Patients must be able to shift their weight for a full minute to provide pressure relief. If the patient is unable to do this as in the case of a high level tetraplegia, morbid obesity or advanced age and weakness, they will need a chair that can tilt or recline to provide the needed pressure relief. When fitting patients in a new seating system it is important to assess the bony prominences while the patient is performing a weight shift to be sure adequate pressure relief is being provided. Evaluation for the proper cushion is also very important. Pressure distribution must be as even as possible to minimize risk of breakdown.
Every body type is different and no one cushion is the answer for everyone.
For example, people with very prominent ischial tuberosities may bottom out on typical gel cushions. Patients must be educated to reposition the gel frequently to prevent this and should be monitored periodically when trying out a new cushion because it will not be immediately evident. This body type may need a different cushion or may require gel overfill to provide adequate pressure reduction Cushion selection can also depend on a person's level of function. Air cushions can provide better pressure and shear reduction but offer less stability for activities such as transfers and less postural support while sitting. Establish a Prevention Partnership Using these strategies successfully will require a partnership between you and your patient.