Education in Motion / EIM Blog / June 2023 / Modifying Wheelchair Cushions to Optimize Riders’ Pressure Management

Modifying Wheelchair Cushions to Optimize Riders’ Pressure Management

Ron is a veteran who sought out additional consultation secondary to concerns with increased redness on his left trochanter. His repositioning schedule and daily activities were discussed during the consultation, and it was evident he was very cognizant of his skin integrity management. Ron was using a JAY X2 cushion, which has a non-contoured, high resiliency soft foam base with a JAY Flow fluid tripad in the pelvic loading area (PLA). Ron had previously contacted his Occupational Therapist at the VA reporting his concern. He inquired about cutting two inches off the front of his cushion and adding to the rear, as he noticed his JAY Flow fluid was typically pushed posteriorly and he was bottoming out in the PLA.

JAY X2 fluid pushed posterior

JAY X2 fluid pushed posterior

Modified cushion
Modified cushion in cover

Ron modified his own cushion by cutting two inches off of the front and adding those two inches to the rear to move the PLA forward

Ron trialed a JAY Fusion cushion that had a pre-contoured, closed cell foam base with a pre-contoured, high resiliency foam layer; a posterior pelvic wall; and a JAY Flow fluid pad. Though the pressure mapping had improved when compared to his JAY X2 cushion, he was still getting areas of high pressure on his ischial tuberosities (sit bones) and the left trochanter (bony prominence where the hip connects with the pelvis). Therefore, a JAY Fusion reduced profile 15" x 16" cushion with the following JAY Your Way modifications was ordered and issued:

20%25 fluid overfill

20% fluid overfill
(redistribute load and reduce pressure on the bony prominences when a client experiences "bottoming out" or discomfort on a standard JAY fluid pad)

Femoral relief cut

Femoral relief cut
(shaves away the front of the pelvic loading area (PLA) to transition from PLA to femoral support area)

Move PLA one inch forward

Move PLA 1" forward
(optimized fluid under pelvis)

Additional positioning components were also ordered, but it is unknown what components are being used. After a three-month follow-up, the following was reported from Ron's primary OT at the VA: "I wanted to let you know I saw Ron today with his custom Fusion cushion and it's going well! He loves it and it pressure mapped better than he EVER has before! Nice work and thank you!"

Ron S.

Did you know JAY seating has been around since 1983? JAY combines science, technology, and design to provide superior clinical seating. JAY seating stabilizes the pelvis, protects skin from the risk of breakdown, and positions the body. Premium materials and positioning components create low maintenance and highly configurable seating solutions. With so many options available, you're sure to find a JAY wheelchair cushion to fit your needs.

However, I know as a clinician, one size does not fit all. When trialing new products as a clinician, I would tell the representative, "It's good, but it would be nice if..." Do you have any of those "If only I could..." situations and want to do better for the people you provide services to, or are you a self-advocate like Ron and you just know when it's not right? JAY Your Way has you covered. With JAY Your Way, JAY products are easily modified at our factory before they are shipped to meet comfort needs and individual styles. From clinical improvements to colored covers, JAY Your Way modifies cushions and backs specifically to address unique individual needs and preferences. Do you need additional support? A cushion to fit perfectly on your chair? Want to show off your military service with a patch? JAY Your Way products can fulfill these specific requirements and more.

Karla Sonderland

Karla Sonderland graduated with a master's degree in Occupational Therapy from the University of Mary in North Dakota. She has 20 years of experience with a focus on individuals with intellectual and developmental disabilities. She brings to the team her knowledge and understanding of providing 24-hour care to individuals with multiple caregivers as well as helping individuals transition to alternate living arrangements with optimal assistive technology to ensure their safety and participation. Karla lives with her husband and three children in Iowa and manages the Midwest Clinical Education program.

Published: 2023-06-12

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