Ride Custom Cushion vs Roho Hybrid Select

[August West]

I am just now evaluating the Roho Hybrid Select and would appreciate feedback. I used the Roho Low Profile a long time ago and liked it. But it offered no positioning and getting a flat meant bottoming out onto the seat sling, which was too risky away from home. Soft foam and honeycomb don't offer positioning or pressure relief. Gel is heavy and bunches up. Hence, I went with the hard foam Ride Custom cushion.

The Ride Custom cushion offers strong positioning and excellent pressure relief. I have used it for many years and have had no pressure sores. A+ in that department. But there is one problem. The hard foam has no give so it locks the hips in place, which limits range of motion. For example, when sitting in most cushions, my hips will roll enough to get my head down to knee level. But in the Ride Custom cushion, my hips are locked so my head won't go much below chest level. The problem with pushing with the head up is that the shoulders do the work that the arms and chest would be doing with the head down.

Hence, range of motion in the hips spares the shoulders.

I noticed a night and day improvement in range of motion in my hips going from the Ride Custom to the Roho Hybrid Select. I find I'm using more chest and arms and less shoulders especially when pushing uphill.

But that's just my opinion. What do you think?

[dw]

August, it's really appreciated that these posts are made and that I have learned a lot from the information that people are sharing on here. I agree with you and mention that the ride custom cushion has been a real benefit to me. I had difficulties with the roho hiprofile becoming deflated. I bottomed out and ended up getting a wound. I've been able to switch different styles of cushions and that's been really helpful. I think the ride cushion does have tremendous advantages and using some of the other cushions when needed or in conjunction has been very helpful.

[August West]

People dread pressure wounds and rightfully so. But you know when you have a pressure wound. Maybe you don't find it soon enough and that's a big problem. But you will find it and you will know the cause. Not so much with range of motion problems. They can build up over long periods of time. It's like the frog in hot water. You put the frog in hot water and it will jump out. But you put the frog in room temperature water and then raise the water temperature, the frog will sit there and die. Now, I don't know if that's just a myth but it makes the point. The cause of range of motion problems have the potential to go undetected until it's too late. Even after you have identified the problem, you don't necessarily know the cause.

I can't blame it all on the cushion and there is definitely an overuse issue. But I can say for sure that my Ride Custom cushion limits the range of motion of my hips and that has lead to making my shoulders work harder. Other's may not have this problem. This post isn't saying not to use the Ride Custom cushion. It is just to raise awareness. Each cushion has it's strengths and weaknesses. You should know what they are.

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[SCI-Nurse]

ROM exercises, standing, and proning (laying on your stomach) are all good ways to maintain your hip ROM. A cushion cannot do that as you are by definition sitting on a cushion with (usually) 90 degrees of hip flexion when using it, regardless of the cushion.

(KLD)

[August West]

My hip range of motion is excellent except when sitting in the hard foam cushion. It is the cushion.

[crispy1981]

August, I have been using the Hybrid Select for ~a couple years now and do like it BUT...I've blown through about 7 of them already because of leaking issues. I don't know if it's because I am hard on them or not. I usually wear exercise pants (because i go to PT 4 days a week) and they don't have a zipper. So that means after i cath or do bowel pgm I need to pull up my pants while seated. I do that by pushing up with one hand and quickly tugging up my pants with the opposite hand = I land hard on the cushion each time. Maybe there is a smarter way to pull up the pants that I should try?

[August West]

I do the same thing and only got one or two flats over several years when I used a Roho. Dirt falling into the cushion is the most likely cause of a flat. Sand is the worst. It's like tiny razors. Probably need to clean them every day.

[crispy1981]

The hybrid has 3 separate cell pads so that may be why it's easy to blow (more points of failure with all the connections). I change the covers often and there is never evidence of sand so it might be a design flaw?

[Gearhead]

I learned the hard way on my Roho's (thick, single cell & quattro). They can't take to many "plops". Took some time to learn to ease down. I know that's not possible for some folks but that's the reality. Divide the cushion into 3 or 4 independent cells makes them more sensitive to "plops" (less accumulator/damper volume per cell). They should be made to handle the patients needs & unique methods of use due to injury. Construction methods and/or materials should be researched better by the manufactures.

[crispy1981]

ah...thanks Gearhead - so I need to learn to yank up the trousers differently. Any tips?

[Gearhead]

Maybe try pulling up on something (a bar?) with one arm, pulling pants with other. A PT might have some better suggestions. As I was told many many times,"everybody is different" (referring to SCI's). Some things I do aren't the best way but the only way I can achieve my intent.

[crispy1981]

Thanks Gearhead but how did you learn to ease down? There won't always be something stable to grab. I'm trying to grab the wheel when i land instead of hitting the cushion. It's amazing how hard it is to retrain after decades of doing it a certain way!

