Preliminary development of an advanced modular pressure relief cushion: Testing and user evaluation.
OBJECTIVE
Effective pressure relief cushions are identified as a core assistive technology need by the World Health Organization Global Cooperation on Assistive Technology. High quality affordable wheelchair cushions could provide effective pressure relief for many individuals with limited access to advanced assistive technology.


METHODS
Value driven engineering (VdE) principles were employed to develop a prototype modular cushion. Low cost dynamically responsive gel balls were arranged in a close packed array and seated in bilayer foam for containment and support. Two modular cushions, one with high compliance balls and one with moderate compliance balls were compared with High Profile and Low Profile Roho®and Jay®Medical 2 cushions.


METHODS
ISO 16480-2 biomechanical standardized tests were applied to assess cushion performance. A preliminary materials cost analysis was carried out. A prototype modular cushion was evaluated by 12 participants who reported satisfaction using a questionnaire based on the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) instrument.


RESULTS
Overall the modular cushions performed better than, or on par with, the most widely prescribed commercially available cushions under ISO 16480-2 testing. Users rated the modular cushion highly for overall appearance, size and dimensions, comfort, safety, stability, ease of adjustment and general ease of use. Cost-analysis indicated that every modular cushion component a could be replaced several times and still maintain cost-efficacy over the complete cushion lifecycle.


CONCLUSIONS
A VdE modular cushion has the potential provide effective pressure relief for many users at a low lifetime cost.
Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH 44106, USA; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA.
Tyler
T
Freeto
SCI/D Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH 44106, USA.
Steven J
SJ
Mitchell
Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH 44106, USA; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA; Department of Orthopaedics, Case Western Reserve University, Cleveland, OH 44106, USA. Electronic address: kmb3@case.edu.
Kath M
KM
Bogie
D004867:Equipment Design / Q000592:standards; D006801:Humans; D000067896:Industrial Development; D008422:Materials Testing / Q000379:methods*; D011312:Pressure / Q000009:adverse effects; D003668:Pressure Ulcer / Q000517:prevention & control; D012656:Self-Help Devices / Q000592:standards* / Q000639:trends; D014910:Wheelchairs / Q000592:standards*; D014944:World Health Organization / Q000458:organization & administration
Standardized biomechanical testing; Value drive engineering; Wheelchair cushion