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    Acclimating to a RIDE cushion

    I just brought my new RIDE cushion home today, along with my new TiLite Aero. I have huge concerns in regards to acclimating to this cushion & chair. I've been on a Supracore Slimline for many years and I sit very low to the ground in my current chair mainly because 1) I am short and 2) it's a VERY old chair and my seat pan is stretched and in 'hammock' form causing me to sit lower to the ground. I knew a new chair was going to lift me, obviously and also that the RIDE would too so I was somewhat prepared... but now I can't reach the floor while leaning to the side. I have short legs and short arms (I am 5'4) transfers are harder with shorter limbs. I especially need the leverage with my legs for transfers.

    And yes, I have been working with the PT and rep at seating clinic throughout the whole ordering process and we are all understanding of changes that need to be made. However.....We only have 1/2" left to lower the frame to the floor and 1/2 inch in front casters. We are also going to put some minor sling in the seat to see if that helps. I'm two inches higher in the new chair and I'm afraid 1/2 inch is not going to do it. I'm trying to be very open-minded about the change but damn, it's been exhausting. When I was younger I used to breeze into new chairs w/out blinking an eye and never had an issue adjusting. My PT doesn't want me in the new chair until my rep comes out to make the adjustments. I'm trying to remain firm with everyone but also keeping in mind that any further changes will be 100% out of pocket (thank you crappy insurance company).

    Have any of you had issues adjusting to a RIDE cushion or one similar, as far as a major height shift?

    #2
    I know what you mean. Sitting higher has complications like you mention plus more. When sitting too high you don't push efficiently. Your shoulders do more work and your arms and torso do less work. You want it to be the other way around. I am ordering a new wheelchair that will be shorter. I see you are doing the same. Until you get your new wheelchair you may want to use the Ride cushion less and use a different cushion more.
    Last edited by August West; 31 Aug 2018, 5:47 PM.

    Comment


      #3
      I think it's more important for your floor to seat height to be setup to maximize the efficiency of pushing your chair, rather than being able to reach the ground. I can't remember what it is (your PT should know) but there is a certain angle at the bend of your elbow when your hand is resting on the top of your handrim that is ideal, and keeps you low enough for an efficient push stroke but not too low that you're raising your shoulders when you push. I would find that sweep spot first and give it priority.

      I'm not sure which ride cushion you have but I have their Java cushion and actually had to put some thin sheets of foam under it to raise it because my butt bones were a little closer to the seat pan than I was comfortable with (I'm pretty skinny/bony). The amount of material you could remove from the bottom of a ride cushion, thus lowering it, depends on how much space you have from bottoming out since your butt bones float in a Ride cushion unlike others.

      If you're not close to bottoming out, you can cut the foam on the bottom down since its like a really hard Styrofoam. I hacked my old Ride custom cushion up a good bit to get it how I liked it. Just remember its not as easy to add the height back.

      Last suggestion is to check your hips often for pressure issues. Since your butt bones float in a Ride, like I mentioned, the weight distribution is offset to your hips. This is usually a good thing as the skin on our hips is probably tougher than our butt bones, but it's just something to be aware of.
      Last edited by Brad09; 28 Aug 2018, 12:49 PM.

      Comment


        #4
        Yes, I see what you mean about arm bend being in proportion. I think i'm ok there, actually. Being so high from the floor has always made me a bit nervous. But the big factor (It's a Ride custom 2, by the way) is that the high rise of the sides of the cushion in front are so insane that I am not going to be able to transfer to toilet. I now have a 4inch hurdle from toilet to chair and I simply can't do it. I would also need to raise my bed a couple of inches. I'm not happy about this. I think I made a bad choice and possibly my PT and rep failed me in that they didn't consider the numbers more. I did stress all of this to them on my first visit, that I needed to be at certain height for this transfer and that transfer. I was willing to give a little as I didn't want to be 'that' person who is just afraid to change anything. But this difference is just too great and simply no doable for me. Ugh! They really didn't offer other cushion choices, stating the RIDE was best for me.

        The rep is still coming out to make the 1/2" adjustment and sling the seat pan a little but that's never going to drop me down close to the 4 inches I really need. And if I'm hammocked, won't that change the load? I pressure-mapped ok, cept for a little issue on the outer side of my thighs but we adjusted that with some shaving down.

        Yes, the shaving off the bottom of the cushion I understand but not sure if we can do that (and I'd never do it on my own , just in case, as you said, can't go back). I am pretty sure she got it as low as possible. I've watched a few videos of Tom Hetzel from RIDE just to see if my PT/Rep followed appropriate steps and didn't miss anything and it seems they did ok. I'm no expert though. I'm still feeling I may have been ill-advised on getting the RIDE simply for the fact that the height will inhibit my transfers. I've never had to deal with something like this... a piece of equipment not working out for me but already paid for. How much do I have a right to change now? Will have a long talk with her (again) about it when she comes out but I think I may be screwed.

