Wheelchair cushion effect on pressure and skin temperature.

Eight wheelchair cushions representing five types of materials were evaluated in two population groups, able-bodied and spinal cord injured (SCI). Objective factors such as area of first light, pressure, tuberosity and thigh temperatures, and subjective factors such as cosmesis, handling ability, and purchase were studied. Twenty subjects (10 men and 10 women; 10 SCI and 10 able-bodied) from 16 to 35 years of age were chosen to participate in the study. Pressure was measured with the Pressure Evaluation Pad and skin temperature of each ischial tuberosity and posterior thigh was determined. Temperature differences were not significant among cushions but the alternating pressure and foam cushions produced consistently higher temperatures compared to other cushions for both groups of subjects. No significant differences among cushions were found for area of first light, cosmesis, handling ability, or purchase. However, three cushions were rated acceptable in cosmesis while three different cushions were rated acceptable in handling ability by all subjects. No cushion rated a perfect score by all subjects regarding purchase but all the SCI subjects said they would purchase the air-filled cushion. Overall pressure differences were not significant but large individual variations were observed. The authors believe that pressure produced by wheelchair cushions should be measured with a standard device such as the Pressure Evaluation Pad, and that, to reduce the incidence of pressure sores, cushion use in each patient should be modified on the basis of initial and periodic assessment of both objective and subjective factors.