Written by Megan Smith, PT
It’s no secret: a wheelchair, while helpful and potentially even life-changing, can cause its own set of physical problems.
For millions of Americans, integrating a wheelchair into daily life has helped them maintain a valuable degree of autonomy and promote a sense of freedom, regardless of whatever medical diagnosis limited their ability to be independently mobile. However, something many wheelchair users have been made aware of is the possibility for skin sores and back pain to develop as the result of prolonged and improper sitting.
For elderly users especially, the risk of painful sores and a curved spine is quite high, and discomfort increases the longer they remain in a wheelchair that isn’t properly distributing their weight. For these people, positioning wheelchair cushions can make all the difference between feeling uneasy, or feeling supported and safe in their wheelchair!
Seating technology has come a long way since the days of the basic sling-seat manual wheelchair, and the right choice of seating cushion can be incredibly beneficial to both a user's health and comfort.
For many individuals using wheelchairs, particular needs arise in terms of proper positioning of spine, limbs, and muscles. The right cushion can do the following:
The following cushions have been selected for their ability to give users an unrivaled amount of support, and help keep them seated in a way that prevents tension, sliding, or uncomfortable hip rotation!
The Support Pro Wheelchair Cushion is a foam cushion that offers quite a few valuable features to address positioning needs - starting with a sturdy, solid foam base!
Providing good, firm support from the bottom layer on up, this cushion includes an optional rigid insert for bariatric users to provide an even sturdier seat. Beyond support, though, the Support Pro comes in three different models - each of which accommodates a particular positioning need!
Adds no height to the wheelchair, allowing the individual to comfortably sit at a variety of desks and tables without needing to worry about their knees bumping into the tabletop. However, due to its modest design, this model is probably not the best choice for someone who needs a moderate to high degree of positioning support.
Uses an angled, wedge-like design to prevent forward leaning, making it perfect for individuals who are prone to slouch in their chair and run the risk of dislodging their cushion. This clever design helps prevent the user from slumping and positioning themselves in a way that compromises their posture.
A rear contour cutout keeps the hips from sliding forward, promoting good upright posture and keeping users safely positioned toward the chair back.
Each of the Support Pro’s three models has a waterfall front, which relieves pressure on the back of the legs, and a coccyx cutout to reduce strain on the vulnerable tailbone area. Optionally, when selecting your cushion features, you can also add a pommel for leg abduction!
Something remarkable about the Support Pro is the optional QuadraGel. These handy gel packs purposely regulate the user’s body temperature in the most high-contact areas of the cushion. This small yet impactful feature makes all the difference between sitting on accumulated body heat, or sitting on a cushion that resists sweat and heat.
Finally, all Support Pro models come with a stretchable Solace fabric cover that’s water-resistant and easy to clean. The fabric also helps regulate temperature, too!
Customers repeatedly mention the comfort and positioning assistance offered by the Support Pro! One customer pointed out the durability of the cushion, since it’s faithfully stood the test of time for her.
Another customer found the anti-thrust feature particularly helpful in correcting their sacral sitting. This user also appreciated the fact that the cover is easily washable!
The ROHO Contour Select cushion is a seating solution that focuses heavily on both postural support and postural correction. It does this primarily through its adjustable air cell design and highly customizable pressure settings!
The Contour Select uses something called Isoflo Memory Control Technology to inflate each of the cushion’s four quadrants, distributing air where it’s needed the most. Depending on the user’s desired positioning, weight, and placement in the wheelchair, they can add or remove air to certain quadrants to achieve the perfect amount of support!
The cushion can be adjusted this way: the user begins by over-inflating the cushion, and placing it on the wheelchair seat. Then, the user sits atop the cushion, manually releasing air via the rotating valve cap, until their sits bones are sunk comfortably into to the cushion.
Another thoughtful element of the Contour Select is the way it enables users to add air via the included hand pump, even while they’re sitting on the cushion! This way, inflation levels can be checked throughout the day, and users or Caregivers can make small additions of air, as needed.
