Abstract: An apparatus or attachment to a wheelchair to allow a patient to move the chair in a forward, reverse, right or left direction. The apparatus comprises a push rod, spring mounted, actuating at a first end a pawl capable of engaging a ratchet axially mounted on a mounting plate attached to the side of the chair. A hand operated shift element activates a cam roller to move the push rod at a second end in a vertical direction. A bicycle type multi linked gear and chain connects the ratchet to the rear driving wheels of the chair. Movement of the push rod in its vertical position changes gears and a handle attached to the top of the push rod assembly permits movement of the chair by direct drive to the bicycle chain. A linkage connecting the push rod housing to the front mounted caster wheel allows the patient to move the caster wheels by turning the push rod handle connected to its housing.