[CapnGimp]

I have always used rohos and I do work a lot where I ave to lay my upper body on my lap, like using a dustpan to sweep a pile of dirt into the pan. I have used pillow cases as a cover on mine, I wear out the flimsy covers in a few months and can't afford them. Pillow cases with high thread counts minimize fine sand/dust and metal when grinding, cutting sanding etc. I recently discovered the Star Plush cushion is way tougher than the new rohos and it has a soft material in the lower part of each cell, preventing bottoming out on a hard surface IF you go flat. Unfortunately the one I bought at low cost used from someone is a 20in x 20in 5inch deep one. I love the design, it's just I use a 17 x 16 and I can't fit it in my manual chair and my power chair tore up right after I bought it. Waiting until I can save the money to buy a computer for it to make it go again. It is one of the quantum edge chairs I bought used about 7 years ago, and IT is 20x20 seat but I have to stack about 5 inches of cushion BENEATH my top cushion I sit on to get enough height for my legs length and that is barely enough. Sucks when you can only buy used and can't ever get proper fit. The cushion is NEW, don't think they ever sat on it once but she sold it to me for 80 bucks total, had to borrow it from my sister as I had already started a pressure sore on my perineum and can't lay around all day, I have to work around the house to live. HOPEFULLY the recent visit to a DR for a prescription for one the right size will be delivered soon. As for patching the rohos, get the liquid electrical tape stuff out there. I used it to seal the holes where the valve stem connects to the roho on my last remaining one and it is holding for me now until I get a new one. Clean the hole area and scuff it up then put a generous amount on it all around and let it dry for 24 hours. I was at my wits end with the pressure sore and I had patched the same area a year ago and used it for about 9 months and it started leaking again. I went to use the liquid electrical tape again but it was dried out so I did not attempt it. I got it back out when I got the pressure sore and prayed hard for God to make it work, as I know He wants us to be healthy as possible. I did my best with the dried out stuff and He Blessed! I even took pictures as it would take a miracle for it to work. I JUST got my new bottle in a few days ago but the old God Blessed patch is still holding. here's a link https://www.amazon.com/dp/B000FPAN2K...t_details&th=1

[CapnGimp]

I have a 20x 20 x 5 inch Starlock WITH foam cushion here. You can lock your contour in with the locking mechanism. It is hands down the BEST design on the market. It isn't flimsy material like the rohos are now. BUT I just learn while searching for the link, they have been bought out by ETAC and I can no longer find the foam filled cell type that I have. I pray they do not quit making this before I get mine!! With the LOCK mechanism, it seals the clls from the bottom air channels when you pump it up. So when you are leaning way over the air doesn't run out like the rohos do. I love mine but it is for a larger person, doesn't fit my manual and the power chair has a raised back/gap that allows the cushion to go backwards and causes it to bottom out into the foam and since I set in a hole when that happens, my legs and feet swell fast and it is really uncomfortable/hurts so that I can't sit in it longer than an hour. Back to square one. GRRRRR EVERY time we get a good product, some big/rich company buys them out and no longer carries or changes it to something different. IT it TOUGH finding what we need out there at a price that can be afforded. https://www.etac.com/en-us/us/produc...ions/starlock/

[Gearhead]

I really like the way that cushion looks. 5 inches deep, I could really use that extra inch (insert joke here). Little confused how it works. Is that a hand pump bulb w/pressure release attached? If so, I could see adjusting it often/daily just for a change.

It sucks every time a company sales out. New bean counters always come in & cut cost (quality) knowing sales will come from past reputation.

[CapnGimp]

That bulb is used to LOCK the cells after you immerse yourself in it, preventing any change, even when leaning any amount in any direction, unlike roho where you can bottom out on the edges. You use a separate pump to inflate it just like roho. I have very different left and right depth of immersion from osteo bone removal from that pressure sore of 4 years back in early 2000s. That 5 incher is perfect for my needs but mine is 20x20 so unable to use it. Hoping to get one with the foam inserts in near future IF that company still has it(entac bought star last month.

When you squeeze/pump the bulb, it builds up pressure beneath small rubber valves beneath EACH individual cell, thereby preventing air to escape from all of them. This 'locks' your 'shape' into the cushion. With rohos,whenever you lean over, air escapes from the highest pressure cells beneath you and flows into the lesser pressure cells. You can bottom out and that isn't good. Even n the quattro, it happens. My profile of bones-no bones and general just plain no muscle mass whatsoever, means I need a deeper cushion than most. My right hip is about 3-4 inches lower than my left hip-the normal side of my butt. That is why I like the 5 inch depth.