        Comment


          #5
          Originally posted by Brad09 View Post
          I think it's more important for your floor to seat height to be setup to maximize the efficiency of pushing your chair, rather than being able to reach the ground. I can't remember what it is (your PT should know) but there is a certain angle at the bend of your elbow when your hand is resting on the top of your handrim that is ideal, and keeps you low enough for an efficient push stroke but not too low that you're raising your shoulders when you push. I would find that sweep spot first and give it priority.

          I'm not sure which ride cushion you have but I have their Java cushion and actually had to put some thin sheets of foam under it to raise it because my butt bones were a little closer to the seat pan than I was comfortable with (I'm pretty skinny/bony). The amount of material you could remove from the bottom of a ride cushion, thus lowering it, depends on how much space you have from bottoming out since your butt bones float in a Ride cushion unlike others.

          If you're not close to bottoming out, you can cut the foam on the bottom down since its like a really hard Styrofoam. I hacked my old Ride custom cushion up a good bit to get it how I liked it. Just remember its not as easy to add the height back.

          Last suggestion is to check your hips often for pressure issues. Since your butt bones float in a Ride, like I mentioned, the weight distribution is offset to your hips. This is usually a good thing as the skin on our hips is probably tougher than our butt bones, but it's just something to be aware of.
          I want to cut a layer off the bottom. But I don't how to to make a clean and even cut across the entire cushion.

          Comment


            #6
            Hi August, I'm not currently using the cushion and I already have the new chair. I picked them both up yesterday and it was my first time in the cushion. Good luck with your new wheels!

            Comment


              #7
              Originally posted by August West View Post
              I want to cut a layer off the bottom. But I don't how to to make a clean and even cut across the entire cushion.
              I had one of these handsaws laying around that helped a lot (much easier than using a knife) since it is so long. It's going to be really hard to get a clean cut all the way across but you should be able to get it good enough that you can't tell there are any inconsistencies. Maybe doing smaller sections one at a time would be easier. :

              https://www.amazon.com/Vaughan-Bushn...70_&dpSrc=srch

              Comment


                #8
                Risky move. Maybe a very thin layer at a time.

                Comment


                  #9
                  If your looking at lowering the cushion and gaining a little more dump, what my vendor did instead of shaving the whole bottom was just cut some channels into the bottom of it along the frame rail. Went in 1/4 '' increments till it was dialed in, didn't affect the integrity of the cushion,got me lowering in wheels and im just as comfy on it as I was on my old cushion.

                  Comment


                    #10
                    I started using a Ride Java cushion after 33 years on a low profile Roho after discovering a stage 3 pressure sore on my butt. The height transition has been a challenge but it has been so worth it in every other way. My sore healed in two months without me having to lie in bed and I feel much more stable compared to the Roho. I have trouble getting dressed in my chair because when I scoot forward to put my pants on I fall back into the "well", so I transfer to the bed to get dressed. Also, when transferring to my handcycle I felt like I had less control and the drop down (and the transfer back up to the chair) was too difficult. My solution has been to transfer on to the Roho when I ride. I know not every cushion is right for everyone, but the Java was a lifesaver for me.

                    Comment


                      #11
                      Originally posted by Shaun View Post
                      If your looking at lowering the cushion and gaining a little more dump, what my vendor did instead of shaving the whole bottom was just cut some channels into the bottom of it along the frame rail. Went in 1/4 '' increments till it was dialed in, didn't affect the integrity of the cushion,got me lowering in wheels and im just as comfy on it as I was on my old cushion.
                      Hmm, this sounds like an option but I'm not entirely sure of the visual I'm getting. I have a severe 4-5inch height adjustment to make. I 'might' be able to get by with 2" higher than I currently am in my Slimline but I'm so darn short my arms are not long enough to give me the leverage I need to make the climb. My biggest issue is the toilet. I simply can't do it and I'm worried I'll be stuck with this terribly expensive cushion. I don't suppose you have photos of the alterations?

                      Comment


                        #12
                        Originally posted by oncetherwasagirl View Post
                        Hmm, this sounds like an option but I'm not entirely sure of the visual I'm getting. I have a severe 4-5inch height adjustment to make. I 'might' be able to get by with 2" higher than I currently am in my Slimline but I'm so darn short my arms are not long enough to give me the leverage I need to make the climb. My biggest issue is the toilet. I simply can't do it and I'm worried I'll be stuck with this terribly expensive cushion. I don't suppose you have photos of the alterations?
                        I'll try and get pic for you. 4-5 is a pretty big number. When they spec'd your new chair with the ride cushion on it, did they take your seating height from your old chair and cushion into consideration at all?

