spaces. To travel on a sidewalk, students must navigate around people, posts, mailboxes, and numerous other obstacles. Nervousness, changes in lighting, glare, and other factors may cause the student to struggle when lessons begin outdoors. People tend to forget the skills they learned indoors when they move outdoors. If the student struggles with a particular task, simulating the problem indoors may help her generalize the skills from indoors to outdoors. Students often struggle to maintain their cane skills when they move outdoors. Before the block travel lesson begins, it is beneficial to review different cane techniques on outdoor walkways or driveways that are away from the street and traffic noise. Students who use auditory skills indoors to keep from hitting the walls may have a harder time maintaining their line of travel on sidewalks.

Travel Cautions

When students transition to outdoors, many change the speed at which they travel. Fearless travelers may increase their speed to the point that they are no longer able to use their cane to preview their path adequately. To prevent injury, always position the cane to the side of the chair instead of the center. Some students may need to reduce their traveling speed. Often, the student does not realize the potential dangers outdoors that were not present in familiar indoor environments. When the student travels in areas with consistent pedestrian traffic, encourage her to match the pace of the pedestrian flow. Instruct the student to avoid weaving around pedestrians and to slow down when she detects intersections. The instructor should determine if the student hears the end of the building line, which may indicate the need to slow down for an approaching intersection. The detection of a large tree may indicate an unlevel sidewalk because of tree roots lifting the sidewalk.

Hills, cracks, and travel distances require some people who use manual chairs indoors to switch to power chairs for outdoor travel. Sometimes the student’s doctor or physical therapist does not want to recommend a power chair. Medical professionals often think in terms of getting from the house to the car; they do not think about getting from the house to the bus stop, which may be farther away than the student can physically manage to travel. It can be very demanding physically to travel more than a block or two in a manual wheelchair. Invite the medical professional to a lesson or provide him with a full-length video of the student on the route. This helps the medical professional to understand the physical demands of outdoor travel. If the student is dependent on the long cane for detecting edges and drop-offs, the amount of time it takes to go just a few blocks in a manual chair may be restrictive. If this is the case, the student should seriously consider switching to a power chair.

Visual travelers should receive instruction at different times of the day and under different weather conditions. Students who travel visually during optimum lighting periods may have problems seeing landmarks at night, when the sun is too bright or the sky is too cloudy, or in other conditions that may cause problems unique to the individual. For example, one student did not initially have a problem visually detecting a curb on her route during her morning lesson. However, when she switched to afternoon lessons, the student could no longer detect the drop-off because the curb was in the shade. Another student suddenly had trouble getting home from school when daylight savings time ended and her bus dropped her off after dark. Fortunately, she had her cane with her and was able to use it to get home. One student with spastic quadriplegia who was an independent routine route traveler did well during lessons, but she struggled with the increased foot traffic that blocked her view of the sidewalk during her lunch hour.

Curbs and Cross Slopes

On narrow sidewalks, without grass between the sidewalk and the street, students who need to turn around should turn so that they face the drop-off instead of putting their back to the drop-off.

Watch video ST9a: Sidewalk Travel: Turn to face curb.

When traveling down the sidewalk, the wheelchair user should try to stay to the inside shoreline (closer to the buildings). On the outside shoreline (closer to the street), level changes are more severe than they are on the inside shoreline. The severe pitch of a driveway edge could cause the chair to tip over. Even if the chair does not tip over, it could suddenly change direction and cause the student—and practiced consumer—to veer toward the street.

Watch video ST9b: Sidewalk Travel: Stay to inside shoreline.

Lateral slopes, or sidewalks that slope across the desired line of travel, can be difficult to navigate. If the sidewalk slopes toward the street, gravity will pull the chair toward the street. In most cases, it is the front of the chair that moves toward the street; but if the chair faces uphill, the chair could roll backward down the slope. Manual wheelchair users may need to push harder on the rail on the downhill side of the chair. The grasp on the wheel on the uphill side of the chair may need to be tighter than normal to keep it from rolling down the hill. The hand motions may need to be shorter and choppier with less time than normal with the wheels freewheeling. For severe slopes, the student may be able to maintain a straight line of travel by pointing the front of the chair slightly down hill and pushing with just the hand on the downhill side of the slope. The uphill hand holds the wheel rail, allowing it to slide through the fingers at a rate that in conjunction with pushes from the downhill hand creates a straight line of travel.

