Toronto clinic paves way for disabled drivers to roll

JIL MCINTOSH FOR THE TORONTO STAR

With the help of physiotherapist Julia Filinski, patient Maurice Woods learns to get in and out of a Camry provided by the Toyota Motor Skills Clinic.

Jil McIntosh

SPECIAL TO THE STAR

How do you get into a car? Where do you put your foot, how do you place your hands, when do you twist your body?

If you're able-bodied, you've probably never given these questions a single thought.

But should your mobility wane, you'll not only have to think about them, but possibly have to learn an entirely new method. And that's the point of the Toyota Canada Motor Skills Clinic, located in Providence Healthcare, a rehabilitation facility in Toronto's east end that helps those who have experienced strokes, amputations and orthopedic surgery, or who require geriatric-related rehabilitation.

Believed to be the only program of its kind in Canada, the clinic started in 2006, thanks to a $300,000 donation from the automaker. It's used exclusively for patients at the facility, who learn how to get in and out of the Toyota Camry parked in the centre, and deal with a variety of surfaces they'll encounter on roads and sidewalks.

The room can be dimmed to simulate night lighting, and includes a programmable traffic light. Patients aren't taught how to drive, but how to get around.

"Before we had this space, we would take patients outside to coach them on getting in and out of a car," says Beth Johnson, Providence's director of communications. "In the dead of winter, or even in summer with the heat, it can be a challenge. To have an enclosed space has made a huge difference."

Prior to the clinic, the centre's therapists used beds and chairs to simulate getting in and out of a car. That's not the best solution, according to physiotherapist Julia Filinski.

"Some patients have cognitive issues and they need the visual to understand it," she says. "It's hard to simulate a door, a handle, the gap between the seat and the doorframe. (Now) it's a car, it's what they're using, it's realistic."

Save for a patch of artificial grass, everything else is real: there are curbs, interlocking bricks, two types of gravel, a cobbled path, and asphalt with road markings.

The seemingly minor variances in the surfaces can be major obstacles for patients, who may need to learn how to manoeuvre a wheelchair or walker over them, or who may not be able to lift their feet sufficiently to clear them.

"With little bumps in the road, you or I take it for granted, but to a patient that's a really scary thing," Filinski says.

"It can be a roadblock to them. If they go to visit a family member and there's interlock on the driveway, it might make them nervous and they won't go."

Before the clinic was installed, many patients were too self-conscious about going outside and learning to navigate on the sidewalks around the centre, or the weather hampered them. Without training, there's a serious risk that some will become housebound.

Staying home wasn't an issue for Maurice Woods; getting in and out of his vehicle was. The 67-year-old retired RCMP officer, who lost his left leg to complications from diabetes, will still be able to drive, but not before he learns to get into his truck when he's fitted with a prosthetic leg.

"It's just me, the dog and the truck," he says. "I'm innovative when it comes to things. They showed me how to stand and walk, and getting into a chair or onto a bed you're pretty level, but here, going into a car, you've got to stand and turn, and you don't have a lot to hold onto. You've got to know where to grab and push. Instead of going in with my left leg and sitting down, I have to turn my butt around and then swing in.

"The (artificial) leg weighs an awful lot. It makes a difference on your balance and how you transfer yourself."

While his Chevrolet Avalanche is considerably larger than the Camry in the clinic, "I've already figured out how I'm going to get in, using the transfer method," he says. "Once I get up on the running board, I'll get in and pull myself in."

Family members are often part of the clinic sessions, where they're also trained in transfer methods. Woods says that people mean well, but without knowing what to do they can make things worse.

"You're opening a door and they think you can't open a door because you don't have a leg, and they just get in the way," he says.

It usually only takes one or two sessions to learn the skills, but it makes all the difference.

"I'll be able to go anywhere I want. Some of the exercises you do upstairs are strange and you wonder why, but they're trying to get you to learn your balance," Woods says.

"Then you come down here and it makes it a lot easier. It all ties together very well."

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