DEVELOPMENT OF A WHEELCHAIR CUSHION COVER WITH MICROCLIMATE MANAGEMENT TO PREVENT PRESSURE INJURIES

Pressure injuries are a common medical problem that negatively influences mortality, causes financial burdens, and reduces quality of life for people with spinal cord injuries or other mobility impairments. Wheelchair seat cushion designs are developed to reduce risk factors for pressure injuries. Pressure, shear and friction are the primary causative factors known to increase pressure injury risk. Other factors include heat and moisture. Current preventive approaches related to seat cushions focus on reducing pressure, shear, and friction. The important heat and moisture factors are seemingly overlooked. Options to manage microclimate at the support surface interface are limited. This study aims to develop a wheelchair cushion cover, which provides currently available wheelchair cushions with an advanced feature to improve microclimate management by reducing heat and moisture at the body-seat interface to help prevent pressure injuries. The development of the wheelchair cushion cover with microclimate management included the following steps: generating a design specification, developing three design concepts, fabricating a prototype, evaluating the cover and conducting focus group interviews. The prototype cover was modeled on mattress low air loss features and its function was applied to wheelchair cushions. The cover was intended for use with the existing cushion and cover. Evaluation of the prototype cover was performed and focused on quantifying the microclimate control features. A thermodynamic rigid cushion loading indenter simulated the environmental conditions of a human body on three cushion types for 3-hour tests. Comparing results for the three cushions with and without the prototype cover demonstrated significantly lower relative humidity after 1 hour (p 0.002) was found for the entire test session. Standardized cushion characterization tests showed that the prototype cover provided additional pressure distribution (p < 0.002) compared to the three test cushions without the new cover. This study included focus group interviews to gather feedback regarding the prototype cover. The cover received an overall positive response from participants. All participants agreed with the utility of a microclimate management feature and necessity of the product. They would recommend the cover to wheelchair users