Watch video ST9c: Sidewalk Travel: Navigation of cross slopes in a manual chair.

When navigating cross slopes, manual wheelchair users must be able to either use their feet to maintain the line of travel or have enough vision to travel without the use of a cane. Cross slopes require either the use of the legs or the use of two hands. Students who need a cane but cannot use their legs will have a difficult time navigating hills and cross slopes. They should consider switching to a powered chair or scooter for travel areas with hills or slopes, including curb ramps.

Watch video ST9d: Sidewalk Travel: Using feet and legs to navigate cross slopes in a manual chair.

Importance of Scanning

Low vision consumers, even those with years of experience, have a tendency to focus on the sidewalk in front of them and not look up. On familiar routes, no one knows when something might hang down in the path. Teach students—and encourage them to use—systematic scanning patterns to check their environments. Scanning also facilitates location of landmarks.

Low vision students who cannot use a cane must use systematic scanning patterns to monitor the sides of the sidewalk as well as to check the path in front of the chair.

Distance From Traffic

It is very important for the student to be able to determine the distance between herself and the passing traffic. The skill is important to maintain a straight line of travel when crossing driveways, streets, and other open areas. It is also important for areas where the sidewalk is either inaccessible or absent. The student must be able to determine independently how much space is available between the curb and the moving traffic to decide whether, or not, it is safe to travel on the side of the roadway.

Position the student at different distances from the traffic and have her guess the distance between herself and the passing traffic. Repeat this with the cars in front, on the left, and on the right of the student. It is not safe to assume that because the student performs accurately with the traffic on one particular side of the street that she can generalize the skill to the other side. The student should also practice under different lighting conditions, at various times of day, and without the use of her vision. Low vision students can start by estimating distances using their vision, but ask them eventually to close their eyes or use a blindfold to practice using auditory skills to determine their distance from traffic. During the course of instruction, the student may need to review the skill to make sure she remains accurate. Some students are accurate when taught the lesson, but make mistakes later when they focus on other skills. When traveling the sidewalk—or in the absence of accessible sidewalks, the side of the road—it is beneficial if the student maintains auditory alignment to the parallel traffic as well as recognizes the changing distance from the traffic. Maintaining the parallel line helps keep the student from traveling down the sidewalk like a pinball and from veering at driveways. Maintaining a consistent distance from the parallel traffic helps the student prevent, recognize, and correct veering.

Watch video ST9e: Sidewalk Travel: Determining distance from traffic.

Grass can mask the height of side drop-offs. The drop-off may appear to be an inch high; but if the grass is growing against the side of the concrete, it may mask that the drop-off is actually 4 or 5 inches high.

Manual chairs can be very difficult to use on hills. The wheelchair user must have the strength to push her weight up the hill and have the ability to maintain the line of travel at the same time. Again, the student must push with equal strength and duration on both wheels. If one arm is stronger or has a greater range of motion, the chair will veer. When the student reaches back to regrasp the rails, she should not reach back too far. Her movement will be stronger if she does not reach past the top of the rail. If the chair starts to move backward, the student must be able to grasp the rails tight enough to stop the backward motion. If the chair gets off line, the student may have to push just one wheel to get back in line.

Watch video ST9f: Sidewalk Travel: Climbing hills in a manual chair.

Hill climbers are devices that allow the wheels to roll freely forward, but when the wheels move backward, the ridges on the hill climbers dig in and keep the wheels from moving backward. When the consumer pushes forward again, the hill climbers release and allow the wheels to move.

Going downhill, the student must learn to control her rate of speed by applying pressure with the fingers on the chair wheel rail. When the left hand squeezes tighter on the left wheel rail, the chair turns to that side, and vice versa.

The following conditions may make it necessary for the student to abandon the sidewalk and travel in the street.

  • The sidewalk is too rough.
  • Curb ramps are absent or not accessible.
  • The sidewalk has stairs or large cracks that are not navigable.
  • Temporary or permanent obstacles, such as trashcans or light poles, are in the sidewalk.

When traveling in the road, the student should shoreline the edge. When there are vehicles parked at the side of the road, she should reassess whether or not there is room for her to pass. She may have to wait for an opening in traffic to get around the parked vehicles. Storm drains are treated the same as vehicles. Even with these obstacles, many consumers find it easier to travel on the street than the sidewalk.

