How To Select the Greatest Wheelchair Cushion for You

What sort of cushion to make use of is without doubt one of the most necessary selections you make when organising your wheelchair. The best cushion can hold your pores and skin protected, enhance your posture and improve your stability. The improper cushion can result in strain accidents, spasticity and ache.

Cushions are available in all differing types, from foam, to air, gel, honeycomb, {custom} and extra. So which is the perfect for you? Like with most mobility aids, the perfect wheelchair cushion relies on your physique, your stage of mobility and your every day life. Listed here are 9 issues to think about when getting your subsequent on a regular basis wheelchair cushion.

Strain Aid

That is what my rehab therapist advised me to place “on the highest” of the checklist. Joking, but it surely’s true. Strain reduction is commonly the highest concern of therapists who do seating evaluations. If in case you have restricted or no sensation, have handled strain accidents earlier than, or have issue repositioning your self, discovering a cushion that evenly distributes strain is important to retaining strain sores away.

Customized cushions like Journey Designs Customized 2 (see Cushion Sorts, under) typically present essentially the most even strain mapping — the place you sit on an digital pad that plots areas of high and low strain. ROHO air cushions are available in a detailed second. Necessary word: Many wheelchair customers overinflate their air cushions, which helps stability however negates the strain distribution advantages. For correct strain reduction, you need to sit within the air cells, not on high of them.

Gel cushions, like the ever-present JAY J2, typically rating within the midrange for strain reduction, as do lesser-known Supracor Stimulite cushions created from a rubberlike honeycomb construction. Off-the-shelf foam cushions typically rating worst for strain reduction, however there are enormous variations based mostly on the form, density and contour of the froth. Strain mapping of various supplies can fluctuate so much based mostly in your physique sort and seating place. So, if strain reduction is your main purpose, it might be splendid to map quite a lot of cushions with a certified therapist.

Stability

Once you switch off the strain map and go about your day, stability turns into an necessary a part of choosing the appropriate cushion. A high-profile ROHO that maps nice and feels good while you’re upright would possibly lose a few of its luster while you bend ahead to choose one thing off the bottom and the change in strain vaults you out of your seat. Single-compartment air cushions supply the least stability of any cushion sort. Air cushion producers fight this downside by providing cushions that may lock the airflow between completely different compartments. ROHO affords cushions with two compartments (Twin Compartment) and 4 (Quadtro Choose). Ki Mobility’s StarLock cushion enables you to lock the air in each cell. Multicompartment air cushions supply higher stability than single-compartment, however they’re nonetheless not as secure as most different cushions.

Foam cushions usually supply the perfect stability. Contoured foam affords extra stability than flat foam, and a {custom} foam cushion just like the Journey Designs Customized 2 will lock you into your seat higher than another cushion available on the market. (Extra on this under.) Stimulite and gel cushions additionally supply good stability. Mixture cushions — just like the ROHO Hybrid Choose, ROHO Hybrid Elite, Vicair Energetic O2, JAY Fusion with air insert or the Permobil Corpus Ergo Air for energy wheelchairs — supply the soundness of froth with a few of the pressure-distribution advantages of air cushions.

Postural Assist

If in case you have wonky hips, scoliosis or another postural points, then postural assist or correction may be an necessary consideration. Most cushion sorts, whether or not gel, foam, mixture or honeycomb, include contoured choices designed to maintain your legs in place and your pelvis in a impartial place. Multicompartment air cushions may also accommodate some postural points. How properly they work relies on your physique’s particulars and your stage of operate. In a nonparalyzed physique, muscle mass do the work of postural assist. The less working muscle mass you’ve gotten, the extra chances are you’ll profit from exterior postural helps.

Customized cushions, like a one-off from a seating clinic or one from Journey Designs, can present glorious postural assist and correction. However do not forget that posture isn’t a static factor: In case you’re going with a {custom} cushion, be ready to do common follow-up visits along with your seating skilled to make it possible for your cushion nonetheless matches your physique. A {custom} cushion that not matches correctly may cause strain accidents, edema and/or elevated spasticity. Additionally, do not forget that the extra postural assist you’ve gotten, the extra you’re going to be locked right into a single place. This may be nice for some. For others who’ve the operate to maneuver round extra — like scooting ahead in your seat to dress or attain for a cupboard — being locked in place isn’t at all times a very good factor.

Transfers

Air cushions suck for transfers. They don’t present a secure floor for a hand or sliding board while you need to get out of your chair. In fact, this may be overcome with energy and method, but it surely does add a level of issue. Foam, gel, honeycomb and mixture cushions all present a extra secure floor to switch from. Cushions with a deep seating pocket — which may be nice for strain immersion, stability and postural assist — may also make transfers tougher as a result of you need to get your butt again out of that pocket.

