Inclusion Criteria:  > 18 years of age SCI, neurological disease with paralysis or multi trauma, all with lack of independency in position change in bed, and hospitalized for primary rehabilitation in either the Spinal Cord Unit (SCU) or the Multi trauma, Neurological disease, Burn (MNB) Unit Requires manual position change Medically approved for the participation by the participant's physician Able to give consent to participate Psychically and cognitively able to properly answer the questionnaires Speaks/understands Norwegian language  Exclusion Criteria:  Ongoing pressure injury External fixation, except neck collar Body weight > 150 kg pre-test pressure assessment above the maximum pressure limit.