NBCOT Occupational Therapy Certification Practice Exam

For an individual with an L4 spinal cord injury wishing to drive independently, which adaptive equipment is most appropriate?

1. A palmar cuff for the steering wheel

2. A spinner knob on the steering wheel

3. Pedal extensions for accelerating and braking

4. Hand controls for acceleration and braking

The correct answer is: Hand controls for acceleration and braking

For an individual with an L4 spinal cord injury, the use of hand controls for acceleration and braking would be the most appropriate adaptive equipment to enable independent driving. An L4 spinal cord injury typically results in lower limb paralysis, which compromises the individual's ability to use the foot pedals effectively. Hand controls allow the driver to operate the vehicle by using their hands instead, making it possible to accelerate and brake without needing to rely on foot movement. The importance of hand controls lies in the control and precision they offer for operating a vehicle when lower body function is impaired. This adaptive equipment can be customized to accommodate the specific needs of the individual and can often be installed in most standard vehicles. In contrast, alternatives such as pedal extensions may not address the lack of lower limb function effectively, and equipment like a spinner knob or palmar cuff, while helpful for enhancing steering control, do not facilitate acceleration and braking, which are critical for safe driving. Thus, hand controls provide the essential functionality required for safe and independent driving for someone with this type of injury.