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Wheelchair Cushion Considerations

Originally posted by Lauren Rosen, PT, MPT, MSMS, ATP/SMS on Advance for Physical Therapy, July 5, 2012

Finding the right cushion for a patient can be difficult. There are no set rules for cushions that will work well for every individual. Making the correct choice requires a thorough evaluation of patients and the equipment that they use. This should always include an interview, mat evaluation and functional evaluation/simulation. When appropriate, it may also include pressure mapping.

Interview

As with any therapy evaluation, a thorough medical history should be taken. Medical conditions as well as nutrition can affect pressure-sore risk so this is important information. The next question should be about sensation. If the client has decreased sensation in his buttocks, then a pressure-relieving cushion is likely going to be needed. If the client has good sensation, then a more basic cushion may work.

The next question posed to the client should be about his history of pressure sores, both past and present. Previous pressure sores are important because after a pressure sore, the skin is at best 80 percent as strong as it was before the sore developed.

For current wheelchair users, the next question should be about pressure-relief technique. Assessing whether a client uses a depression, a side lean, standing or power tilt to achieve pressure relief is also important to decide on the correct equipment. Some types of cushions are not appropriate with certain types of pressure-relief methods…

 

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