                        Comment


                          #13
                          Originally posted by oncetherwasagirl View Post
                          Yes, I see what you mean about arm bend being in proportion. I think i'm ok there, actually. Being so high from the floor has always made me a bit nervous. But the big factor (It's a Ride custom 2, by the way) is that the high rise of the sides of the cushion in front are so insane that I am not going to be able to transfer to toilet. I now have a 4inch hurdle from toilet to chair and I simply can't do it. I would also need to raise my bed a couple of inches. I'm not happy about this. I think I made a bad choice and possibly my PT and rep failed me in that they didn't consider the numbers more. I did stress all of this to them on my first visit, that I needed to be at certain height for this transfer and that transfer. I was willing to give a little as I didn't want to be 'that' person who is just afraid to change anything. But this difference is just too great and simply no doable for me. Ugh! They really didn't offer other cushion choices, stating the RIDE was best for me.

                          The rep is still coming out to make the 1/2" adjustment and sling the seat pan a little but that's never going to drop me down close to the 4 inches I really need. And if I'm hammocked, won't that change the load? I pressure-mapped ok, cept for a little issue on the outer side of my thighs but we adjusted that with some shaving down.

                          Yes, the shaving off the bottom of the cushion I understand but not sure if we can do that (and I'd never do it on my own , just in case, as you said, can't go back). I am pretty sure she got it as low as possible. I've watched a few videos of Tom Hetzel from RIDE just to see if my PT/Rep followed appropriate steps and didn't miss anything and it seems they did ok. I'm no expert though. I'm still feeling I may have been ill-advised on getting the RIDE simply for the fact that the height will inhibit my transfers. I've never had to deal with something like this... a piece of equipment not working out for me but already paid for. How much do I have a right to change now? Will have a long talk with her (again) about it when she comes out but I think I may be screwed.
                          Yea, the Ride custom 2 is way different than the Java I have. I can see how that one would sit you up a lot higher. You could cut a whole lot more off the bottom of that one if someone is willing to help you with it. If you took the bottom of the bowl in the back and went down 1/2" you cut the rest off below that point. That's the way my Java came. It sits much lower than the Custom cushions (I had to add some foam under mine) and has a layer of soft foam on top of the hard foam that is more forgiving. Or can you swap yours with the Java at this point or did they custom make the cushion to fit you? I had a Ride "custom" before but it was an off the shelf version. If not, to solve your toilet transfer issue you can get one of these:

                          https://www.amazon.com/Essential-Med...2Bhandles&th=1

                          It raises the toilet seat about 4", I used one at my old house for years. It bolts on in the back and I put some double sided foam tape under the front to keep it from sliding. I removed the handles too.

                          Also, I don't think bowing your sling seat pan will help lower you much with a Ride cushion because of how stiff the foam is. I would pull the seat pan as tight as I could so it doesn't put extra pressure on your hips because its leaning in from the sides.
                          Last edited by Brad09; 7 Sep 2018, 11:50 AM.

                          Comment


                            #14
                            I like the Ride Custom cushion. It is an innovative cushion that helps reduce skin breakdown and compensates for hip obliquity. But the rigid foam limits where and how you can sit. For a long transfer out of the wheelchair, you have to sit on the edge of the cushion in order to get close enough to the transfer target. This is not a problem with a soft foam cushion because the soft foam conforms to your body (Figure 1). It's the other way around with the Ride Custom cushion. Because it is rigid, your body conforms to it's shape. The result is that your hips will be leaning in the wrong direction when transferring from the edge of the cushion (Figure 2).

                            Just don't transfer from the edge of the cushion? Easier said than done. Transferring from the middle of the cushion adds several inches to the transfer, which is huge. The better solution is to eliminate the contour. That can help. But it won't eliminate the problem. It's just the nature of the beast.

                            Similar problem applies for mobility and access. You want your hips to move more than you may realize. When doing simple daily activities like pushing your wheelchair or just reaching for something, you want your hips to move in the direction of your spine, which should move in the direction of your shoulders and neck. Otherwise, you sacrifice strength and range of motion and increase risk of injury. After my shoulder injury, I've tested this phenomena with a Ride Custom vs Roho. Noticeable improvement with the Roho - less pain, greater range of motion, and easier transfers. Who would have though that a cushion can have such a significant effect on your shoulder?
                            Attached Files
                            Last edited by August West; 7 Sep 2018, 10:04 PM.

                            Comment


                              #15
                              Actually, I think Figure 2 should be more like this. Because your hips are pointing in the opposite direction of your shoulders, your spine curves downward, which lowers your shoulder (natural position of shoulder is shown in green). But that doesn't work because your shoulder will be too low to do the transfer, so you compensate by shrugging your shoulder (shown in red). You end up contorted. It's not pretty. All because of poor hip alignment.
                              Attached Files

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