Interface pressure reduction effects of wheelchair cushions in individuals with spinal cord injury: a rapid review

Abstract

Objective Wheelchair cushion is routinely used to manage the sitting acquired pressure for an individual with spinal cord injury, but which kind of wheelchair cushion performs better in terms of interface pressure management is unclear. This review aims to compare different kinds of wheelchair cushions on their effect of interface pressure reduction in individuals with spinal cord injury. Methods and results The databases of MEDLINE, CINAHL, EMBASE and Web of Science were searched. Totally 10 studies were included in this review. Seven of the included studies indicated that air cushions were superior to gel cushions in interface pressure reduction. Three of the included studies reported that gel cushions were superior to polyurethane foam cushions in interface pressure reduction. The variables of measurement duration, measurement focus, measurement devices, cushion covering, sample variations and body positioning of patients may confound the comparison of interface pressure reduction effect of different wheelchair cushions among studies. Conclusions Air cushion was reported more consistently effective in interface pressure reduction than gel and foam cushions. While the variable parameters (measurement duration, focus, devices) and individual conditions (BMI, body positioning) may interfere the comparison among studies. Researches disseminating consistent parameters and clinical prescriptions with individualized evaluation are suggested for the establishment of an evidence-based practice in clinic. Implications for rehabilitation Wheelchair cushion is routinely used for an individual post spinal cord injury to manage the sitting acquired pressure. Which kind of wheelchair cushion performs better in terms of interface pressure management is unclear. Air cushion is found more consistently effective in interface pressure reduction than gel cushion and foam cushion. Individualized evaluation of the interface pressure is suggested for the prescription of wheelchair cushion in clinic.