One of the most critical needs of a wheelchair rider is for a good cushion. Lack of a well designed and maintained cushion can quickly lead to serious pressure sores that are more disabling than the original disability. One of our promising wheelchair builders has lost his life to pressure sores, and several others have been too ill from sores to be able to build chairs well.
A good cushion is one that provides good support, evenly distributed over all of the rider's seat. When redness or sores indicate, a good cushion can be easily modified to give even less pressure on the bony parts of the rider's buttocks. A good cushion is well ventilated, so that sweat or spilled liquids do not keep the skin too damp, because dampness alone can cause the skin to break down. A good cushion is lightweight, is inexpensive - a few dollars at most - and lasts a long time with few repairs.
A cushion combining all these assets is unfortunately very difficult if not impossible to produce. We will offer two cushion designs with the following warning: No one cushion will work for everybody. Every cushion must be custom fit to the rider, and it cannot be safely used without careful and regular inspection of the rider for redness or, worse yet, for any signs of skin sores.
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THE CARDBOARD CUSHIONThis cushion is the best all-purpose low cost cushion we have been able to develop sofar. Ken Hawkins, David Werner, and Wally Motloch have made significant contributions to its design. The base of this cushion is made of corrugated cardboard from ordinary shipping cartons. The cardboard is cut to provide pressure relief and molded to adapt it further to the individual user. |
On top of this base is a softer cushion of about 2" (5cm) of high density foam or other cushion material. The cover is made of absorbent cotton, fit loosely.
MATERIALS
| ITEM | SIZE | QUANTITY |
| Corrugated cardboard | The same size as the user's seat upholstery | Enough layers for 2" (5cm) thick |
| High-density foam, 2" (5cm) thick | Same as above | Same as above |
| Soft cotton fabric | 40 inches (1 meter) wide | One half yard (meter) |
DIRECTIONS
1) Cut out enough rectangles of corrugated cardboard to make a stack 2" (5cm) high. Bend each of these pieces with your hands so that they match the curve of a wheelchair seat.
2) Glue all the pieces of cardboard together with a water-resistant glue.
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3) Cut out a pressure relief hole under the bony parts of the rider's seat as in the diagram. The dimensions given are approximate, and will have to be adjusted to the needs of the rider. The cardboard can be cut with a saber saw, a coping saw, or a keyhole saw. 4) Dampen the top of the cushion thoroughly until the water soaks through 2 or more layers of the cardboard. 5) Have the person who will be using the cushion sit on the dampened cardboard cushion base, without a cushion on top of the base, for several hours. The cardboard will change shape somewhat, molding itself to the shape of the rider's bottom. It is dangerous to sit on any surface without a good cushion. Inspect the rider regularly to be sure that there are no signs of skin breakdown. |
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6) Dry the cushion base and coat it thoroughly with waterproof varnish. 7) Make a cushion cover by sewing a loose envelope of absorbent cotton fabric. Do not make the cover tight - a tight cover can create extra pressure on the rider's bottom. 8) Use enough padding over the cardboard base to guarantee that there will be no areas of high pressure. If high density foam is not available, other cushioning materials might work: a much thicker low density foam, fiber furniture padding, or even a very soft folded blanket. In every case watch for red spots on the rider; there is no cushion design that will guarantee success in all cases. |
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THE INNERTUBE CUSHION
This cushion is a very low cost design that is well suited for sitting on hard surfaces, as in the bath. The cushion can also serve as a general purpose wheelchair cushion for some people. It was developed by the wheelchair rider-builders at Tahanan Walang Hagdanang (House With No Stairs), Quezon City, Philippines.
This cushion is made from a single bicycle innertube, 28 x 1.5 inch size, folded and tied in a pattern like the letter E. Because this cushion does not allow as much ventilation as some, a thick, soft terry cloth cover is recommended.
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DIRECTIONS1) Fold the innertube in the pattern shown. Using strips of rubber cut from old innertubes, tie the folds of the innertube together. Place the valve in one corner, on the bottom side of the cushion. Make sure that all the knots in the rubber strips are also on the bottom of the cushion. You may need to use more ties than are shown. 2) Inflate the cushion slowly, adjusting the strips to keep the tubes well aligned. Be very careful to be sure the valve is not pressing on the user. |