Cushion Consideration

When do you know its time for the dreaded shopping trip for new shoes?  Do you go based on how much tread is left?  Do you wait until you have toes poking through a hole in your shoes?  Is it time to go when you no longer have any arch support?  Or do you schedule it for every 6 months?

 Thinking about shoes, how many hours of work do they put in a week?  Your shoes most likely work overtime everyday for you.  What if shoes were optional?  Meaning what if you used a wheelchair instead? Lets just steal some anatomy terms.  Let say the wheels of the chair are a person’s legs.  What then becomes the shoes?  What offers support?  The seat!  That’s right, the wheelchair cushion.  If we think about that lets think about the fact the cushion works overtime just like we say shoes do.  A person who uses a chair relies on good cushion support.  Often, if we do not use a chair ourselves, we don’t think of the chair as components.  However, each component of a wheelchair needs to work for the person using that chair.   So back to shoes, aka, THE CUSHION.  It needs to provide support daily and often works overtime.  Most cushions do not last longer than 1 to 2 years at best.  However, think of the people you support.  We know that most insurances will only pay for a new wheelchair every 5 years.  That is the frame of the chair, but what about the cushion?  When was the last time you checked a wheelchair cushion?  Much like checking your smoke alarms, fire extinguishers, and other items to be sure they are working properly, routinely checking wheelchair cushions for proper support is best practice.  Replacing worn out cushions can go a long way in proper body alignment, reduction of pressure, and overall comfort.  Replacing worn out cushions should be done as soon as possible.  It may take time for insurance (if covered) to replace the cushion.  It is best to start this process as soon as wear and tear are noted.  Again, industry standards are 1-2 years, however, this can change based on the style of cushion (foam, air, gel) each person’s physique, style of cushion, wear and tear, and frequency of use.  See below for tips and techniques for checking cushions. 

Start with the cover: Look for tears or holes in the cover or zipper malfunction, which might expose the cushion surface or create a wrinkled sitting surface. If the cover contains a foam liner, look for tears or flaking in the foam. The bottom of most covers have a Velcro or a nonskid surface. Inspect this surface for worn or torn Velcro or breakdown of the nonskid material. The cover is designed to protect the cushion, so it should be replaced if damaged.

Look for signs that the cushion is fitting improperly on the wheelchair. Just because the cover is facing in the right direction doesn’t mean the cushion inside it is. Backward or upside -down cushions are common.

Remove the Cover:  Inspect the cushion itself.  Check each cushion based on the material it is made from.

• Foam Cushions:  Check for cracks and flaking on the surface and the foam’s inability to recover its shape when it is not in use. If you remove a cover from a flat foam cushion and it appears compressed or contoured, then it needs replaced. This indicates that the foam lacks resilience and will no longer be able to distribute and support the weight of the user.

• Solid Gel Cushions: require a covering material to protect the gel. If its cover is cracked or torn or if the solid gel is exposed, it needs replaced.

• Fluid cushions (3 types):  air, water, or viscous fluid. An impermeable cover must encase. All types must be encased by a cover, if there is any leaking fluid, these need replaced. 
  • Viscoelastic fluid or Water: Check for any separation of fluid.  This creates areas that are harder or softer than others do. Viscoelastic fluid should be kneaded daily to reposition the fluid and prevent pockets under the weight-bearing surfaces.
  • Air:  Leaks may not be as obvious. Most often, a cushion will develop a slow leak rather than being punctured. Therefore, an air cushion should be checked weekly to insure that it is properly inflated.

Foam, gel, and viscous fluid cushions should be checked monthly and air cushions should be checked weekly.

And after all your inspecting is completed, be sure to wash the cushion cover!

Whether we get around on shoes or wheels, it’s clear that the condition of our equipment is a big deal. It only takes a few minutes to make a complete quality inspection. Those few minutes go a long way to ensure good support and comfort.