Page 20 - Mobility Management, September 2017

ATP Series
Immersion, Envelopment, Off-Loading
J2 Deep. Then we have ones that do a little bit of everything with a good, balanced approach. That would be the Fusion. We have different ways of reaching that goal, because we know everyone presents a little bit differently.”
Measuring Immersion
As can happen when defining terms, what seems simple on paper can become much more complex when applied to actual clients.
Tom Whelan, Ki Mobility’s VP of product development, explained the nuances of immersion, for example.
“Immersion has been characterized as the linear distance that you sink into the cushion,” he said. “The problem with immersion, like everything else in science, is where do you start measuring from on a highly contoured surface? You start to run into problems using immersion as a comparative measure.
“Conceptually, it’s easy. If I sink into the cushion more, I’m going to create at least the opportunity to have more surface area to distribute my load over. But now if you want to start talking about immersion in four different cushions, how do
you characterize immersion? Because if it’s a linear dimension from a starting point to a finishing point, the starting point becomes the subjective part of the measure; the finishing point is straightforward.”
How do you measure immersion, for example, in a contoured cushion?
“If you have a cushion that has a slight upward contour on the outside of the cushion that isn’t really material to loading,” Whelan said, “do you measure from that point? If it’s highly precontoured, and it matches your butt, do you measure from where you first contact the cushion to where you end? Are those comparisons meaningful?
“To talk about immersion and just say that immersing is important and it’s one way to look at a cushion is easy. To drive it into a scientific measure that gives you values that a clinician could use is incredibly difficult.”
Medicare’s cushion testing, Whelan added, measures immer- sion — by sinking an “indenter,” a mechanical model repre- senting a human rear end, into the cushion.
“[Medicare testing] is purely an immersion test,” Whelan said. “The problem is that when you use a cross-sectional analog of a pelvis, which is what [Medicare’s] indenter is, you have to have a material that responds to a cross-sectional analog the same as it would respond to a complete butt. And that’s not rational.
“If you use something that has fairly consistent materials, like a foam cushion, a cross section analog of a pelvis isn’t a bad indi- cator of how it would perform with an actual pelvis. But if you
THE CRITICAL ROLE OF CUSHION COVERS
Wheelchair users might treat cushion covers as little more than upscale pillowcases, existing mostly to keep seat cushions clean.
But covers on complex rehab cushions do far more than that. And educating consumers on a cover’s true role can be the differ- ence between an optimal seating system and one that compro- mises function.
Maximizing Interaction with the Client
Jeff Rogers is the senior product manager, pediatrics and seating, for Sunrise Medical. He explained how Sunrise (and other complex rehab manufacturers) design cushion covers.
“We have designs in some of our cushion covers which opti- mize immersion,” Rogers said. “For the Fusion, we do a cutout in the rear to allow only a thin layer of black stretch fabric to be in between the individual and the fluid medium, which allows better immersion. If that cover were put on backwards and you sat on top of spacer fabric [instead of the thin stretch fabric], you would hinder that. So there are things like that that we do to maximize [cushion] interaction with the client.
“With the J3 cushion, the cover was really a critical part of the design. The comfort part — with spacer fabrics and things like that — were built into the cover. But we know people take covers off and wash them, so if a cushion can be more forgiving while someone’s cleaning the cover, that can be a good thing, too.”
Rogers explained that consumers sometimes continue to use seat cushions while covers are being cleaned.
“There are a lot of facilities and clinics where the person can’t be off their chair while their cover’s being washed,” he said. “Instead of being in bed for a couple of hours, they’re going to just sit on their cushions. So we make sure cushions are protected when that happens.”
Rogers said that while an outer cover is being washed, an inner cover remains on the cushion to protect the foam.
Blankets, Towels & Slings
It’s also wise to educate consumers on the importance of cushion covers, and why it’s a bad idea to put a blanket or towel between the user and the cushion cover.
“We’ve seen people leave the
sling for their Hoyer lift under-
neath them, between them
and the cushion,” Rogers said.
“That sling is very dense and
does not stretch whatsoever. It really hinders what the cushion is designed to do.
“We say, ‘You’re buying this cushion that was specifically designed for you to sit in, and when you throw a towel over it or throw a blanket over it or a sling under it, you’re defeating the purpose you bought it for.” m
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