Pressure-reducing Cushions Research Articles

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.

Reducing pressure ulcer incidence in a long-term setting

Selection of appropriate pressure prevention equipment relies on risk assessment and clinical assessment of the resident/patient. Decisions are then made in combination with manufacturer's recommendations, such as interface pressure testing. However, risk assessments can over-predict and laboratory investigations do not necessarily provide an accurate picture of how individual patients will react to pressures from support services. There are few studies on visco-elastic mattresses and their benefits in reducing pressure ulcer incidence. Therefore, a small study was undertaken to review the efficacy of a pressure-reducing visco-elastic foam mattress. For the benefit of the study, a 20-bedded nursing home was provided with 20 visco-elastic mattresses (Pressurease) and 20 pressure-reducing cushions (Mediform Visco). The study aimed to demonstrate a reduction in pressure ulcer prevalence. The study involved 21 residents over a 6-month period. There was a 58.3% prevalence (of Stirling grade 1-2 pressure damage) at trial initiation. The results showed an 85.7% decrease of pressure ulcers within 4 weeks, and an overall decrease of 82.5% over the 6-month period. Comfort levels, scored by residents on a visual analogue scale, demonstrated the Pressurease mattress to be superior to the nursing home standard mattress.

An investigation of the impact of the Force Sensing Array pressure mapping system on the clinical judgement of occupational therapists

To examine the impact of pressure mapping technology on the clinical decisions of occupational therapists and to examine the role of the Braden Scale in assisting with the selection of pressure-reducing cushions. Case studies. Community. Forty clients. Clients were pressure mapped on their current seating surface and on four pre-selected cushions by the principal researcher. An occupational therapist completed the Braden Scale and a decision tree to assist in recommending a suitable pressure-reducing cushion. Interface pressure maps, Braden Scale, and the cushion recommended, using a decision tree to guide clinical judgement. Thirty per cent (12) of the 40 cushions recommended were changed when the pressure maps from the Force Sensing Array (FSA) system were viewed. In 70% (26) of cases, the maps supported the cushion recommended. In 25% (10) of the cases, the maps showed that the client's current seating surface was unsuitable. After viewing the pressure maps, a surface other than the client's current surface was recommended in 47% (19) of the cases. There was a lack of agreement between the risk level of the clients as identified by the Braden Scale score, and the risk level of the clients as identified by the occupational therapist using a decision tree and the FSA maps. Pressure mapping technology has a positive impact on clinical decisions regarding the provision of pressure-reducing cushions. Future research should examine the predictive validity of this technology. The Braden Scale may underpredict the risk level of the clients.

A Randomized Control Trial to Evaluate Pressure-Reducing Seat Cushions for Elderly Wheelchair Users

A Randomized Control Trial to Evaluate Pressure-Reducing Seat Cushions for Elderly Wheelchair Users

Interface pressure measurements in leg ulcer management.

Interface pressure measurements are undertaken in health care as a useful tool to assist in understanding the pressures that exist between the skin surface and another surface. Pressure monitors are utilized to measure pressures under compression bandages and pressure garments and in determining pressures between patients and support surfaces such as pressure-reducing mattresses and cushions. This literature review identified that many studies using these measurements are inadequately described, and that there are many variables such as the effect of time, posture and temperature associated with such measurements that may lead to misinterpretation of results. Studies utilizing interface pressure measurements should be interpreted with caution and measurement techniques could be improved.

The contribution made by an armchair with integral pressure-reducing cushion in the prevention of pressure sore incidence in the elderly, acutely ill patient

The paper describes a clinical controlled trial of an armchair with integral pressure-reducing cushion, which took place on two elderly acute medical wards in a district general hospital. The aim of the study was to evaluate whether the armchair would have an impact on reducing the occurrence of pressure sores. All patients were provided with a mattress or overlay in accordance with the hospital policy on mattress provision following a Waterlow risk assessment. Patients on ward A were provided with an armchair with integral pressure-reducing cushion, whilst patients on ward B continued to use their existing bedside armchair. Nominal data were collected on all pressure sores in patients who were not bedridden. Ward A had a significantly lower incidence of hospital-acquired pressure sores compared to ward B, and non-hospital-acquired pressure sores on this ward showed more improvement than those on ward B.

The Vicair Academy and Liberty range of pressure-reducing seating.

Many patients can be sitting in a chair for between 3 and 14 hours each day, consequently the type of cushion they are sitting on is of the utmost importance. These patients are often at high risk of developing pressure sores--possibly more so than bed-bound patients. Vicair, whose UK distributor is Gerald Simonds Healthcare, has developed two types of pressure-reducing cushions: the Vicair Academy and Liberty Fluid-Air. These cushions offer pressure reduction in a system that is user-friendly and particularly lightweight. This product focus highlights the problems associated with seating and explains how the Vicair range of cushions attempts to address them.

The Flo-tech range of pressure-reducing cushions

Early rehabilitation of bed-bound patients has highlighted the need for pressure-reducing seating to complement pressure-reducing mattresses. The technology within cushion manufacturing has responded with a customized contouring principle for cushions. This has previously only been available on an individual patient basis. The range of Flo-tech cushions has attempted to provide the general patient population with a cushion that will reduce pressure, provide support and improve posture. The importance of seating in pressure sore prevention cannot be overemphasized. The provision of pressure-reducing cushions can assist in providing a total package of pressure reduction for the patient.

Pressure reducing cushions

Pressure reducing cushions

Pressure reducing cushions

Pressure reducing cushions