Seven Steps for Selecting a Seat Cushion

By Lee Ann Hoffman, O.T., MSc. Rehabilitation

August 2, 2017

Topics: Wheelchair Lifestyle

When it comes to selecting a seat cushion, it is important for you to consider all the elements. Consider what the cushion can offer you and make sure that it meets your specific needs.

We advocate the use of a seat cushion and back support system in unison. This provides holistic support to the pelvis and the trunk. The pelvis is considered the foundation of seating, and cushions play a vital role in proper pelvic positioning. If appropriate support is provided to the pelvis, then posture can be controlled above and below the pelvis for better function, comfort, and to help prevent secondary complications such as pressure injuries.


The seat and back system you choose will largely depend on your level of seated posture along with your need for external support to perform everyday tasks such as propelling your wheelchair, sitting upright, and other daily activities.


1. Consider Comfort

You will be the one sitting on this cushion, so it’s important that you play a role in selecting your cushion and selecting what suits your body and activity level. You may only find yourself sitting for a few hours each day or you may be sitting for several hours at a time. Make sure that the cushion you select provides you with a level of comfort that suits your specific needs.


2. Find Stability and Balance

Stability and balance are not only essential to feeling comfortable in your wheelchair, but also to supporting your body and activity level. When you are stable and balanced you have more control and better use of how your body functions mechanically. Select a cushion that can be adjusted if you have specific positioning needs that can’t be met with a basic cushion. A cushion that provides you with stability and balance while sitting helps prevent sliding, which reduces friction and shear. Look for a cushion with a combination of off-loading, immersion and envelopment.  When you are positioned correctly, the cushion design can help provide more comfort, endurance, function and stamina.

Seven Steps for Selecting a Seat Cushion

3. Look for Skin Protection

If you have needs or have a history of pressure injuries, be sure to thoroughly investigate the properties of the cushion you are selecting. It is important to look for a cushion that has pressure redistribution capabilities, such as off-loading, immersion and envelopment that match your level of ability and mobility to independently carry out pressure relieving weight shifts. Also, check to see if the cushion you are selecting promotes the reduction of friction and shear to help with pressure injuries.


4. Be Aware of Microclimates

Microclimate refers to the local temperature and moisture of the body at the point where it meets the seated surface. Moisture is known to be one of the causes of skin breakdown. The cushion should feature intelligent fabric and properties that are considerate of the microclimate. Moisture and temperature control should be a focus of the cushion and fabric. Look for properties in the fabric that allow for air flow and for a cushion composition that is not influenced by environmental temperature. The composition of the cushion may also have special anti-microbial properties which help to control odor.

 Seven Steps for Selecting a Seat Cushion

5. Think about the Cushion Weight

When you look at the overall weight of your mobility system, the weight of your cushion is essential. For example, if you have a lightweight manual wheelchair, the weight of the chair plays a part in your ability to propel the chair.  Consider the weight of the cushion as it could negatively impact the overall weight of your wheelchair and wheeled mobility.


6. Consider Cushion Height

The height of the cushion is an essential part of your seating and mobility needs. When looking at transfers the ability to fit under desks and tables and factors such as the stability and the height of the cushion are often overlooked. The height of the cushion could make a considerable difference when accessing your environment. For example, a cushion that raises you four inches from the base of the wheelchair may mean not being able to fit under a desk, table or may even impact your ability to transfer from one surface to another.


7. Research Maintenance

Consider the ease of use and set up of the cushion. Is the cushion ready to use? Does it require periodic maintenance? Is there a way to tell if the cushion is not set up correctly or if it is still working as intended? Some seat cushions require correct set up and ongoing maintenance while others have relatively low or no maintenance requirements. Make sure you are aware of all the aspects relating to maintenance.

How to Help Prevent Pressure Injuries


Lee Ann Hoffman, O.T., MSc. Rehabilitation

Lee Ann Hoffman, O.T., MSc. Rehabilitation

Lee Ann qualified as an Occupational Therapist in 1999 in South Africa. She completed a post graduate certificate in Posture Management for complex disabilities in 2010, and obtained a Master of Science degree in Rehabilitation: Posture Management, 2015 in the United Kingdom. Lee Ann has experience in working with children and adults with complex disabilities and adopts the 24-hour approach to postural management. She is currently a clinical educator for Invacare USA.

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