Wheelchair cushion

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Wheelchair cushions are cushions specifically designed to provide comfort and protection against injury for wheelchair users. They also aid in properly positioning the user in the correct posture.

Contents

Wheelchair users are at great risk for pressure sores. [1] A number of factors are included in the formation of these ulcers including:

  1. Insufficient vascularization in areas of high pressure, typically under bony prominences. [2]
  2. The collection of sweat on the skin due to inadequate air flow. [3]
  3. The presence of local areas of elevated temperature. [4]
  4. Shear stresses on the skin. [5]

A number of studies point to interface pressure between the body and the seating surface as the primary contributor to the formation of pressure sores. [1] In response, manufacturers have developed a number of wheelchair seat cushion alternatives. Over 200 models of wheelchair cushions were on the market[ where? ] as of 2001. [6] [ needs update ]

Characteristics

Various characteristics, combined with a number of cover material options, offer a myriad of possibilities, which can be manipulated to provide various performance properties. These properties are intended to provide the wheelchair user optimal comfort, stability, and postural support, as well as aid in the prevention of pressure ulcers. [6]

The effectiveness of a particular choice of material and design has high variance with respect to a user's medical needs and activities. For instance, if a wheelchair user frequently moves on rough surfaces, gel cushions are less optimal as they are not as effective at absorbing impact. [7]

Sprigle et al. proposed the following criteria for defining and describing cushion characteristics: [6]

Material and construction
Physical characteristics

Design examples

Related Research Articles

Rheology is the study of the flow of matter, primarily in a fluid state, but also as "soft solids" or solids under conditions in which they respond with plastic flow rather than deforming elastically in response to an applied force. Rheology is a branch of physics, and it is the science that deals with the deformation and flow of materials, both solids and liquids.

<span class="mw-page-title-main">Polyurethane</span> Polymer composed of a chain of organic units joined by carbamate (urethane) links

Polyurethane refers to a class of polymers composed of organic units joined by carbamate (urethane) links. In contrast to other common polymers such as polyethylene and polystyrene, polyurethane is produced from a wide range of starting materials. This chemical variety produces polyurethanes with different chemical structures leading to many different applications. These include rigid and flexible foams, and coatings, adhesives, electrical potting compounds, and fibers such as spandex and polyurethane laminate (PUL). Foams are the largest application accounting for 67% of all polyurethane produced in 2016.

<span class="mw-page-title-main">Ulcer (dermatology)</span> Type of cutaneous condition

An ulcer is a sore on the skin or a mucous membrane, accompanied by the disintegration of tissue. Ulcers can result in complete loss of the epidermis and often portions of the dermis and even subcutaneous fat. Ulcers are most common on the skin of the lower extremities and in the gastrointestinal tract. An ulcer that appears on the skin is often visible as an inflamed tissue with an area of reddened skin. A skin ulcer is often visible in the event of exposure to heat or cold, irritation, or a problem with blood circulation.

<span class="mw-page-title-main">Foam</span> Form of matter

Foams are materials formed by trapping pockets of gas in a liquid or solid.

In materials science and continuum mechanics, viscoelasticity is the property of materials that exhibit both viscous and elastic characteristics when undergoing deformation. Viscous materials, like water, resist shear flow and strain linearly with time when a stress is applied. Elastic materials strain when stretched and immediately return to their original state once the stress is removed.

<span class="mw-page-title-main">Skin grafting</span> Surgical transplantation of skin

Skin grafting, a type of graft surgery, involves the transplantation of skin. The transplanted tissue is called a skin graft.

<span class="mw-page-title-main">Mattress</span> Large soft sheet for laying on to sleep

A mattress is a large, usually rectangular pad for supporting a lying person. It is designed to be used as a bed, or on a bed frame as part of a bed. Mattresses may consist of a quilted or similarly fastened case, usually of heavy cloth, containing materials such as hair, straw, cotton, foam rubber, or a framework of metal springs. Mattresses may also be filled with air or water.

<span class="mw-page-title-main">Pressure ulcer</span> Skin ulcer (bed sore)

Pressure ulcers, also known as pressure sores, bed sores or pressure injuries, are localised damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in combination with shear or friction. The most common sites are the skin overlying the sacrum, coccyx, heels, and hips, though other sites can be affected, such as the elbows, knees, ankles, back of shoulders, or the back of the cranium.

Stasis dermatitis refers to the skin changes that occur in the leg as a result of "stasis" or blood pooling from insufficient venous return; the alternative name of varicose eczema comes from a common cause of this being varicose veins.

<span class="mw-page-title-main">Memory foam</span> Component primarily utilized for making cushions or mattresses

Memory foam consists mainly of polyurethane with additional chemicals that increase its viscosity and density. It is often referred to as "viscoelastic" polyurethane foam, or low-resilience polyurethane foam (LRPu). The foam bubbles or ‘cells’ are open, effectively creating a matrix through which air can move. Higher-density memory foam softens in reaction to body heat, allowing it to mold to a warm body in a few minutes. Newer foams may recover their original shape more quickly.

<span class="mw-page-title-main">Pressure-sensitive adhesive</span> Type of non reactive adhesive

Pressure-sensitive adhesive is a type of nonreactive adhesive which forms a bond when pressure is applied to bond the adhesive with a surface. No solvent, water, or heat is needed to activate the adhesive. It is used in pressure-sensitive tapes, labels, glue dots, stickers, sticky note pads, automobile trim, and a wide variety of other products.

