Lose the Pedals, Keep the Keys: Hand Controls for CMT

CMTA community member using electronic hand controls in their car.

CMT often reaches your feet before it reaches anywhere else. Foot drop, weakness in the ankles, and loss of sensation in the soles are some of the earliest and most common signs. For many people this means frequent tripping and a slower walk. For drivers, it means losing the feel of the pedals.

Ruth Levitan, a person with CMT, described it this way, “My adventure with hand controls started with the realization that the numbness in my feet had progressed until I could no longer feel the pedals when I was driving. With the loss of the sense of proprioception in my feet, it became harder to judge the distance between the brake and accelerator pedals. What if I had hit another car, I thought. What if I should miss the brake and hit a pedestrian?”

Levitan was feeling so anxious, she almost gave up driving. Someone at her local CMTA Branch meeting suggested she try hand controls instead. That suggestion saved her independence.

If your feet are getting weaker, slower, or harder to feel, hand controls are worth a look.

How do car hand controls work?

A hand control lets you operate the brake and accelerator with your hand instead of your foot. The pedals stay in place, but you do not press them with your feet. A lever mounted to the left of the steering column connects to the pedals by metal rods. When you move the lever, the rods press the pedals for you.

The most common type of hand control is push/pull. You push the lever forward to brake, and pull it down (or back, depending on the design) to accelerate. Other styles include push/right-angle, push/twist (like a motorcycle throttle), and push/rock. Which pattern works best depends on your hand strength, grip, and any thumb or finger involvement from CMT. A driver rehab evaluation will help you choose.

Because you steer the car with one hand, a small spinner knob is usually added to the steering wheel. It lets you make full one-handed turns without crossing your arms. “With only my right hand to steer with, I was unable to turn the wheel hand-over-hand as I usually did, but with a knob installed on the steering wheel, I could turn the wheel in a full rotation with one hand,” Levitan said.

Mechanical car hand controls are the standard. They are reliable, mostly maintenance-free, and do not require working power steering or power brakes to function. Electronic hand controls use sensors instead of rods and take minimal force to operate, which can matter if you have hand weakness or grip issues. They cost more and require professional electrical installation.

There are also smaller add-ons that may be useful by themselves or in combination with a primary hand control including left foot accelerators (a pedal added to the left side so you can use your stronger foot), pedal extensions, and steering wheel grips shaped for limited grip strength.

Learning to drive with hand control

Switching from feet to hands is a relearning project and most drivers need formal instruction.

The right place to start is a Certified Driver Rehabilitation Specialist, or CDRS. A CDRS is typically an occupational therapist with extra training. First step is a clinical evaluation to check vision, reaction time, range of motion, strength, and cognition.

Next comes an on-road evaluation in a vehicle equipped with hand control. The CDRS will recommend the type of hand control that fits your body, and train you to drive with it. The Association for Driver Rehabilitation Specialists (ADED) maintains a directory of CDRSs by state.

Training on a hand control is like learning to drive for the first time. Levitan started in an empty parking lot with hay bales, “I took the driver’s seat and he coached me on how to ease up a tiny bit on the brake so that the car began to roll forward, then to press the lever slightly down to accelerate, then up again and forward to brake. With my heart in my mouth I went forward while he gave me directions.”

Learning to turn was Levitan’s next assignment. At first, it wasn’t easy for her to coordinate the left hand controls with turning the wheel using the knob. Gradually Levitan’s turns became smoother, “as my brain formed new synapses, and my hands learned to do what my feet used to do,”

Levitan was on the freeway by her fourth lesson.

Most people need somewhere between four to 10 hours of behind-the-wheel training before they feel confident in normal traffic. Learning to parallel parking and reverse may take longer.

Many states require a road test or a driver’s license restriction code. Your CDRS or local DMV can tell you what your state requires. Notify your auto insurance carrier about the change. Most carriers do not raise rates for hand controls.

How much does a car hand control cost?

Costs can vary widely, so plan on a range rather than a single number.

Basic mechanical hand controls usually run between $500 and $2,000 for the equipment itself. A spinner knob is another $50 to $200. Professional installation by a qualified mobility dealer adds roughly $300 to $1,000, depending on the vehicle.

Electronic hand controls are more expensive. Equipment runs from about $1,000 for entry-level systems to $6,000 or more for advanced digital systems with accelerator rings. Installation costs are higher because the installer has to wire into the vehicle’s electrical system. A full electronic install can total $5,000 to $12,000 or more.

A CDRS evaluation typically costs $300 to $750. Behind-the-wheel training is usually billed by the hour, in the range of $100 to $200 per hour.

There are several sources to offset the cost. The major automakers run mobility reimbursement programs that offer reimbursement for adaptive equipment installed on a new vehicle. As of 2026, Toyota, Ford, Honda, and most others reimburse up to $1,000. GM reimburses up to $1,500. The reimbursement is paid after install, on a vehicle bought or leased new, and you keep the manufacturer’s warranty. Ask the dealer about the reimbursement program before you buy.

State vocational rehabilitation agencies often pay for adaptive equipment if the vehicle is needed to get to work. Veterans with a service-connected disability may qualify for the VA’s Automobile Adaptive Equipment grant, which covers the cost of equipment and installation.

How to get a car with hand control

Get evaluated by a CDRS first, before you buy equipment or a vehicle. An evaluation will tell you which type of hand control fits, if you also need a left foot accelerator or modified steering, and whether your current vehicle is a good candidate for installation.

Pick the vehicle second. Not every car is a good fit. The driver’s seat needs enough room around the steering column for the lever. Power steering and power brakes make hand-control driving much easier. Bench seats and small cars are harder to retrofit.

If you are buying a new car, work with the dealer’s mobility coordinator (most dealerships have one, or can reach the manufacturer’s mobility program directly) to confirm the model is compatible.

Use a certified dealer from the National Mobility Equipment Dealers Association (NMEDA) for installation. NMEDA members go through a quality assurance audit covering technician training, insurance, and safety practices. A bad install can be dangerous. This is not where to save money on a discount shop with untrained mechanics.

Once the hand control is installed, notify your DMV and your insurance carrier to have any restrictions added to your license. Schedule a follow-up training session with your CDRS if your state requires a behind-the-wheel test.

From awkward to automatic: crossing bridges under hand control

Having CMT changes a lot of things. Driving does not have to be one of them. If your feet are no longer reliable on the pedals, consider cruising with a hand control.

“Actions that at first were awkward and took conscious concentration, began to be automatic,” Levitan remembers. “The first time I drove across the Bay Bridge into San Francisco was a great milestone, and I realized that I would not have to give up the independence of driving.”