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For individuals who have suffered spinal cord injuries, pressure ulcers caused from wheelchair use are a serious concern during rehabilitation and are the most common long-term secondary medical complication for spinal cord injury patients. That’s why a study conducted in 2001 by researchers at the University of Florida Department of Occupational Therapy deserves attention.

The study examines how wheelchair design—and more specifically, wheelchair cushion design—helps to mange and prevent this type of complication. Because almost all wheelchairs are marketed as “the best” for pressure reduction, the researchers wanted to provide useful information to occupational therapists that would help them distinguish between wheelchairs that were actually effective at doing this versus those that were not.

This particular study focused on a single patient, with the hypothesis being that the Roho cushion, as compared to Jay or gel cushions and Pindot or polyurethane foam cushions, would provide the most pressure relief. The researchers used a computer pressure-mapping pad called Xsensor to determine and measure the patient’s pressure points on each of the three different types of cushions during the course of the study. The study concluded that the Roho cushion was in fact the most effective in relieving pressure on the seating surface for the patient who participated in the study, a conclusion that aligns with other research on the same question.

The study is purposefully not empirical. That is, the researchers note from the outset that prescribing an appropriate wheelchair cushion requires an occupational therapist to evaluate each individual separately—there is no “one size fits all” approach to preventing pressure ulcers. Instead, the study offers a methodology for therapists to use in order to prescribe the best cushion for each patient and to monitor its effectiveness over time.

This type of one-on-one treatment and the use of technology to measure pressure points with different cushions could go a long way to helping spinal cord injury patients manage the complications associated with their condition.


  1. Gravatar for Jason

    I am a huge fan of the Roho seat cushion. As with all things there are pros and cons and the Roho is no different. When they work they are very great. But when they deflate you are in serious trouble. I have used the Roho for 19 years and have never had an incident until October 2010. I developed osteomyelitis in the right ischial tuberosity. I got sick and while I was sick I was so out of it that I never noticed when my cushion bottomed out. Now, the tricky part is knowing which came first. As I said I was sick already for a few days when this happened and my doctors tend to believe that I was already dealing with the osteomyelitis, secondary to a pressure ulcer that was developing underneath the skin. This was probably due t a slow leak in my cushion that went unnoticed before it completely bottomed out. After having surgery to fix the ulcer and osteo my doctor was adamant about me needing a Roho cushion. I was skeptical about going back to an air only cushion and tried mapping on the verilite and Jay but the roho gave me the best results. I am still waiting for a cushion design that merges air and foam and that gives me the same results as the roho but until then I will stick with Roho cushion.

  2. Gravatar for SEE AND BE SAFE

    I transferred into my chair this morning only to realize that the roho was not holding air. Another slow leak!!!!!!!!!! WOW! I'm just hoping it wasn't under inflated for too long before I caught. A year off of a flap and a long disheartening bout of osteo has me extremely worried. As I stated, when the roho works it's cool but if they bottom out you have nothing to back you up.

  3. Wayne Parsons

    Thanks for these comments. Do you have any tips about the use of cushions? You have a lot of knowledge.

  4. Gravatar for SEE AND BE SAFE

    Check your cushion regularly!!!!!! Once per week is the usual recommendation but I believe in hyper-vigilance. Foam cushions should be exchange every three years at least. Even if you think that your roho is not losing air you should always perform a re-inflate and position once per week. Make sure to close the valve tight. A half closed valve will leak air. If you are a smoker be especially careful if you sit on an air cushion. A piece of hot ash could change your life in a second.

  5. Wayne Parsons

    Thanks. These are great tips. They will help me advise my clients with spinal cord injuries who often have pressure sore problems with their wheelchairs.

  6. Gravatar for SEEANDBESAFE.COM

    You're welcome. I forgot to mention that smoking not only puts you at risk for a flat cushion but it is absolutely one of the worse tings we can do for our skin! Smoke and excess sugar intake are free radical factories. Supplementing with ha, vitamin E and co-q10 is highly recommended.

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