Ride Cushion and pressure sores.

[Burgerman]

I tried and used for years gel, roho, jay, and several other cushions. And spend a lot of time on bed with recurring Ischeal Tuberosity issues. Mostly on the left side.

This cushion sits you in mid air, with all the usual pressure spread around the outer edges with a carefully shaped hard closed cell foam. It allows air under you and has a large vent to the front to do that to keep you dry too.

BROCHURE AND DETAILS
https://www.wheelchairdriver.com/doomed ... ochure.pdf


My local wheelchair services just dropped mine off FOC here at my house.

I have a bunch of the wedges, some of the side supports to stop my legs splaying, on order, and a bunch of other foam parts and a very carefully made bit of green foam that goes in the bottom to detect if you bottom out even once during the day. It compresses easily. But it doesent return. You use it once! Any marks and you need a different cushion.

Initially I asked a nurse to contact them about it. They relied that it "wasnt available in the UK. Because well, Wheelchair Services are like that. So I sent the nurse a screenshot from sunrise of an email I already had about it. And another showing it was available in the UK on the sunparts website...

Several months passed. Then they just turned up with a sunrise rep that explained that they were 3d printed and he saw it happening. They are not, its just moulded high density closed cell foam... Whatever. The original mould may be 3d printed...

But this SHOULD cure my problem. And available on the NHS.

Have a read https://www.sunrisemedical.co.uk/seatin ... va-cushion
Carefully.

Order form
https://www.sunrisedice.com/asset-bank/ ... 112488.pdf
Manual
https://www.sunrisedice.com/asset-bank/ ... 112077.pdf

One thing.
Its bottom is curved to sit on a sling base seat. So I will need to add a strip of foam along the left and the right edges underneath to "take up the difference" in order for best stable setup. Thats a minor technicality.

[Burgerman]

Your bony prominant parts are totally unloaded. So zero pressure. I will omit the black optional centre foam. As it says, for optimal pressure reduction, dont use these!
This gives less pressure as well as allowing airflow to directly contact all of your bum that is sat over it. Because heat and damp make this stuff worse fast.

This is the adjustments, lateral, and rear height. And shows the firm part of the base and why it unloads the bony bits.

Airflow Theres a large half circle cut out that goes under the cushion and leads to the front edge. About 50mm diameter. But flatter/ oval. This connects directly to the bowl part. As you roll and move around it pushes air in and out. So keep you dry and the air fresh. (I have considered adding an extra couple of 25mm tubes that go to the rear corners too.

Then I realised there are a lot of "holes" in the bottom of that bowl shaped part. Look at image 2. So I will drill some in the steel seat base to match. For easy mod that increases airflow. Or just put a 3 inch hole saw through the foam ad the chairs seat plate in one go.
The bottom of the cushion cover is a simple mesh so flows air.
You could even fit a small PC fan below the seat plate to force ventilation... Then if you poop the shit really would hit the fan.
To prevent

So I ordered a roll of 60mm wide 15mm thick adhesive foam. To add two lines to the wheelchair base metal. To give the support needed at the sides. So it thinks its on a sling seat.

Theres are many studies online with this cushion compared to other types such as here with a Roho (which from experience was the best) V the Ride cushion.

Since you are literally OFF the coccyx and ischal tuberosity bones completely, this is exactly what you would expect. I absolutely expect that this cushion will defeat my 5 years of hell with most of it on my bed. Back to normality.

For others in a similar situation I really do suggest you try one. I have not yet tested. But fully convinced it will do the trick after looking at it.
Only arrived today. Still awaiting a few bits like the forward supports, adhesive foam (because the base of this is not flat. Its curved slightly to match a manual wheelchairs sling seating).

Mapping...

[Burgerman]

Because the base of the Ride cushion isnt flat I ordered some tape.

5 meters (5x 39 inches, huge overkill but I have many chairs!)
60mm wide (about 2.5 inches)
15mm thick relatively hard foam rubber. That lasts. 15mm thick is just over half an inch. Around 9/16ths?

A single strip can be added to each side of the cushion bottom - inside the cover. Or added to the metal seat base on the chair. This basically gives the same profile as a sling seat base that this cushion was designed for. It would work regardless. But this is better.

[Raro]

Good luck with it, let us know how it goes.

[Burgerman]

Thanks, I will. I am however fully confident that it will cure that Isheal Tuberosities (IT's) issue. After years of frustration.

I just love how wheelchair services replied to the nurse by email assuring them that it wasnt available in the UK market...

[martin007]

I don't (yet) use those cushions, but I'm interested in the topic.
What makes it different?

[Burgerman]

There are 3 points on your backside where pressure ulcers or "sores" are problematic for powerchair users.

