Looking for more information on seating and positioning? Check out our digital, rehab-focused Wheelchair Seating & Positioning Guide here.
We’ve talked before on the Permobil blog about cushion mediums, but in this blog post we’re looking a bit closer at the different types of cushion mediums and the benefits and considerations associated with each medium.
Foams Typically used in Cushions
High Resiliency (HR) Foam
- Instantly “springs” back to its original shape post compression
- Durable foam, can withstand repeated compression and maintains resiliency over time
- Provides structure and stability
- Great for use as the base layer of a cushion
Visco Elastic Foam
- Memory foam, meaning it takes time to resume the original shape post compression
- Allows for the most immersion and envelopment, contouring to the unique shape of the user
- Great to use as top layer of a cushion
|*Density is the measure of quality for foam. A density of 1-3 pounds is considered good for heavy use.
What you need to know is, you get what you pay for. When the cost of a cushion seems too good to be true, it is!
Benefits and Considerations of Cushion Mediums
|Can be designed to be as supportive/contoured as needed||Foam can be heavy; consider the weight of the cushion|
|Can allow for offloading or immersion||Need to protect the foam from incontinence|
|Low maintenance||Most foams inherently retain heat and moisture|
There are different types of air cushions: Individual air cells and air bladders
|Promote immersion and envelopment of bony prominences, increasing pressure redistribution||Easily affected by altitude:
Higher altitude = firmer
|Perceived as “soft” and comfortable||The softness may affect transfers|
|Can be adjustable||May require some maintenance|
These cushions are made of a thermoplastic material, using a hexagonal honeycomb shape
|Inherently breathable||Not adjustable and may not accommodate orthopedic deformities|
|Lightweight||Can be perceived as “firm”|
|Low maintenance||Not adjustable; client balance, endurance, and ROM need to be considered|
There is a perception that gel is the best medium for skin protection: NOT TRUE!
|Can allow for immersion of bony prominences for pressure redistribution||Effectiveness is dependent on the cushion geometry and stability|
|Some gels state that they are “cooling” to manage microclimate||Fluid gel can migrate and result in high peak pressures|
|New gel technology offers solid gel options, eliminating the problem of gel dispersion||Certain styles require daily maintenance or with every reposition, need to be kneaded and readjusted to provide pressure relief|
|With sun exposure, can retain heat|
These are a combination of foam & air or foam & gel; style is dependent on the manufacturer
|Foam provides a stable base for transfers with the skin protection of air/gel||Can be heavy depending on medium and/or manufacturer|
|Can allow for immersion and envelopment of bony prominences for increased pressure redistribution||With well cut-outs, the migration of gel or loss of air, can result in the ITs resting on edge of the foam, causing peak pressure|
|May require maintenance to ensure gel packs are in position or air cells are properly inflated|