Manual Wheelchairs - World Health Organization

2.5.2 Cushions
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An inadequate pressure-relief cushion is the one component of a wheelchair that is most likely to
cause pressure sores, serious injury or premature death. Wheelchair cushions are used for three
reasons: comfort, pressure relief and postural support. For many users, a cushion that provides
some comfort will help them to use the wheelchair for a longer time. Users with limited or no
skin sensation are always at risk of developing pressure sores when using a wheelchair without a
proper cushion. These users must use a pressure relief cushion to help reduce this risk as shown in
Fig. 2.10 and Fig.2.11.
Fig. 2.10. Wheelchair cushion Fig. 2.11. Wheelchair cushion
Many users require some adaptations or modifications to their cushion to help provide additional
postural support or pressure relief. Wheelchair manufacturers need to either keep a good stock of
different types and sizes of cushion or have the capacity to produce and modify a cushion as and
when needed. Recommendations for cushions are given in Box 2.6.
Box 2.6. Guidelines for cushions
n The cushion should be removable from the wheelchair.
n The cushion should be easy to clean using basic materials such as soap and water.
n The cushion should be an appropriate size to fit on the seat base.
n Correct cushion use and the way in which it should be placed on the wheelchair seat (which side is up, and which is
the front of the seat) should be clearly indicated.
n Information on how the cushion should be used and maintained should be available.
Pressure relief cushions
n A pressure relief cushion should reduce pressures at the high-risk areas for pressure sore development (commonly at
ischial tuberosities and sacrum).
n A pressure relief cushion should minimize the build-up of moisture between the cushion and the user’s skin.
n Information should be available on how to use the cushion, how to maintain it, the expected life of the cushion, when
to replace the cushion or parts of it, and any particular risks when using the cushion.
n The cushion and cushion cover material should not cause high pressures, thereby reducing the effectiveness of the
cushion in distributing pressure over the seat surface.
n Pressure relief cushions should maintain their pressure relief properties in the climates where the cushion is expected
to be used.
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