On a simple typical flat rectangular foam cushion, like a sofa, cheap wheelchair cushion, the bits of you, that sink into into the foam the deepest exert the greatest pressure between your skin and the bones. These 3 danger zones are your tailbone (cocxyx) and the two lowest parts of your backside, the bones refered to as the sitting bones. (Or in medical terminology the Ischial Tuberosity bones).

With foam, the deeper these three parts "push" or sink in to the cushion or seat, the higher the pressure exerted. Usually a lot higher. The result is that the blood supply in the tiny capilliaries in the skin gets stopped. No oxygen then reaches the flesh below the skin. It doesent hurt because many of us are paralised and cant feel it. The result is dead tissue and a hole appears in your backside that can reach the bones. Suddenly! Sometimes theres little warning.

Gel cushions attempt to reduce this pressure by floating these bones in a pool of gel. Air cushions float these parts on air. You sink in and float. In both cases that REDUCES the pressure difference, but it doesent remove it. So the deepest body parts STILL see more pressure on the skin, its just reduced compared to a foam cushion. So pressure sores/ulcers can still happen.

THIS specific cushion levitates the 3 bony parts in mid air. They do not have any pressure. And does so without increasing pressure elsewhere by very much and with no high pressure points at all. It supports your mass over every part, legs, hips, (corners of the cushion) etc. So as to decrease average pressure on the whole area that are holding your mass. And no pressure on the 3 boney parts that suffer from the ulcers.

Does that help?

[Burgerman]

A picture is worth 1000 words.

When you sit, these two bones have most of the load. They are covered in muscle and skin.

With people that are paralised and dont walk. The MUSCLE wastes away. That leaved hard bones, covered in a thin layer of skin. When you sit that part of the skin that covers these ischeal tuberosities is squashed (pressure) and that prevents the blood oxygenating the tissues. The cells dIe. You get a hole in your ass.

This cushion allows these bones to "hover" in mid air, no weight on them at all.

[martin007]

OK.
I understand.

[martin007]

The main difference (I see) is that the cushion also uses the legs to distribute the pressure.

[Burgerman]

And your hips, to the rear corners of the cushion. And NOTHING in the centre.

[martin007]

The idea is very simple.
As the contact surface area increases, the pressure decreases...

[Burgerman]

It does that without any peaks of pressure.

If you took a typical flat cushion, just cut holes where those bones are. Or one large hole. Then that removes the pressure over the boney parts. But it increases pressure everywhere else. Because less total area. So risks sores in other places. But much worse is that it causes elevated pressures all around the parts where you cut the foam away. Making the problem worse instead of better.

This allows your whole backside, including the rear corners (normally unsupported) and the parts that are capable of surviving higher loads (thighs etc) to take your weight. While having no higher pressure areas and no pressure at all under the IT or Coccyx parts.

I rtied to make one very similar to this years ago. But couldnt get firm enough foam. It needs to be a pretty firm shaped base. This is a type of closed cell moulded foam. It doesent move much.

I am tempted to make a mould from it. So I can make others! (Personal use only as copyright etc).

Cover it in plastic "cling" film. COAT with heavy layer of release wax. Build wood box the correct height. Use iterally pour liquid resin, hardner in. Wait for it to set. Take my box apart and the original seat base foam out. Put back on chair.

That will leave a perfect mould. Fill it with this:
https://www.mbfg.co.uk/foam-hard.html

Will make myself one per chair. Will customise the size so its perfect for me!

[jefferso]

Did you get this cushion? Have you tried it yet? Is it as good as hoped?

I have a Roho Quadtro SELECT® but I keep having recurring sores. Nothing terrible yet, but have to put dressings on and sometimes the adhesive from the dressing irritates the skin. And then I have to spend more time in bed, and more time reclining in my chair.
I also get sweaty and itchy. I made a little thing out of folded wire with makes an air space under the crotch, and I've started having a little usb fan on the cushion between my legs, but the whole setup is far from ideal.

[Burgerman]

Did you get this cushion? Have you tried it yet? Is it as good as hoped?

I have a Roho Quadtro SELECT® but I keep having recurring sores. Nothing terrible yet, but have to put dressings on and sometimes the adhesive from the dressing irritates the skin. And then I have to spend more time in bed, and more time reclining in my chair.
I also get sweaty and itchy. I made a little thing out of folded wire with makes an air space under the crotch, and I've started having a little usb fan on the cushion between my legs, but the whole setup is far from ideal.

Cant test yet. Bladder infection right now (aren't those fun) and sore waiting to heal... But its here and I am looking at it! I am convinced that it will totally prevent Ischial Tuberosity sores returning every few days. Since they touch nothing. And its well ventilated. Especially if you shove a 3 inch hole saw through the seat plate base under the correct spot. Sounds like you have the exact same issues.