12-3 Measuring the quality of pressure-sore prevention cushions

Measuring the quality of pressure-sore prevention cushions through the use of a pressure mapping system
Meir Lotan, Merav Gat, Ruth Dickstein

Abstract

Background: The constant wheelchair user needs an adapted seating system tailored to his specific needs and limitations. As such, a seating system that serves him for many hours each day, has to be carefully adapted to the functional level, sensory condition, abilities and difficulties of the individual. A professional adaptation of a seating system can improve the user’s quality of life, increase his independence and reduces the secondary medical dangers of long-duration seating and inactivity; such as pressure sores.
Yet, the complexity and variety of seating systems and pressure-sore prevention cushions necessitates that the clinicians maintain a high level of expertise and constantly improve their knowledge. One of the ways to improve objective evaluation of seating quality is through expansion of existing knowledge regarding pressure relieving cushions used by wheelchair users.

Goal: To rank the efficiency of pressure relieving cushions thorough objective means.

Method: Twenty one pressure reliving cushions from different materials (foam, gel, visco-foam, silicon, and combinations of those materials) were tested by two observers using a pressure mapping system. Each cushion was tested for 15 minutes by each observer and the results were averaged. The following outcome measures were evaluated: maximum pressure, average pressure, pressure gradient, number of sensors activated in each measurement and symmetry of sitting. The data regarding all cushions were compared and analyzed.

Results: We found significant differences between the measured cushions with regard to the measured objective parameters. This suggests that some cushions present better pressure preventing qualities than others, and these should be favored when considering a proper seating system for the constant wheelchair user client.

Conclusions: Objective criteria can be found and used by the clinician when deciding on a proper pressure preventing cushion. The findings also suggest that the price, type of cushion and manufacturer specifications cannot be relied upon as measures for the quality of a specific cushion. The pressure mapping system was found to be an efficient technology that can assist the clinician in making knowledgeable decisions when suggesting a specific cushion for his client. The researchers suggest that an objective test should be run annually for all pressure reliving cushions sold in Israel.

Key words: pressure-relieving cushions, pressure mapping system.