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If you have lost the use of one of your legs, you may need to consider:

• an automatic transmission car which overcomes left leg disability without the need for adaptations, eliminating the use of the clutch

• if you have a right leg disability, the accelerator on an automatic car may need shifting to the left side of the foot brake. Specialists can fit detachable pedals, which enable the car to be used in both ways

• if you want to stick to a manual gearbox, you may need to convert to hand controls

• if you have a left leg below-the-knee amputation you may find that you can drive as usual

• if you have a right leg below-the-knee amputation, you may need a hand-controlled accelerator or cruise control to relieve your right thigh of strain

If you have lost the use of both legs, you may need to consider:

• if you are driving a car with a manual gearbox, you can get manually-controlled clutch, footbrake and accelerator

• automatic cars can be adapted with manual footbrake and accelerator controls, either as two separate controls, or as single combined controls

• problems stemming from any weakness in the arms or shoulders can be overcome by fitting a manually-controlled, vacuum-operated brake

• steering assistance might be required depending on individual needs

• tetraplegic drivers should have automatic cars with power-assisted steering

• the hand not engaged in steering operates braking and accelerating controls, which can be moved round the wheel in a plane parallel to the wheel itself

• cam-type hand-brakes can be operated without requiring finger movement
  
  

• a steering wheel knob is normally fitted on the rim of the steering wheel

• if you have an artificial limb fitted below the elbow you can drive the car with a minimum of alteration, by means of a special concave limb attachment which allows you to control the vehicle by fitting over the steering wheel knob or the gear lever

• if you are driving with only one arm, automatic transmission is essential: by eliminating the problem of changing gears, your left foot is free to operate secondary controls such as windscreen wipers

• you need to mount direction indicators and the horn so that you can reach them with your fingers without having to let go of the wheel. Alternatively, these can be controlled with foot controls

• the original manufacturer's layout will limit the degree of adaptation customised to your preferences

• centrally placed handbrakes are no problem for left-handed drivers, though if you are right-handed you need to find a car with a handbrake on the right, or to have the handbrake moved over to the right.

• joystick steering. These can be fitted to most vehicles with rack and pinion steering on either side, or elsewhere.

Even if you have lost the use of both arms, you can still drive. It necessitates a complete redesign of the car controls, but can be done. A great deal of research has resulted in the development of control systems which do not require use of the hands or which require only minimal use of perhaps the vestige of an arm or finger. Alternatively, you could try a foot steering system.

If you have limited strength and dexterity, you may want to consider:

• power-assisted steering is often required; specialists can fit this to many normal cars

• special power-assisted hand controls have also been developed

If you have rigid or limited neck movement, you may want to consider:

• additional mirrors

• use a panoramic mirror or a four/five section Subascoper mirror

• mirrors fitted on the inside of the windscreen by means of suction pads enable you to see right and left at crossroads

• a nearside wing-mirror is indispensable for reversing round corners and for judging the distance from the kerb

• use an overtaking mirror also for checking the offside of the car before starting and reversing.

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