Bill Klaproth (Host): After stroke or serious injury, being able to drive and having that feeling of independence is a major goal of many patients. With information on the Tidelands Driver Rehab Program is Ian McClure, a certified driver rehabilitation specialist at Tidelands Health. Ian, thank you so much for your time today. So, getting back behind the wheel after stroke or serious injury, that has to be a wonderful feeling for many patients, right?

Ian McClure (Guest): Oh, absolutely. Getting your complete independence back is the ultimate goal of a driver rehab program. A lot of people talk about being independent with ADLs but full functional independence requires the ability to return to driving.

Bill: That’s for sure. So, how do you evaluate patients for this program?

Ian: The clinical or pre-screen evaluation that is performed for the driver rehab program consists of looking at upper extremity and lower extremity range of motion and strength, cervical range of motion--so we’re looking to make sure that you can check your blind spots, that you can manipulate the steering wheel, you can use the gas and brake pedal, and if you can't, what type of adaptive equipment is available to compensate for whatever physical disability you’re having. Also, looking at vision and depth perception and peripheral vision, color vision, road sign recognition, upper extremity and lower extremity sensation. So, we’re pretty much covering everything that you would need to operate a motor vehicle and if you’re having any problem, we will figure out what we can do to fix that problem or modify that problem.

Bill: So, Ian, if someone falls short in and they, say, not enough arm strength yet, do you say to them, “Work on that and let’s try again in a few months”?

Ian: Yes, that maybe the case. If someone is that extremely physically limited but most of the time there is a piece of adaptive equipment available to allow that person to return to driving anywhere from mechanical hand controls to electronic to drive-by wire, digital steering wheels, joystick driving, and electronic gas/brake hand controls. So, we’ve got something that requires a decent amount of upper extremity strength to use to something that a quadriplegic wheelchair driver could use.

Bill: Well, that’ amazing. I didn’t know there are those types of equipment available to help people like this. So, I know it depends on the person and situation, but, in general then, is there a timeframe for the program, is it like a six week program or a four week or it independently evaluated for each different individual?

Ian: It’s independently evaluated for each individual. Just like a fingerprint, everybody’s different and what one person needs that comes in with a diagnosis of stroke may be completely different than what the next one comes in with the same diagnosis. The amount of time can vary based on how quickly that individual learns. Also, if there are any type of impediments to learning based on where the stroke was or were there any type of learning disabilities prior to the stroke. So, all those things are taken into account when looking at and learning how to drive in a different fashion than most of us are used to.

Bill: So, is this a daily program, then? Do they come to you every day until they achieve the milestones when they’re ready to take the wheel on their own?

Ian: They can come every day. The program is available five days a week, Monday through Friday. Most people will come in once to twice a week; some people come in once a month, and we’ll practice certain skills at home as a passenger. So, it, again, really just depends on the individual and exactly what they need.

Bill: Do you go to their home to pick them up or do they come to you? How does that work?

Ian: Both. I cover the entire state of South Carolina, parts of Georgia and North Carolina as well. So, I do travel to see individuals who have no way to get to me. People who live in the local area or have somebody that can provide them transportation, they come here.

Bill: And, after the program, do people need to retake their driver’s test, and, if so, do you help prepare them for that?

Ian: Some people, depending on the type of adaptive equipment that is being prescribed, may require re-licensure so that you have the proper requirements on the driver’s license authorizing you to utilize that type of adaptive equipment, and some state department of motor vehicles require that you road test again using the equipment so that that can be properly licensed. I also am licensed by the state of South Carolina to conduct the state road test, so we can actually do the department of motor vehicles road test right here.

Bill: Oh, that’s wonderful that you provide that as well. So, speaking of equipment, do you take a look at the person’s vehicle then, and help determine what adaptive equipment they may need for that particular vehicle?

Ian: Oh, absolutely. Some equipment is vehicle specific. Especially when you’re talking about more of the electronic equipment, it really starts to become limited in vehicle selection. Most mechanical equipment can be put in any type of vehicle. So, a lot of times what I’m having to assist some individuals with is vehicle selection as well.

Bill: So, you’ll say, “Here’s several different vehicles to purchase where we can install this adaptive equipment because the car you currently have, it just won't work on that car”? Is that what you’re saying?

Ian: Exactly. Yes. That’s not true in most cases. Like I said, most mechanical equipment will fit in most vehicles. It’s when you start getting into the high-tech electronic equipment that the vehicle selection becomes more limited.

Bill: And then, do you suggest a dealership or a service station that can install this equipment?

Ian: Yes, there are certified mobility equipment dealers that are certified through the National Mobility Equipment Dealers Association that are specially licensed to install this type of equipment. It’s not just any regular mechanic’s service station that can actually install this level of equipment because you are modifying the primary driving surfaces of a vehicle.

Bill: Right. And so, you’ll help them do that. And, will you help them find this equipment to buy then too? So, it’s a one stop shop. “You’re going to need this. You can purchase this there and have it installed here.” So, you really help them through the whole process?

Ian: Yes, absolutely. What I do at the completion of their training is actually write what’s called a “vehicle modification and adaptive equipment prescription”, and they take that prescription to a mobility equipment dealer and the mobility equipment dealer will install the equipment or modify the vehicle exactly as I have prescribed. In fact, a mobility equipment dealer will not install any type of adaptive equipment unless you have a prescription from a certified driver rehab specialist or you already have the restrictions on your driver’s license authorizing you to use that type of equipment. Mobility equipment dealers will not even accept a prescription from a physician for that type of equipment any more.

Bill: And, being a certified driver rehabilitation specialist, you can write that prescription?

Ian: Exactly.

Bill: Wow, that’s really a nice service that you offer there. So, Ian, if you could wrap it up for us. If someone is interested in learning more about the driver rehab program, what should they do?

Ian: They can call me here at Tidelands Health NextStep Rehab Services at Murrells Inlet. My phone number is area code 843-652-8240 or they can email me at ianmcclure@tidelandshealth.org.

Bill: Well, that’s great information and thank you so much for your time again, today. It sounds like a really beneficial and useful service that you and Tidelands provide. So, thank you again for your time. And for more information about Tidelands Health physicians, services and facilities, visit www.tidelandshealth.org. That’s www.tidelandshealth.org. This is Bill Klaproth. Thank you so much for listening.