Power wheelchair users often have complex medical conditions with varying degrees of upper body weakness. An inability to lift and/or shift one's own weight can make necessary pressure relief hard to achieve. If combined with ill-fitting or inappropriate wheelchair seat cushions and positioning aids, severe skin trauma can occur due to
- constant, concentrated pressure from sitting
- moisture build-up and lack of air at point of contact
- poor circulation and localized numbness
- hazardous forward sliding or slipping from the seat
- friction and shear forces1
These, along with other risk factors, may lead to the development of painful and progressively serious pressure ulcers.2
However, a properly prescribed wheelchair cushion for pressure sore relief can contribute to a healthier seating environment by delivering stability, supportive weight distribution and all-day comfort to the power chair user.
Choosing a Wheelchair Cushion for Pressure Relief
The selection of the right kind of power wheelchair cushion is an essential factor of functional mobility. Based on the results of a doctor's mobility assessment and physical examination, a prescription may be written for a power chair that will provide the necessary and custom features needed to resolve the individual patient's seating requirements.
There are four basic types of wheelchair seating cushions: air, foam, gel, and urethane. Each has its own unique benefits, but all are intended to create an optimal seating solution.
In general, a wheelchair cushion should
- be comfortable enough for all-day seating.
- promote basic stability and corrective alignment.
- provide for necessary pressure relief and weight distribution.
- help to maintain skin integrity.
- aid in proper blood flow.
- reduce the risk of skin ulcers.
- prevent existing pressure sores from worsening.
- minimize moisture retention and enable aeration.
- reduce friction and shear (e.g., when transferring).
Have you talked about power wheelchair cushions and positioning aids with your doctor? Please call Hoveround at 800-542-7236. Our mobility specialists will work with your healthcare provider towards determining and fulfilling your essential mobility equipment needs.
1Friction is the "mechanical force of two surfaces moving across each other." Shear is "the mechanical force that is parallel to the skin." Sliding, pulling, dragging or stressing the skin and deep tissues that are attached to bone can cause traumatic skin injury (blisters, abrasions, ulcerated sores). Patients who cannot lift, reposition, redistribute and/or shift their weight, or who tend to drag and slide while transferring are at a heightened risk for friction and shear injury. Pressure ulcers may result. For more information on pressure sore development and treatment, visit University of Maryland Medical Center, "Pressure Ulcer "
2Pressure ulcer, pressure sore, skin ulcer: a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of constant/excessive pressure, or pressure in combination with shear and/or friction (EPUAP/NPUAP, 2009).
3A doctor's diagnosis will determine a patient's need for custom power wheelchair cushions, as well as the most appropriate type. Complete documentation and a valid doctor's prescription are required. Insurance coverage depends on medical necessity which is determined by the insurer. Consult a licensed physician for details.
This article is for informational purposes only and is not intended as a substitute for medical advice.