The Contour Select cushion is perfect for users who are at moderate to high risk of developing pressure sores, or who have thin, dry skin that breaks down easily under pressure. The air in the cushion is easily adjusted to correct for flexible pelvic obliquity (one side of the pelvis sitting higher than the other), or for posterior pelvic tilt. The caregiver would adjust the patient into the desired positioning, then add or remove air from the cushion until that position was supported.
Last but not least, this cushion is easily cleaned with soap and water, and comes with a stretchable cover that can easily be repaired in a cinch with an included repair kit!
Users of the Contour Select cushion, as well as their caregivers, have nothing but praise for its excellent comfort and positioning stability! People with challenges ranging from full-body paralysis to cerebral palsy to those with diabetic pressure sores mention the uncommon comfort they’ve achieved by integrating this product into their everyday lives.
In particular, fewer pressure sores and markedly better posture are two things many Contour Select users have experienced.
The only downside mentioned is that the cushion can be punctured. (However, the fact that it can be hand-repaired is a plus!)
No stranger to Rehabmart’s 5 Best lists, the Jay Union Wheelchair Cushion ranks highly in a number of our competitive product reviews, garnering awards like Most Advanced Foam Cushion and a number-two spot on our 5 Best Wheelchair Cushions for Ulcer Prevention!
The Jay Union’s high-density foam at the base of the cushion provides its super solid structure, while lateral wedges for stability, a pommel for leg abduction, a coccyx cutout for pressure relief, and waterfall front work together to deliver exceptional positioning comfort!
This high-density foam is then topped with two layers of super-soft Visco™ memory foam, and an added layer of liquid tucked into the pelvic well conforms to the user’s unique contour for even greater pressure relief.
While most wheelchair cushions feature a fabric choice of either Lycra or Nylon, Sunrise Medical takes it five steps further and cocoons the Jay Union in a unique X-static® fiber woven with 99.9% pure silver - a naturally anti-microbial element. The outer cover layer has a handle, and a zipper with a cover flap and waterfall seams to prevent rubbing.
Last but not least, the Jay Union’s cover is double-layered: the inner layer is made from stretchable, waterproof Lycra, with a water-resistant zipper that won’t rust or get stuck when exposed to moisture. In fact, it uses the same anti-wicking seam thread used on military uniforms and duffel bags! These two innovative features work together to ensure no moisture reaches the cushion body.
Almost all reviewers of this cushion focused on its overall comfort and fabric breathability, which customers said offered them hours of sitting without perspiring! Others shared that the cushion is adaptable and gently compresses with the user’s shifting body, giving them time to adjust without feeling unbalanced.
For wheelchair users who need both customizable skin protection and a good deal of positioning support, the Vicair Vector X Cushion is the perfect solution!
With the Vicair Vector X, users get to build a truly customized seating experience, thanks to air-filled tetrahedronal comfort cells which can be added or removed to suit any positioning need. This cushion makes both a great offence and defense against painful skin shearing and pressure sores - a valuable combination for users whose support needs may change over time!
What’s more, there’s no need to re-fill this cushion with a hand pump throughout the day. Once you reach the ideal configuration of air cells, little maintenance is required.
The Vector X is perfect for users who need relief from pain and pressure in the coccyx area, and those who need maximum prevention of shearing and pressure ulcers. Adjustable lateral leg contours add to this support, keeping the user in an upright and aligned sitting position, while removing the center section relieves pressure on the trochanters and femurs.
As far as covers go, the Vector X comes in two choices of durable fabric: StretchAir, which is breathable and waterproof, or ComforTek, which is soft, waterproof, and easier to clean by hand. Both include the option of a Glidewear shear reduction zone for extra skin protection!
Adjustability and softness are the two features most frequently applauded by users of the Vicair Vector X cushion. Many reviewers are people who spend the majority of their time in a wheelchair, and both they and their caregivers note the way the air cells work to conform to the user's body and protect against pressure sores!
