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Meeting stability and other seating goals on wheelchair cushions

Roisin Moore

PMG Conference 2021

12th to 14th July 2021 in Telford. Our annual conference provides an educational programme, industry exhibition and networking events for professionals working in the field of posture and wheeled mobility.

Meeting stability and other seating goals on wheelchair cushions

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Roisin Moore

Occupational Therapist


15 June 2020


I joined the South Sefton Wheelchair Service in November 2018 and was honoured to be selected for a bursary to attend the PMG conference in July 2019. Prior to joining the therapy team at South Sefton I had no wheelchair service experience as my background as an occupational therapist was mainly in acute in-patient services.

The PMG conference was an ideal opportunity to network with other agencies, meet companies who we currently purchase equipment from, develop new working relationships with other companies, and to familiarise myself with the range of products on the market.  It was also very beneficial to meet clinicians from many other services to learn from their experiences and expertise.

My initial impression of the conference was very positive: everything had been well organised including the accommodation which was within close walking distance to the venue; the friendly staff at the registration desk; the seminars and lectures; and the exhibition stands which were interactive, interesting and informative.  Prior to the conference, I had selected the two breakout sessions I wished to attend which were both relevant to my learning needs and in which I had a particular interest. It was beneficial to experience the variety of learning opportunities from lectures, seminars, exhibition stands and also the poster presentations which we were able to study and reflect on in our own time.

As well as developing my product knowledge by visiting the various exhibitors to view new and current products, I was particularly keen to develop my skills and expertise about pressure cushions for wheelchairs, and therefore chose to report on the free paper presentation by Arne Compernolle, Meeting stability and other seating goals on wheelchair cushions: an evidence-based approach.

This was an interesting lecture discussing the stability of air cell based cushions and the market research completed. The presenter discussed four main seating goals which the prescriber aims to achieve through the provision of an appropriate pressure cushion.

These are dynamic positioning, in-seat stability, skin and tissue protection, and comfort.

A test method was developed with the aims of measuring air cushions with interconnected cells and their ability to compensate for the air transfer from one side of the cushion to the other when a service user leans to the side, and how this may affect stability in seating.

Prior to the study, there were no published RESNA or ISO standards available to allow objective comparison of cushion stability; therefore it was necessary to develop a test protocol which could be used in a laboratory setting. The following seven objectives were set for testing in a laboratory environment:

  1. Perform stability testing (lateral load shift)
  2. Perform stability testing (anterior load shift)
  3. Perform pressure mapping under conditions above
  4. Compare stability results between conditions (lateral and anterior)
  5. Compare pressure distribution results between conditions
  6. Evaluate correlation between pressure distribution and lateral stability
  7. Evaluate correlation between pressure distribution and anterior stability

Comparisons were made between 54 sample cushions including foam, gel, hybrid and air cell cushions.  The test methods described proved to be repeatable from trial to trial on the same cushion sample. Results indicated that air cell cushions with restricted side to side air flow had lower tilt angles, suggesting that this type of cushion may enhance service users’ stability when leaning laterally outside their centre of gravity.

Arne completed his presentation by reflecting on the process, identifying the following key points:

  • It is essential to establish a thorough understanding of the service user’s needs when selecting a suitable pressure cushion. This is identified through an in-depth assessment process
  • A comprehensive knowledge of cushion characteristics is needed when selecting cushions
  • It is important to consider comfort, skin and tissue protection
  • It is important to consider how the cushion provides stability
  • One seating goal should not be compromised to achieve another
  • It is possible to achieve seated stability on air cell cushions

This presentation was thought provoking in terms of considering the provision of air cell cushions whilst maintaining postural stability. It will be interesting to see if research is undertaken in future which will provide further evidence for the prescription of specific cushions.

I would like to thank Arne Compernolle for delivering this presentation and also the organisers involved in PMG.  I am very grateful to have been given the opportunity to attend the PMG conference this year as a bursar and new member of the South Sefton wheelchair service. This was an invaluable learning experience for me, and I would recommend attending the PMG conference to anyone new to the speciality of wheelchairs. This is also a unique and valuable CPD opportunity for everyone within the wheelchair services to keep up to date with current research, product knowledge and service improvements. 

 

This has been a thought provoking and motivating event to expand my knowledge and skills as well as highlighting r areas of interest and development. It hasprovided me with the inspiration for potential research in the future and presenting at PMG. I look forward to attending the PMG conference again in the future.

 

    Comments

    • Please note that there is now an ISO standard at the DIS stage for measuring stability, and this should be published in full in 2020. ISO DIS 16840-13 Wheelchair seating – Part 13: Determination of the lateral stability property of a seat cushion

      by Barend ter Haar on 24th June 2020 | 10:35am (reply)

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