Potential Bottom Out Risks of Various Types of Cushions

There are several different types of wheelchair cushion to choose from.  Some are inherently riskier than others because they are open to environmental hazards and influences that can adversely affect the integrity.  That is, the cushion protection can be lost either over time or suddenly and the extent that it becomes a safety risk for the user. The information below is a summary of types of cushion and those associated danger levels ranging resulting in bottom out from very low to high risk.



Foam cushions are the most popular type of cushion or pad for mobility chairs. They are a good choice for individuals looking for a low maintenance, inexpensive, and a lightweight seating surface. Some foam cushions can be custom-shaped for added comfort.  Wheelchair cushions made of foam tend to compress over time. This type of cushion can’t compress down to an ineffective thickness causing bottom out quickly.  It takes a long time and happens gradually where the user can see that the foam is compressing.   The user has constant protection from bottom out. Risk level is low.



Gel seat cushions are good for positioning and support. Although they absorb heat very easily, gel is not as effective at absorbing shock but the comfort is good.  Gel cushions are heavier than other types of cushions. This type of cushion offers protection unless it leaks the gel.  The user will instantly know if this happens because the gel will make a mess and they can react by transferring off. Risk level is low.


Urethane honeycomb

This type of cushion provides good shock absorption and prevents users from bottoming out. These cushions are designed to evenly distribute weight and can allow some air to circulate around the cushion.  These cushions will lose some of their shock absorption characteristics over time. Risk level is low.


Air cushions

Air cushions are lightweight and designed to spread pressure evenly so that the skin’s pressure points get adequate relief. They can also be good at absorbing shock. Air cushions require some regular maintenance. Most air cushions need to be regularly inflated to keep pressure properly balanced. If a leak occurs the user is in grave danger because all protection is instantly lost.


Star cushion has one model that has foam inside the air cells so if it goes flat the user still has some protection from bottoming out. Star has no alarm system to warn of a flat cushion.  Risk level is medium to high depending on the model.



ROHO has no alarm system if the cushion suddenly deflates due to an environmental factor.  This is the most dangerous as there is absolutely no protection from total bottom out.  The user could potentially bottom out on a metal seat pan in seconds.   Risk level is HIGH.


AQUILA alternating cushions

Aquila cushions have internal air bladders that are protected from environmental influences that could cause a leak.  We also have 3 inches of various densities of foam surrounding the alternating air bladders which provide comfort and stability.  If an air bladder were to leak, our custom cushions will alarm to alert the user but the user is not in danger of bottoming out due to the 3 inches of foam protecting the skin and tissue.  Risk level is very low.


Aquila Corporation urges you to do your research.  Bottom out protection is of utmost importance.