Testing The Empulse StreetJet With Tetra Option

Powered pull add-on devices for manual wheelchairs look much like a powered scooter, and have the same purpose – they allow you to have an active life with better mobility. Yet some of these devices aren’t practical to manage independently. If you have problems with your arms or core stability it can make things even more difficult to manage.

StreetJet with Quad Control

That’s why the Emplulse StreetJet now has a feature to enable many people with impaired arm use to be fully independent with a powerful long range pull device, even many people with tetraplegia.

In my experience, design details matter, especially with equipment designed to foster independence for people with restrictions in the use of their arms and torso. They make the difference between something working and being completely unsuitable. The details of individual skills are just as important, even among people with the same diagnosis. For example, one person with tetraplegia could have a little hand strength and another might not have active hand use at all, compensating with a trick of other arm movements to move the fingers passively. One person may have relatively good central stability in sitting while another may need much more support to sit up against gravity due to limitations in muscle use.

So, I was excited to try out the new Tetra StreetJet with tetraplegic option directly with wheelchair users. My demo model comes with the standard equipment, consisting of a customised throttle and brake lever plus One Touch docking clamps.

My first "victim" is a former patient and friend. Thomas has incomplete tetraplegia, but with his positive nature and incredible assertiveness (as well as a little bit of luck) he has managed to regain quite good trunk stability and limited hand function. He is currently even practising walking.

He transfers to the wheelchair, has the docking and operation briefly explained to him and then races off. You can tell that he already has a good deal of experience with pull devices from his own Empulse F55. He is enthusiastic about the extra power of the StreetJet and immediately starts suggesting small adjustments to his own F55 to make it easier to use. Even though he has made significant improvements in his hand use, he still finds it a little difficult to operate the F55.

Encouraged by this positive experience, I headed off to the Heinrich Sommer Clinic in Bad Wildbad, Germany. I was hoping to find more interested people at the rehabilitation centre for paraplegics and explore more challenging environments for the Tetra StreetJet.

• The first trial patient had been living with his tetraplegia for several years and had residual function in his left hand. He knew his body well, including how far he could lean out of a central sitting position without falling over. He also managed the Tetra StreetJet docking well with a little guidance and skilfully manoeuvred in the hallway and outside.
   
• Next, a very young patient tried the Tetra StreetJet. He was still struggling with the challenges of tetraplegic life. Not only was his blood circulation giving him a lot of trouble, but he also did not have good trunk stability and his hands had no finger function. Things started off more tricky for him - he needed help docking, as he could not lean forward and stabilise himself. When riding, he quickly realised that, with his long legs, reaching the handlebar was more difficult. This still worked well when riding straight ahead, but when turning, he could not lean forwards to steer into the bend without trunk control. And here we saw the difference that details and gravity make. The further his arms were stretched away from his body, the less strength his muscles had, and the harder gravity worked. He therefore got a lot of his limited steering movement from the shoulder joint.
  
  Fortunately, our custom-built Tetra StreetJet is available with an extended handlebar stem, which would solve this problem. I noticed that he had to operate the brake lever from his shoulder. The levers needed to be pressed down to accelerate and up to brake. However, he could not actively bend his wrist downwards as he lacked the necessary wrist flexion muscles. We adjusted the position of the levers for him, which made it easier to use the brakes.
   
• ​The last patient of the session arrived in an electric wheelchair and gave me concern. How would he manage to operate the Tetra StreetJet when we already had to make individualised adjustments? After my colleague transferred him to the active wheelchair, my worries dissipated. Courageous and curious, Toni explored the functions of the Tetra StreetJet with a mischievous look on his face. We helped operate the lever during docking, but it seemed that this was more a question of practice. Using the electric reverse gear, the StreetJet pushed itself into the holder and lifted the steering wheels into the air. Then all he had to do was close the clamps. The optional frame guard allowed adjustment of the clamps so that the limited force was sufficient to close them. He too lacked the flexor in his wrist, but he coped well with the steering.
  
  Despite his lack of trunk stability and hand function, he cruised straight off and we took a short trip outside. He rode up and down a steep hill and over lowered kerbs - no problem at all. He could easily adjust the direction of travel with the palm of his hand. However, I imagine that manoeuvring in this way in a very confined space is challenging. Toni’s eyes sparkled as he enjoyed his new freedom.

Not all tetras are the same and the new StreetJet adaptation should definitely be tested before buying. Nevertheless, it offers a great opportunity to enjoy mobility and flexibility, especially with limited arm strength.

Many thanks to the passionate therapists at the Heinrich Sommer Clinic and our test subjects for the opportunity to test the Tetra StreetJet in action!

 

ABOUT THE AUTHORS

Article written by Leonie Vinchhi, Clinical Advisor at Sunrise Medical Germany, and reviewed by Faith Brown, Clinical & Education Lead at Sunrise Medical UK & Éire