It doesn’t matter if you sit in a wheelchair most of the day or only use your chair occasionally for doctor’s visits, shopping or other errands—choosing the right wheelchair cushion is essential to your health. A wheelchair cushion can not only affect your posture and ability to move freely, but also prevent or contribute to pressure ulcers, a dangerous medical condition.
It may be tempting to buy a wheelchair cushion based solely on an appealing material or style. However, purchasing a wheelchair cushion without considering how it will work with your abilities or medical conditions could lead to discomfort, a lack of support or stability and even harm to your health.
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Vive Health Gel Seat Cushion
- Luxuriously soft, extra large 3" thick cushion with waterproof, washable cover
- Liquid gel core redistributes your weight away from the tailbone and coccyx
- Easily fits in wheelchairs, office chairs, lawn chairs, bleachers and cars
- Relieves back and tailbone pain from sciatica and other conditions
- Premium foam layer will not flatten under your weight
On Vive Health's Website
Why Use a Wheelchair Cushion?
A wheelchair cushion can either enhance or significantly impede your function, says Tori Goldhammer, an occupational therapist and clinical manager for the Department of Aging and Community Living Safe at Home program based in Washington, D.C. “The right combination of comfort and positioning can make you comfortable and able to do the things you want to do during your day. The wrong combination can do the opposite,” she says.
Ideally, a wheelchair cushion should help the user be as comfortable and functional as possible. However, a wheelchair cushion that doesn’t provide proper pressure relief for someone who spends much of the day in a wheelchair can cause pressure sores that can break the skin and cause serious infections.
Benefits of Wheelchair Cushions
Beyond comfort, a wheelchair cushion provides a “base” from which the user’s wheelchair positioning stems, according to the Academy of Neurologic Physical Therapy (ANPT), a section of the American Physical Therapy Association. The cushion can provide pressure relief and ulcer prevention, shock absorption and postural alignment to help improve the user’s overall movement and function.
What to Consider When Buying a Wheelchair Cushion
When choosing a wheelchair cushion, factor in your activity level and the amount of time you typically spend sitting in a wheelchair. For example, if the wheelchair is your primary seat throughout the day, you need to be especially careful in your selection since you’re at increased risk for developing a pressure ulcer (often caused by sitting for long periods).
Other factors to consider include, comfort, stability and positioning. Cushion size and height is also important, as well as choosing a waterproof, washable cover if the wheelchair user has incontinence.
Types of Wheelchair Cushions
Generally, there are five types of wheelchair cushions, with many versions and styles available for each kind of cushion:
- Foam cushions provide structure and stability by conforming to the user’s body. Foam cushions are generally inexpensive, lightweight, easy to maintain and available in a wide variety of sizes, densities and thicknesses.
- Gel cushions have a gel pocket that’s surrounded by a foam base. Gel wheelchair cushions may also feature a contoured base to provide stability and support better posture, as well as comfort and cooling effects. These cushions provide better pressure distribution than foam cushions.
- Air cushions contain cells or chambers that are inflated with air. They’re lightweight and good for both pressure relief and shock absorption. Air cushions require some maintenance, however, since the air cells can deflate.
- Honeycomb cushions feature a matrix pattern similar to a honeycomb and are made from thermoplastic, a material that’s capable of softening when heated and hardening again when cool. Honeycomb cushions provide effective shock absorption, even weight distribution and comfortable airflow.
- Combination “hybrid” wheelchair cushions combine air, foam and/or gel elements.
Material
Each type of wheelchair cushion material has its benefits and drawbacks. For example, foam cushions are more affordable but can lose their shape and deform quickly and may need frequent replacement. They’re also less likely than air or gel cushions to distribute pressure. Meanwhile, gel cushions provide better pressure distribution but require more maintenance than other types since the gel inside may need to be redistributed regularly by kneading the cushion.
Air cushions are great for pressure relief but require proper maintenance, too. “An air cushion is good for pressure release, but it has to be inflated properly, or the cushion could do the exact opposite,” says Goldhammer. And honeycomb cushions are lightweight and provide some pressure relief and comfort, but they don’t have the same pressure-relieving properties as air cushions, says Goldhammer.
Stability and Support
Your individual needs for stability and support determine the best wheelchair cushion choice for you. For example, you may like the pressure relief offered by an air cushion, but this type of cushion may not provide enough support for someone with balance issues, says Goldhammer.
To be sure you’re picking a cushion that offers proper stability and support, Goldhammer recommends making an appointment with a “seating clinic” at a rehabilitation hospital. At the seating clinic, an occupational therapist or physical therapist with specialized training, along with a cushion vendor, will have you try a variety of cushions and help you select the best one for your situation.
Seating clinic appointments aren’t free, but health insurance typically covers the cost with a prescription from your primary care doctor. The therapist then writes a letter of medical necessity for coverage of the wheelchair and seating components during your appointment. “The seating clinic is worth it because you’ll know you’re not putting yourself or the person in the wheelchair at risk,” says Goldhammer.
4 Layers of Supportive Comfort
Vive Health's Gel Seat Cushion relieves back and tailbone pain from sciatica and other conditions. The gel core and premium foam layer will not flatten under your weight, so you sit comfortably day after day.
Height and Weight
A cushion that’s too high can impede your ability to fit your wheelchair under a table or desk. Cushion height should also allow you to transfer easily from your wheelchair to your bed or other piece of furniture.
Meanwhile, a heavier gel cushion may add more comfort, but can negatively affect your self-propulsion abilities and become cumbersome if it needs to be removed from the chair for transport in a vehicle.
Skin Protection
In addition to choosing a cushion that provides proper pressure relief to prevent pressure ulcers, consider other factors that can affect skin health, too. For instance, gel cushions may be better for active wheelchair users because they can alleviate “shear force,” which can damage skin by causing the person to slide forward in the chair, according to the ANTP. And if the wheelchair user has incontinence, a waterproof, washable cushion cover can help protect skin integrity.
Breathability
Body temperature and moisture can negatively affect skin breakdown. Choosing a wheelchair cushion with good airflow and breathability may help protect the user from skin problems caused by sitting in a wheelchair for long periods.
Additional Features
A standard “sling” wheelchair with a fabric seat and back is one of the worst chairs for sitting for extended periods—the lack of support can cause back pain, slouch and pressure, says Goldhammer. If you have a sling wheelchair, she recommends purchasing a solid seat insert (typically made with plywood or firm plastic) and pairing it with a cushion for added support and stability.
Cost
Wheelchair cushion prices vary depending on the type, materials used and overall quality of the cushion. Prices for off-the-shelf models range from $20 to $75, and cushions with advanced features, such as exceptional pressure distribution or optimal stability, can cost several hundreds of dollars. Consult your physician to determine what features you need in a wheelchair cushion for your specific situation before buying one.
