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    Cushion height

    I currently use a standard 2-inch foam cushion on my ZRA and it's horribly uncomfortable. I have full sensation so skin breakdown isn't an issue. I'm looking at a new ROHO cushion and trying to get an idea on low, mid versus high profile. I've already read up on cell height versus immersion depth, but it's confusing. Is that immersion depth at the ischials? If so, about how much immersion is there typically at the front of the cushion?

    Right now the tips of my fingers go to the center of my axle and I'm afraid to throw that off. I also dont want to get too high that getting under tables is an issue. It'd be nice to raise up my footplate for better ground clearance, but I manage fine the way it is now.

    I have Reflex Sympathetic Dystrophy and I use a chair because of severe pain in my left leg and intermittent dystonia as a result of the RSD. What are your thoughts on a contoured cushion?

    #2
    Find a good seating clinic........ and try many different kinds.

    As far as you roho question. The deepest immersion is at the ischials. Typically, there is minimal immersion at the front.

    Also, I always recommend people have and use two different cushions. It changes up things and keeps your butt moving...

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      #3
      No doubt the best way is to use a seating clinic.

      I'm just looking at specs and thinking of how different cushions might or might not work for me so I can narrow them down. I never like going into an appointment not having a clue what's going on.

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        #4
        Because you have a ZRA you will be adjust the rear/front seat height and footrest length to match your cushion, I would choose the most comfortable cushion, after going to a seating clinic and trying different types. Disability trade shows can also be good for this if there is one near you soon.

        My husband is full-time in a chair and has mostly full sensation with heavy post-stroke neuropathic pain. We have found that the high profile cushions are more comfortable for him. He has a Synergy Spectrum Air 3.5" cushion now that is semi-contoured with a Roho like insert for the ischials. It works pretty well for him, because the full Roho's make him flop around a lot. We are also looking to get a Varilite Evolution PSV 3.8" semi-contoured cushion too, and have looked into the Supracor Stimulite Contoured cushions also (both of which get good reviews on this site).

        It's not easy for us to go to a seating clinic or demo cushions, but if we could, I would wait until then to make decisions, and I would try as many as you are able to, making sure you keep table height and other things like sinks, desks and workspaces in mind.
        Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

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          #5
          My current chair was a demo bought off of Ebay so the measurements aren't exact, but it works very well for me. With that being said, my RSH is already as low as it can go. I couldn't stand the almost no dump and felt like I was sitting on top of the chair instead of in it. Thankfully the added dump worked out ok with how far down I can reach on my rear wheels. Since I'm not able to decrease the RSH any further I'm even more interested in figuring out how much higher I'd sit on a new cushion. Of course a 4" cushion does not translate into sitting 4" higher so that's what makes it difficult to figure out. I may be able to decrease the dump if I actually had a cushion with some give to it.

          Right now my ischials hurt when I'm in the chair for even a brief period of time. I've worn some sharp looking grooves into the cushion in those areas. I've got some meat on my hips, but when I sit my butt bones aren't protected by much.

          Ashleigh, do you have a pic of your chair on here somewhere, or could you post one? I'd like to see what the high profile looks like on an actual chair. Do you sweat much because of the cushion? Summers are brutal where I live.

          Much thanks to everyone's replies. As I've mentioned before, this is new territory to me.

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            #6
            Supracor makes a lot of different Stimulite cushions in various depths. I’m sure you could find one that suits your needs. Even at 1.5” they are not supposed to bottom out.

            You said you didn’t like “sitting on top” of your chair. In that case you could do what I did—skip the contour and get a flat cushion like the Stimulite classic then loosen your seat sling to create a curved contour that lets you sit deeper into your chair.

            You can adjust your height/dump this way by loosening the rear of the sling more or less than the front. I managed to find myself a sweet spot using this method. I created a little bucket for myself, and it works well for my "bucket" too. I feel better than when I was sitting on that hard stretched seat upholstery my chair came with. There are some among us that do like a solid seat pan; you don't sound like one of them.

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              #7
              Have you tried a supracor cushion at all? Because my fear w/Roho is that it would increase your seat height too much - I tried one out (Roho) and it made me sit much taller, even with quite a bit of air let out. Because I do have reduced sensation, we found that I had too much pressure when I let out enough air to lower myself (as I don't want anymore dump/bucket). Even though you have sensation, you may find yourself bottoming out if you really need to lower yourself down significantly.

              I also prefer Supracor because of breathability, washability, and easy maintenance (none really).

              Another thought - is your alignment of your pelvis good? I was having terrible pain right over ischial tuberosities, and recently found out that my pelvis was rotated. I did some PT that helped get my SI joint into better alignment, and I've been feeling a lot better ever since.

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                #8
                Supracor cushions are definitely awesome! They are they best wheelchair cushions out there on the market. Very expensive, but insurance companies will usually be able to cover the cost for it if it's for a primary use wheelchair. I have the contoured model, and I love it! No gel to have to punch back into shape, and no foam bottoming out. The honeycomb molds to your sitting position, and provides excellent positioning support.

                I wish I can get one for my manual wheelchair as I have a very old ROHO cushion that I wish I can get replaced. But, I have to wait until I can get enough money from my disability income because my insurance will not pay for it since it's for my manual wheelchair (and they already had paid for the one for my power chair).
                Samantha

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                  #9
                  I've been thinking about trying to get a stimulite cushion through vocational rehabilitation. My insurance wouldn't cover a good cushion for me since I don't have paralysis/loss of sensation.

