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Wheelchair Cushion Maintenance

by Barbara Sweet-Michaels, OTR/L
Extend the life of your cushion and ensure the protection of your skin. Inspect and clean your cushion regularly.

Given the price of some wheelchair cushions on the market today, one would think that they should last at least as long as the wheelchair, if not longer. I have a 10-year-old couch and it looks brand new, but I don’t sit on it every day for 12 hours. Nor do I put the cushions in the trunk of my car in 90-degree heat or sub-zero temperatures. Because a wheelchair cushion takes a beating, it should be treated like a part of your wardrobe. The cover should be washed and the cushion should be cleaned and inspected regularly.

Proper wheelchair cushion maintenance begins with the inspection. Foam, gel and viscous fluid cushions should be checked monthly and air cushions should be checked weekly. Look for signs of the cushion fitting improperly on the wheelchair. Just because the cover is facing in the right direction doesn’t mean the cushion inside it is. Unfortunately, upside down and backward cushions are common. This is especially important if the cushion is custom contoured to match your skeletal structure. Skin breakdown, pain and orthopedic deformities can result.

Inspection Steps

  1. Remove the cover from the cushion. That means that you must be out of the wheelchair.
  2. Look for tears or holes in the cover or zipper malfunction, which might expose the cushion surface or create a wrinkled sitting surface. If the cover contains a foam liner, look for tears or flaking in the foam. The bottom of most covers has a Velcro or a nonskid surface. Inspect this surface for worn or torn Velcro or breakdown of the nonskid material. The cover is designed to protect the cushion, so it should be replaced if damaged.
  3. Inspect the cushion itself for signs that it's no longer doing it's job. Signs of cushion failure will differ depending on the cushion's material.
  • Fatigue of foam is indicated by cracks and flaking on the surface and the foam’s inability to recover its shape when it is not in use. If you remove a cover from a flat foam cushion and it appears compressed or contoured, then the foam is fatigued and should be replaced. This indicates that the foam lacks resilience and will no longer be able to distribute and support the weight of the user (Ultimate: Invacare, Geo-Matt: Span America).
  • Solid gel cushions require a covering material to protect the gel. If its cover is cracked or torn or if the solid gel is exposed, the cushion should be replaced (AKTON: Action Products).
  • There are three types of fluid cushions: air, water or viscous fluid. An impermeable cover must encase all these and cushion failure is indicated by a leak of fluid.

  • A leak of viscoelastic fluid (Jay: Sunrise Medical, Cloud: Otto Bock, Personal Seat: Invacare) or water (WC1822-Water Flotation Cushion: Lotus Health Care Products) is evident by the presence of the fluid. Cushions that use viscoelastic fluid indicate cushion failure by the separation of the fluids creating some areas that are harder or softer than others do. Viscoelastic fluid should be kneaded strong>daily to reposition the fluid and prevent pockets under the weight-bearing surfaces.

    Leakage in air cushions (Roho: Crown Therapeutics, Inc., BBD: Ken McRight Supplies, Inc., Star: Star Cushion Products, Inc.) may not be as obvious. Most often, a cushion will develop a slow leak rather than being punctured. Therefore, an air cushion should be checked weekly to insure that it is properly inflated and the bony prominences are supported. Placing one’s hands under your ischial tuberosities and sacrum will help determine proper inflation. All owners of air cushions should know how to check the cushion's inflation. Please refer to your owner’s manual or contact your therapist. If punctured, air cushions can be repaired with a patch once the hole is located. If the inflation valve stem malfunctions, it must be replaced. Manufacturers will often replace this and repair leaks for a fee.

    The failure mode of an externally powered alternating air cushion (Pegasus: Pegasus Airwave, Inc., Ergo air: ErgoAir, Inc.) should be well understood by the user. Indicator lights are usually present to indicate proper operation. The battery should also have a warning system to indicate when power is running low. All batteries, whether for your cushion or wheelchair, need to be properly charged to insure good operation. You should only use the chargers supplied with the battery and should be familiar with the charging instructions.

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    Remember that wheelchair cushions are an important piece of equipment for all wheelchair users. Because cushions typically do not last as long as a wheelchair, they should be inspected frequently. Foam, gel and viscous fluid cushions should be checked monthly and air cushions should be checked weekly. Some cushions are a combination of materials such as foam and viscoelstic fluid (Infiniti: Invacare, Jay Deep Contour: Sunrise Medical) or foam and gel ( Xact: Action Products, Inc.) or foam and air ( Nexus: Crown Therapeutic, Varilite: Cascade Designs, Inc.). Each product should be inspected separately. The only way to properly inspect a cushion is when you are out of the chair, so the cushion and cover can be removed.