Wheelchair Cushion for Pressure Sore Prevention


When it is time to move the elderly user from the wheelchair to the bed, an awful often starts. The sound of Velcro ripping apart that is holding the elderly user in the chair.

At KARMA, we hear all the time from families telling us they use straps because their elderly relative will “fall forward”, is “easily agitated” or even “because it is safer to tie them to the chair!” For elderly users who are conscious and responsive, being restrained to a wheelchair must feel hot, uncomfortable, and even inhumane! 

The seat restraint isn’t always a bad tool, however, there are better solutions that will make the user and caregivers’ lives easier and prevent the elderly user from sliding forward in the wheelchair.


How do you Prevent the Elderly User from Sliding Forward?

Why does the elderly user slide forwards? Some long-term wheelchair users have poor trunk control, limited hip angle range of motion, or the wrong size wheelchair i.e. the seat depth is too deep. The user will then try to find a more “comfortable” and “stable” position in the wheelchair and slide forward. In this case, we can prevent the likelihood of the user sliding by tackling the “seat” problem.

Solution 1: Ergonomic Seat Design

Most standard wheelchair seats are flat, but there are seat frames designed to curve along the human body to evenly distribute the pressure on the hips, improve riding comfort, increase stability, and most importantly reduce the possibility of sliding down the wheelchair. This is a great method for those who are using a wheelchair less than few a hours per day and still have good trunk control. However, if the user is using the wheelchair for long stretches of time or has an unbalanced pelvis, then we recommend using an air seat cushion. 

Solution 2: Air Cushion

There are many brands of air cushions on the market that serve different needs. The following comparison table shows the different properties of each seat cushion:

Wheelchair Cushion Form Liquid Gel Interconnected Air Cells Airbags
Ability to Redistribute Pressure Medium High High
Stability Highest Medium High
Adjustability Low High High
Weight Heavy Medium Light
Breathability Low Medium High
Maintainability Does not require much maintenance Needs regular inflation maintenance Does not require much maintenance
Risk of Deflation Low High Low


How do you Prevent the User from Leaning Forward?

Have you ever sat on a stool for a long time? Without any support for your back, all of the body’s weight falls on your buttocks. It takes all of your strength to hold your centre of gravity to sit comfortably. However, if someone has poor physical strength then they are likely to succumb to the call of gravity and fall forwards. 

Solution 1: Solid Backrest Support

Completely covers the back and can be adjusted from multiple angles.

The solid back support can be adjusted according to the user’s body shape. A combination of curvature and support means the user can sit more comfortably. The back angle and depth can also be adjusted to suit the user. If you want the elderly user to independently propel the wheelchair, they must first sit firmly and stably so that propelling can be as efficient as possible.

Solution 2: Recline and Tilt-in-Space

The use of a backrest can solve part of the user’s body support problem, but if the user cannot even sit up straight or the user has very poor torso control, other wheelchair functions are needed to prevent them from leaning forward.

The concept is very simple, like a game of tug of war. If the elderly user’s body keeps leaning forward then why don’t we use the opposite force to counter it? For example: 

1. Opening the angle of the backrest will allow the user to lie back, so the user won’t lean forward.

 VIP2 is a KARMA wheelchair available in Malaysia that can be reclined.

2. Tilting the user backward will shift the center of gravity of a user from their hips to their back, making the person more stably positioned in the chair. 

 VIP515: Tilt-in-Space KARMA manual wheelchair. Source: KARMA Medical YouTube: VIP515 – Product Intro

If the user’s body is very weak, the elderly user’s family can choose to combine the above two functions, and use the two-in-one wheelchair to recline and Tilt-in-Space. Research shows that when the reclining and Tilt-in-Space angle is greater than or equal to 45 degrees and the reclining angle is greater than 10 degrees, there is a significant decompression effect!

Tilt-in-Space and Reclining KARMA wheelchair; VIP 2

We’re here to help

Whether you are a wheelchair user or a caregiver, both your physical and psychological state of mind matter to us. Choosing the correct wheelchair for the elderly user can reduce psychological stress and physical labor. KARMA Malaysia is always here to assist. Talk to a KARMA representative today! 

Call us: 03-5612 1921 / 010 – 238 1921

Email us: [email protected]