Ramps at Buildings

Strategies for navigating ramps at buildings vary depending on the coordination and strength of the consumer, slope of the ramp, and the presence or absence of handrails. Students who use electric chairs and scooters need to learn when to adjust the chair speed/power to climb and descend ramps. On any given speed setting, the chair descends a slope at a faster rate than the chair moves on a flat surface at the same power setting. If the student forgets to reduce the power setting, she may lose control on ramps and run into the rails.

Ascents

Most practiced consumers who use manual chairs are able to push straight up a ramp that meets accessibility standards. Students should lean forward at the hip crease and keep their abdominal muscles engaged. This position keeps the student’s weight over the front wheels, which helps propel the chair up the ramp. If the instructor notices that the student struggles with the ramp, he can step up behind the student and brace the chair. The instructor should avoid pushing the chair, but he can help keep it from rolling back. If the student does not have the strength to make it all the way up the ramp, the instructor has two options. Tell the student to stop and the instructor can push the chair the rest of the way up the ramp, or the instructor can apply just enough pressure to allow the student to finish pushing up the ramp. When spotting, instructors should not push a chair without first making sure a student's hands are free of the rails. If the instructor pushes along with the student, the instructor must make certain he does not push the chair too fast for the student to keep up.

Watch video ST9g: Sidewalk Travel: Ascending building ramps in a manual chair.

If the student can use her feet on the ground, she has the option to turn the chair around and ascend a ramp backward. Instruct her to walk the feet back one at a time to keep the chair from rolling back down the hill. If she needs more strength, tell her to push with both legs and then move one foot back at a time. She must lean forward to keep the chair from tipping over backward. If she rolls back down the incline during transitions, recommend that she not move her feet and hands at the same time. Wheelchair users who use this technique should not let their feet get too far under the chair. The legs are weaker when the knees bend more than 90 degrees.

  1. The student starts with the feet near the chair and the hands reaching as far forward as possible.
  2. The student pulls back on the wheels and pushes with the legs at the same time, leaning forward to keep the weight over the front wheels.
  3. Leaving the feet in place to brace the chair, she moves the hands forward on the wheel rails.
  4. The student bends the knees to pull the feet back toward the chair.
  5. The student repeats this procedure until she reaches the top of the ramp.

Watch video ST9h: Sidewalk Travel: Ascending ramps backward in a manual chair.

If the ramp is too steep for the student to pull independently using the wheel rails, she may need to solicit assistance.

Ascending Ramps With a Handrail

If available, the student can use ramp handrails to help pull the wheelchair up the ramp. If handrails are present on both sides, the student may alternate pulling with one arm at a time, or may pull with both arms at the same time.

Watch video ST9i: Sidewalk Travel: Ascending ramps with handrails in a manual chair.

If only one handrail is within reach, then the student’s strength determines how she ascends the ramp. If the student is unable to push the chair wheel and pull on the handrail at the same time, then use the following procedure:

  1. The student puts one hand on the handrail, arm fully extended. The other hand is on the wheel rail near the 12 o'clock position.
  2. At the same time, the hand on the handrail should pull, while the hand on the wheel rail should push forward until the elbow locks. The student should try to remain straight in the process. Often, one hand or the other will move a greater distance. If the chair is not straight, the student should adjust the downhill hand, and try again with just that hand. The student may be able to straighten the chair by rotating her trunk muscles, pivoting on the arm that holds the handrail.
  3. Next, the student releases the hand on the rail and quickly reaches forward to a new grasp.
  4. Then, the student releases the hand on the wheel and quickly establishes a new grasp.

If the student is strong enough, she may be able to let go with both hands at the same time. However, still teach the sequence listed above in case she encounters an incline that is too steep for moving both hands at once. An alternate method would be for the student to use her feet and the handrail to back up the ramp.

Watch video ST9j: Sidewalk Travel: Ascending ramps with one handrail in a manual chair.

Descents

When going down building ramps, the student must be careful to control her rate of descent. Most consumers control the descent by grabbing the wheel rails—with arms fully extended—and allowing the rail to slide slowly through their fingers.

Watch video ST9k: Sidewalk Travel: Descending building ramps in a manual chair.