Our number-one pick for best in positioning goes to the Saddle by Comfort Company, and it’s no surprise: with its dynamic combination of pressure distribution, unrivaled support and temperature regulation, customers would be hard-pressed to find a cushion more reliable and better suited for proper positioning!
Constructed of a double layer of high-resiliency foam, the Saddle cushion provides a firm, stabilizing base. Beyond this simple foundation, however, it includes several unique positioning features that set it far apart from the rest.
Much like our number five winner, the Support Pro (also from Comfort Company!), the Saddle cushion comes in three innovative positioning options:
Zero Elevation, which doesn’t add height and offers more freedom of movement; Wedge, which gently positions the user’s body back in the seat to prevent forward leaning; and Anti-Thrust, which provides thigh and pelvic support to prevent the user from slipping out of the wheelchair.
The cushion's waterfall front takes pressure off the legs to promote better circulation, and optional Quadragel insert packs offer additional pressure relief and regulate lower body temperature.
The stretchable Solace fabric cover offers extra protection against agitation-driven skin ulcers, while also doubling as a water-resistant defense against incontinence and spilled liquids!
Finally, all Saddle cushions are designed with two valuable safety features: a large bottom surface that fits snugly into both sling and flat-seated wheelchairs, and Kwik Straps that buckle on to the wheelchair for a no-slip seating experience.
One feature of the Saddle cushion that customers remarked on was its ability to help users maintain a healthy, ergonomic, upright position. The Kwik Straps keep the cushion steady and centered on the wheelchair, so that sliding and slumping are totally preventable.
In addition, one particular caregiver submitting a product review noted that their formerly irritable wheelchair-using client became much more positive and happy once they began using the Saddle Cushion!
With over one hundred wheelchair cushions available at Rehabmart.com, the process of choosing the top five in the category of positioning was carefully executed through a week of hands-on product testing! The major factors we considered when ranking these five high-quality cushions were comfort, positioning, and the advances in technology they use to provide a superior user experience.
The Support Pro cushion’s high-quality foam, built-in gel packs, and three seating models added up to a number five placement, with our product testers and real-life Support Pro customers especially appreciating its durability!
For users with a moderate to high risk of pressure sores, our number four pick, the ROHO Contour Select, comes highly recommended. Its four-quadrant Isoflo technology ensures a deep, soft seating surface, and user feedback confirms this cushion works to reduce skin injuries and correct pelvic deformities that could later develop into more serious problems.
In the number three spot, the Jay Union wheelchair cushion arguably offers the deepest, plushest sitting experience. By combining an internal layer of liquid along with two layers of memory foam, users love the way it distributes heat and prevents uncomfortable perspiration.
The Vicair Vector X appeals to nearly any individual with its amazing 550-pound weight capacity, while the cushion itself remains remarkably lightweight. Thanks to its individual air cells, the Vicair is highly customizable, and faithfully protects delicate coccyx and femur areas with its tetrahedronal Comfort Cells.
But at the end of the day, there can only be one!
Our champion in wheelchair cushion positioning is the Comfort Company’s Saddle Cushion. Combining all the best features of the other four cushions on this list, it sweeps the category with its ability to address a range of positioning needs, from spinal alignment to pelvic rotation and everything in between.
Users and caregivers alike have praised the Saddle cushion for the difference it has made in their lives, acting as both a preventative measure against skin breakdown while also helping wheelchair user rehabilitate from painful pressure points. For these reasons, it is our number-one choice for a positioning wheelchair cushion!
Keep reading with our article How to Choose the Best Wheelchair, and watch dozens more product reviews at Rehabmart’s YouTube channel!
Megan has been a part of Rehabmart since its inception nearly 20 years ago. For the past several years she has been enjoying her role as HR Director while maintaining her Physical Therapy license. When she isn't working on her next in-service or working to find a new team member, she enjoys her five children, helping those who have PT type ailments, baking, practicing yoga, and working out.