Sturdiness

With a foam cushion, you have to be checking for compression or deformation after a 12 months of use. In fact, they’ll and do last more, however the extra that foam compresses, the much less efficient it’s for strain discount, and uneven compression may cause stability and postural modifications. Air cushions can final for years, or you possibly can poke a gap the primary week you’ve gotten it and out of the blue be sitting in your seat rails. If in case you have an air cushion, at all times have a backup and patch kits — which is doubly necessary while you’re touring. Gel cushions used to begin getting stiff after a few years, though producers say that is much less of a problem now. Nonetheless, when you have both a gel or honeycomb cushion, it’s a good suggestion to begin eager about a brand new one on the two-year mark.

Adjustability/Modifiability

Multicompartment air cushions are easy to positive tune. You unlock the airflow valve, shift your weight and positioning, and lock it once more. Vicair cushions, which have compartments stuffed with air packets, are equally simple to regulate. To let your self sink into a bit extra, take away some air packets. To make a bit firmer, add extra packets.

You may take an electrical carving knife to foam or honeycomb cushions to chop out a bit with out compromising the integrity of the remainder of the cushion. Why would you ever need to do this? Perhaps you’re downgrading your cushion from on a regular basis use to sports-only and you could modify it to suit on a handcycle or in your sports activities chair. Perhaps you’ve had a strain sore in your coccyx. In case you minimize a notch the place your coccyx usually rests, you possibly can let it free-float.

Mixture cushions are troublesome to change, though the air cells on the again do supply some adjustability. Cushions with a gel pocket are additionally onerous to change or regulate. In case you can’t or don’t need to make structural modifications to your cushion, Stimulite affords a wedge that you should use to lift the entrance by 1 or 2 inches.

Cleanability

The way you clear your cushion won’t be one thing you concentrate on, however you’ll be glad you probably did when an accident occurs. Air cushions are created from rubber and are simple to spot-clean or handwash. Vicair O2 cushions may be machine-washed, and Stimulite cushions may be machine-washed and machine-dried. Gel cushions are likely to have waterproof covers. Some foam ones do, others don’t, so when you have incontinence points, it’s price checking. Waterproof covers do inherently restrict breathability although. Cushion producers say airflow is necessary, particularly in case you can sweat, are lively and/or reside someplace humid.

Weight

Weight is an under-discussed consideration for cushions, at the least for guide wheelchair customers. You may spend hundreds of {dollars} to scale back weight by just a few kilos with superior body supplies however then negate all these weight financial savings by placing a heavy cushion on it. Don’t select a cushion solely based mostly on weight — however in case you’re waffling between two comparable choices, the burden can “tip the scales.”
Gel cushions are the heaviest. A 16-inch-by-16-inch JAY J2 Deep Contour weighs a whopping 6.27 kilos. Sarcastically, air cushions aren’t that gentle both. A 16-inch-by-16-inch high-profile ROHO weighs 4 kilos. Honeycomb and mixture cushions are sometimes within the midrange. A Stimulite Contoured weighs 3.25 kilos and a ROHO Hybrid Choose, 3.2 kilos. Foam is often the lightest. A Ki Mobility Axiom S cushion weighs about 2.2 kilos, relying on dimension, and a Journey Designs Java is available in at 2.3 kilos. The Journey Designs Customized 2, additionally foam, is the lightest wheelchair cushion we’ve discovered, coming in at 1.8 kilos.

Value

I do know, every thing is dear. Most high quality wheelchair cushions retail within the $450-$550 vary, which might carry an insurance coverage copay of $100 or extra, plus the price of appointments at a seating clinic. You could find offers at on-line DME outlets in case you don’t need the insurance coverage problem or don’t have insurance coverage, however you’re nonetheless going to pay round $350 or extra for a very good cushion. Though, for lower than $100, you could find a easy foam cushion just like the Axiom G, or a easy gel cushion just like the Parts from Consolation Firm.

A {custom} cushion is just accessible by means of a seating specialist and might run into the hundreds of {dollars}.

In case you’re broke and with out insurance coverage, or the kind of one who thinks poorly of the medical-industrial advanced, do-it-yourself choices can be found. You should buy quite a lot of foam sorts and densities anyplace from JOANN Materials to Walmart, all of which may be minimize, glued or duct-taped into no matter configuration you need, though you’ll want to determine a canopy … pillow case anybody? Or you should purchase a 2-inch thick hexagon gel cushion off Amazon for $30 and minimize it to no matter dimension you want. DIY is decidedly not therapist-approved, however may be an choice for these with good sensation and mobility or in case you want a backup or sports activities cushion with out forking over a ton of cash.

Ultimate Ideas

That was so much. An important takeaway is that each sort of cushion has its execs and cons. Spend a while eager about what you want about your present cushion, and what you don’t. Suppose by means of what concerns are most necessary to you and attempt to discover a cushion that balances them. Don’t be afraid to ask for assist. seating specialist, be they a bodily therapist, occupational therapist or assistive know-how skilled, will hear, ask questions and perceive that your wants lengthen far past the clinic.