<span class="mw-page-title-main">Negative-pressure wound therapy</span> Therapeutic technique

Negative-pressure wound therapy (NPWT), also known as a vacuum assisted closure (VAC), is a therapeutic technique using a suction pump, tubing, and a dressing to remove excess exudate and promote healing in acute or chronic wounds and second- and third-degree burns. The therapy involves the controlled application of sub-atmospheric pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump. The use of this technique in wound management started in the 1990s and this technique is often recommended for treatment of a range of wounds including dehisced surgical wounds, closed surgical wounds, open abdominal wounds, open fractures, pressure injuries or pressure ulcers, diabetic foot ulcers, venous insufficiency ulcers, some types of skin grafts, burns, sternal wounds. It may also be considered after a clean surgery in a person who is obese.

<span class="mw-page-title-main">Package cushioning</span> Protective packaging

Package cushioning is used to protect items during shipment. Vibration and impact shock during shipment and loading/unloading are controlled by cushioning to reduce the chance of product damage.

<span class="mw-page-title-main">Wheelchair</span> Chair with wheels used by people with mobility deficiencies

A wheelchair is a mobilized form of chair using 2 or more wheels, a footrest and armrest usually cushioned. It is used when walking is difficult or impossible to do due to illnesses, injury, disabilities, or age related health conditions.

Microrheology is a technique used to measure the rheological properties of a medium, such as microviscosity, via the measurement of the trajectory of a flow tracer. It is a new way of doing rheology, traditionally done using a rheometer. There are two types of microrheology: passive microrheology and active microrheology. Passive microrheology uses inherent thermal energy to move the tracers, whereas active microrheology uses externally applied forces, such as from a magnetic field or an optical tweezer, to do so. Microrheology can be further differentiated into 1- and 2-particle methods.

Kristjan T. Ragnarsson is an American physiatrist who focuses on the rehabilitation of individuals with disorders of the central nervous system. He is the Dr. Lucy G. Moses Professor and Chair of Rehabilitation Medicine at The Mount Sinai Medical Center in New York City.

Rheological weldability (RW) of thermoplastics considers the materials flow characteristics in determining the weldability of the given material. The process of welding thermal plastics requires three general steps, first is surface preparation. The second step is the application of heat and pressure to create intimate contact between the components being joined and initiate inter-molecular diffusion across the joint and the third step is cooling. RW can be used to determine the effectiveness of the second step of the process for given materials.

<span class="mw-page-title-main">Diabetic foot ulcer</span> Medical condition

Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It may occur due to a variety of mechanisms. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. It is a major complication of diabetes mellitus, and it is a type of diabetic foot disease. Secondary complications to the ulcer, such as infection of the skin or subcutaneous tissue, bone infection, gangrene or sepsis are possible, often leading to amputation.

Comparison of orthotics refers to podiatrists molding custom orthotics to address patients' foot malformations. There are multiple means developed to create the basis for the molds, including plaster casts, foam box impressions, and three-dimensional computer imaging. The molds are used to create custom inserts that generally fit into three categories: firm, flexible, and soft.

<span class="mw-page-title-main">Gait deviations</span> Medical condition

Gait deviations are nominally referred to as any variation of standard human gait, typically manifesting as a coping mechanism in response to an anatomical impairment. Lower-limb amputees are unable to maintain the characteristic walking patterns of an able-bodied individual due to the removal of some portion of the impaired leg. Without the anatomical structure and neuromechanical control of the removed leg segment, amputees must use alternative compensatory strategies to walk efficiently. Prosthetic limbs provide support to the user and more advanced models attempt to mimic the function of the missing anatomy, including biomechanically controlled ankle and knee joints. However, amputees still display quantifiable differences in many measures of ambulation when compared to able-bodied individuals. Several common observations are whole-body movements, slower and wider steps, shorter strides, and increased sway.

References

  1. 1 2 Ferrarin, M; Andreoni, G; Pedotti, A (2000). "Comparative biomechanical evaluation of different wheelchair seat cushions". Journal of Rehabilitation Research and Development. 37 (3): 315–24. PMID   10917263.
  2. Kosiak, M (1961). "Etiology of decubitus ulcers". Arch Phys Med Rehabil: 19–29. PMID   13753341.
  3. Stewart, SFC; Palmieri, V; Cochran, GVB (1980). "Wheel chair cushion effect on skin temperature, heat flux, and relative humidity". Arch Phys Med Rehabil. 61 (5): 229–33. PMID   7377945.
  4. Finestone, HM; Levine, SP; Carlson, GA; Chizinsky, KA; Kett, RL (1991). "Erythema and skin temperature following continuous sitting in spinal cord injured individuals". J Rehabil Res Dev. 28 (4): 27–32. doi: 10.1682/JRRD.1991.10.0027 . PMID   1941646.
  5. Bennet, L; Kavner, D; Lee, BK; Trainor, FA (1979). "Shear vs . pressure as causitive factors in skin blood occlusion". Arch Phys Med Rehabil. 60: 309–14.
  6. 1 2 3 Sprigle, Stephen; Press, Larry; Davis, Kim (2001). "Development of uniform terminology and procedures to describe wheelchair cushion characteristics". J Rehabil Res Dev. 38 (4): 449–61. PMID   11563498.
  7. Fleming, Joe. "Wheelchair Cushion: Selection and Maintenance". Vive Health. Retrieved 6 January 2017.