Pressure-reducing cushions: perceptions of comfort from the wheelchair users' perspective using interface pressure, temperature and humidity measurements.

INTRODUCTION: There are many static pressure-reducing cushions commercially available consisting of foams, gels, air or a combination of these. There is, however, little evidence available on their effectiveness to guide prescription. In practice, comfort tends to be a major factor in determining whether a pressure-reducing cushion will continue to be used, although it is unclear as to what determines comfort. The aim of this study was to assess if perceptions of comfort could be associated with the measurable parameters of interface pressure and temperature. This pilot study was undertaken in the community with individuals who were totally reliant upon a wheelchair for their mobility who each used a series of four different cushions for up to 7 days.
METHOD: The temperature and humidity characteristics of four commercially available pressure-reducing cushions of differing mediums were measured using data loggers for a continuous period of up to 7 days. Snap-shot interface pressure measurements were taken and perceptions of comfort were obtained via specifically designed questionnaires.
RESULTS: The cushions that wheelchair users found to be the most comfortable for them were not necessarily those, which provided them with the lowest interface pressures. If a cushion was discontinued by the wheelchair user, it was invariably a "softer" medium. Wheelchair users tended to acknowledge discomfort only after 2 days continuous use.
CONCLUSION: There are potential implications for clinical practice with respect to how cushions are issued to wheelchair-reliant individuals. Findings support the undertaking of a larger study.