Attempts at Achieving Seated Pressure Relief that Fall Short
It is well known that people in wheelchairs are at risk of developing pressure ulcers. It is also well known that in order to prevent pressure ulcers the skin and tissue must have regular pressure relief to re-establish circulation.
The Mayo clinic website states “Position changes are key to preventing pressure sores. These changes need to be frequent, repositioning needs to avoid stress on the skin, and body positions need to minimize pressure on vulnerable areas.”
There are a number of methods and products that aim to deliver pressure relief but as you can see they can fall short. Below are some examples.
Wheelchair push- ups are an effective method of relieving pressure to the tissue of the posterior. They must be done every 15 minutes to derive the benefits. There are many people that either physically cannot do wheelchair push- ups or they forget to do them.
There are methods such as phone alarms or apps that send a message on regular intervals to serve as reminders to do manual push- ups.
The underlying fact with wheelchair push- ups is that the person must take physical action and lift themselves up to achieve any benefit.
Another method for pressure relief at one specific location using foam cushions to cut out or make a cavity directly under the desired location. The idea is that there will be an area of pressure relief exactly where it is needed. This is true but the area along the edge of the cutout will have significantly higher pressure. This can be shown with pressure mapping. Also, the entire remainder of the cushion will have constant pressure unless the person lifts themselves up.
Static air cushions such as roho or the many roho knock offs can only provide pressure reduction (assuming they are inflated to the correct pressure) but they cannot provide pressure relief. Pressure relief using these simple air cushions can only be achieved by the direct action of the user by repositioning or doing wheelchair push- ups.
A Tilt/recline feature of power wheelchairs is another technological advancement designed to provide pressure relief. This method involves spreading the body weight over a much larger surface area by reclining the wheelchair. The result is pressure reduction to the posterior but there is no pressure relief. This method is expensive too. The tilt/recline feature shown recently in New Mobility magazine showed a cost of $12,000 for just the tilt/recline option. Additionally, reclining a power chair may draw unwanted attention to the client so that may limit the frequency of using this feature.
Most of the above mentioned methods simply are not effective with the exception of manual pressure lifts, but there is a much easier solution and it is automatic.
The only custom fabricated cushions that by themselves give pressure relief are the APK2 and the SofTech cushions. These cushions produce a physical change in the support areas which in turn changes the pressure distribution of the posterior and the result is pressure relief to skin and tissue. This happens automatically for the entire time the cushion is operating.