If the student has use of her legs, she can use them to control her rate of descent. When using the legs, the student either moves the legs in a walking motion or moves the legs at the same time and alternates repositioning the hands and feet. Until the student is able to descend ramps consistently and determine if the incline is steeper than her abilities, the instructor should be ready to stop the chair. The instructor monitors from the front, side, or back. From the front, the instructor may want to back down the ramp, with his hands ready to grab the armrests of the chair. Use the front edge of the seat if armrests are not available. If nothing else is available, use the student’s knees or upper shins; be aware that the student could get hurt or feel uncomfortable by having the instructor grab her legs. If the chair is too heavy and the instructor does not feel like he can stop it, he should try to redirect the chair to hit a wall or rail. If this is necessary, the instructor should create a sharp enough turn that the student’s hand does not smash between the wheel rail and the wall or handrail. If the instructor turns the chair too sharply, the chair could tip over sideways. Somewhere between 30 and 45 degrees is ideal. The footplate will hit the wall and help to slow the chair.

Descending Ramps With a Handrail

If available, the student can use handrails to control the chair’s rate of descent. If only one handrail is within reach, use the following procedure:

  1. The student puts one hand on the handrail, arm fully extended. She places the other hand on the wheel rail near the 12 o'clock position.
  2. The student allows the chair to move forward, down the ramp with both hands at the same time. The elbow on the handrail bends while the arm on the wheel rail extends.
  3. She quickly reaches forward with the hand on the handrail side until the arm extends fully.
  4. She quickly reaches back to the 12 o'clock position with the hand on the wheel rail.
  5. The student repeats this procedure until she reaches the bottom of the ramp.

Watch video ST9l: Sidewalk Travel: Descending ramps with handrails in a manual chair.

Whether ascending or descending, students often have trouble remembering which hand to move first. Arms with locked elbows are stronger than bent elbows. The student should move the bent elbow first, then the other arm.

Hill Climbers

An accessory called hill climbers allows the wheels to roll forward, but not backward. Hill climbers are essentially uni-directional brakes attached above the wheel. Push the lever back and the hill climber does not touch the tire. Push the lever forward and a ridged half circle glides over the forward moving tire. When the tire moves backward, the ridges grip and the hill climber rolls down to apply pressure, stopping the regress of the tire. The student has to be able to flip the hill climber on or off. If the hill climber remains on, the student cannot back up from a desk, obstacle, or make a backward pivot turn.

Correction for Veering at Driveways or Street Crossings

If the student veers away from the sidewalk after crossing a driveway, street, or other large open space, she will need to utilize a recovery method to correct for veering. Once the cane hits the curb or shoreline, instruct the student to pull up to the edge of the street and check both sides with the cane. If she does not feel the sidewalk with the cane, she must listen to traffic sounds and determine how far she is from the street. Once she decides whether to turn to the right or left, she turns and shorelines the curb. Once the sidewalk is located, she uses the landmarks determined for navigating tight spaces to know when to turn to get back on the sidewalk.

Watch video ST9m: Sidewalk Travel: Correction for veering.

Parking Lots

When traveling in parking lots, students need to be concerned about visibility. To make themselves more visible to drivers who are backing out of parking spaces, students may choose to drive down the center of the parking rows. If the student drives on either side of the lane, across the rear bumpers of the parked cars, a driver backing out of a space may not see the wheelchair. Bicycle flags help with visibility; but due to lack of durability and their hindrance when maneuvering tight spaces, such flags do not last long on the wheelchair. Some consumers keep an umbrella in their chair. It is useful for rain or shade, and it makes the wheelchair users more noticeable to automobile drivers.

Watch video ST9n: Sidewalk Travel: Parking lots.

Speed Bumps

Speed bump slopes are greater than the 12:1 maximum run-to-rise ratio required by the ADA. Therefore, most chairs do not have enough clearance to go over speed bumps.

Once the student detects the speed bump, instruct her to drive to either end of the speed bump and look for the space for rainwater to run through. The opening may be too narrow to drive through; however, if she gets one wheel on the speed bump and the other in the gap, it may be enough to allow the chair to clear the bump. In the absence of accessible sidewalks, speed bumps with a gap smaller than 36 inches violate ADA guidelines. A consumer may be able to get the size of the gap increased. Speed humps, speed lumps, and speed tables usually have sloped edges; but these still need to have at least one gap of 36 inches, preferably at both sides of the street or parking lot lane, not in the middle.

Watch video ST9o: Sidewalk Travel: Speed bumps.


« Chapter 8 9 TOC Main Menu Chapter 10 »