                  I started with a curve by the comfort company but I experienced pain very quickly, in the coccyx first and then my ischials. A friend sent me a Jay combi which was too small for her and that was MUCH better, but still problematic with longer periods in the chair. Now I'm using an invacare infinity that I got off ebay and its the best of the 3, but I still can't do long sessions regularly in the chair the way I would need to hold down a regular job. My DME had everything perfect on my chair EXCEPT my rsh is too high, and my infinity is about 3 inches while the curve was 2 so I'm higher than I started. The combi is shorter in back than the curve at least. I need to meet with the DME about the rsh and haven't, I read in the manual that it can be lowered with switching some parts so I really should follow up and see if that can be done through them and my insurance. My fingers reach a few inches above the axles. I'd also like to switch to a solid seat pan to see if its better for my hip pain, but that raises you higher.

                  Pg, do you have a price range? Are you able to afford a seating clinic? I'm assuming this is out of pocket since the chair wasn't paid for by insurance. I wanted to go somewhere and try out cushions for a better idea when looking at ebay but wasn't able. Since I have medicaid those places that accept medicaid are not able to sell me a cushion out of pocket even if I lied and said I would purchase from them. So next I contacted a bunch of local places claiming I didn't have insurance and was looking to purchase a cushion out of pocket and asked about coming in to try cushions. A few had never heard of the brands Jay, Invacare, Comfort Company, and Supracor. A few said they could get me any cushion from those brands but did not have any in stock for me to try out. The only cushions anyone had in stock were cheap brands like Drive.
                  Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

                  I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

                  Comment


                    #10
                    i've been using a varilite evolution for about a year now. best, most comfortable cushion i've ever used. plus it's super light. you can leave it aired up or let some air out and sink down in it.

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                      #11
                      Good to hear Rollin64 -- thanks. We don't have cushions to demo, but the weight and ability to change the air pressure make us like the Varilite too.
                      Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

                      Comment


                        #12
                        The supracor cushions seem to be what I'm looking for. Our summers are brutally hot and I've read too many complaints about peope sweating on ROHO's. A friend of mine with dystonia just got a TR3 with a ROHO, has full sensation and loves her cushion. That's why I was looking at those. Too bad she's away for several months or I'd try hers out. Also not sure I want to constantly be messing with the air in those.

                        This would be out of pocket for me. No definite price range. I know they are not cheap by any means. By the time I travel to a good seating clinic, pay for a hotel, find someone to watch my dogs, pay for the seating clinic, pay for the cushion, etc. I could buy several cushions!

                        My pelvis does tip forward, always has. Gives me a nice booty though...when I'm not constantly sitting on it... I've been to PT, done the stretches and it just won't budge. My sister has the same figure so I'm not sure there is much to be done about it.

                        Also, my chair is 17x17 and I know I could fit into a 16x16. If I DO get insurance to buy me a chair I'd hate to have a cushion that is too big and now doesn't work. I'll have to see if I can make a 16x16 work on my current chair. I have sideguards and my cushion is quite tight between them. A 16 width might be alright.

                        Comment


                          #13
                          Dear PG2005,

                          I work for ROHO, so if I can help you out with an assessment of a ROHO product please let me know.

                          Specific to your question on immersion and cushion height, here are a couple points for your consideration:

                          1) You immerse into any of the 3 cushion heights to about the same distance from the bottom of the cushion (typically about 3/4" from the base), so your seated height should be close to the same regardless of which of the 3 ROHO cushion height options you would select. Where you would notice a change would be under your legs. Your legs would position the lowest on the LOW PROFILE, and would position the highest on the HIGH PROFILE. After adjusting the cushion for immersion, my guess is the difference in cushion height under the front of your legs would be about 1" between those 2 models. Everyone has a unique shape and unique ROHO adjustment, so I can't give you a more precise measurement differential.

                          2) As you and others on the forum know, it is very hard to be prescriptive on a product solution without a seating clinic assessment. My best guidance in terms of your selection between the various ROHO products would be to try the MID PROFILE and see how it works for you. Given that you are experiencing pain on a foam cushion, that would suggest you might benefit from the additional immersion of a MID PROFILE Cushion versus a LOW PROFILE Cushion. But given that you have full sensation and no history of pressure ulcers, that would suggest that the HIGH PROFILE Cushion might be more immersion that you require. But in the end if you have a seating clinic to visit for a full seating and mobility assessment, that is the way to go.

                          Hope this information helps, and feel free to contact me offline if I can provide assistance in the evaluation process.

                          Good luck!

                          Tom Borcherding
                          tomb@therohogroup.com
                          618.222.3505

                          Comment


                            #14
                            Cushion on chair I just got is a Supracor sport. Wanted low profile. Had an old Supracor countoured as well as a Roho. Roho blew up 1X I sat on it. Maybe too much air. Do like cushion just got. Do not have any bottom/sore issues. The honeycombs are not easy to clean if anything gets in them.
                            Last edited by rlmtrhmiles; 7 Dec 2012, 3:46 PM. Reason: more info

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                              #15
                              Pg2005:

                              When shopping for Supracor Stimulite cushions, even though they list at $400-$700, I found that several places sell at more reasonable prices. This is especially true if you buy online and pay out of pocket. I bought my Stimulite Classic for $302.93 shipped from Allegro Medical. They were having a 50% off list price sale at the time. They are always having a sale—20% off reg. price or 50% off list or free shipping and so on.

                              If you want non-standard sizes then the Wheelchair Cushion Sage is a good choice. You can get your 17”x17” there. That size is currently $359 with $15 for the XS option (I recommend).

                              http://www.allegromedical.com/

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