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Stability and Balance

 

 

Stability and Balance

Stability and balance can also be a high priority or goal for individuals who require a specialised cushion. Data from lateral stability and horizontal stiffness can assist with cushion selection as part of the clinical reasoning process.

Lateral stability 

(ISO 16840-13:2021)

A more stable cushion while leaning may help to manage sitting balance.
Beneficial when considering whether a cushion needs to provide additional stability or less stability to achieve the individual goal.

Keep in mind that no one metric can be used by itself, and should be used as part of the clinical reasoning process.

Horizontal stiffness

(ISO 16840-2:2018 Annex C)

How much force is required for the indenter to slide forward.
Beneficial to consider if forward movement and sliding is a concern for positioning and function.

Keep in mind that no one metric can be used by itself, and should be used as part of the clinical reasoning process.

APAC_Stability table resized

*Please note, not all products may be available in your local area.

 

The University of Pittsburgh performed lab-based ISO testing on a total of 50 cushions. Permobil statistically analyzed the data for primary performance metrics into quartiles, or four equal groups. For any one performance metric:

  • The 25% cushions with the highest values may be a match for an individual who puts a higher priority on that cushion characteristic.
  • The 50% of cushions that are closest to the middle values may be a match for an individual who puts a typical priority on that cushion characteristic
  • The 25% of cushions with the lowest values may be a match for an individual who puts a lower priority on that cushion characteristic.

 

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Skin Protection

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Scientific Report and Understanding Performance Metrics

Understanding Cushion Performance Metrics

 

This document provides the summary of the scientific report. It provides an overview of the ISO testing results and provides clinical examples. Download Understanding Cushion Performance Metrics below for a concise and functional guide to applying ISO Testing to your clinical practice.

Download Document

Scientific Report: Guidance to individualized cushion selection based on performance metrics

 

This scientific report contributes to filling the gaps between clinical decision making, individual needs assessment and the lack of sufficient scientific evidence for cushion selection. Individuals’ needs are essential to be considered when selecting a cushion alongside performance considerations for skin protection and stability and balance. You can download the Scientific Report below.

Download Scientific Report

 

Interested in learning more?

Other Resources

NPIAP's Clinical Practice Guideline

Skin protection and preventing pressure injuries is important to every person with limited mobility. 

The National Pressure Injury Advisory Panel's (NPIAP) Clinical Practice Guideline (CPG) for the prevention and treatment of pressure injuries was published in 2019. Over 250 international experts reviewed evidence of over 3500 peer reviewed research studies. 

The CPG provides a clinical perspective that can be applied to the development and application of ISO tests. The CPG also includes recommendations such as prevention and treatment of pressure injuries, the etiology of the wounds and patient risk factors.

 

Visit NPIAP Page

Data from the University of Pittsburgh’s Rehabilitation Engineering Research Center (RERC)

The University of Pittsburgh’s Rehabilitation Engineering Research Center (RERC) has been involved in the development of ISO standards for wheelchairs and wheelchair seating. 

The Wheelchair and Cushion Standards group at RERC applied a subset of test methods (from the ISO 16840) and created a tool to explore the cushion performance data of their research. Of approximately 50 cushions from multiple manufacturers, the RERC researchers selected 10 cushions that are manufactured or distributed by Permobil Americas, to be included in the study.

Explorer RERC Data

Pressure Management Guide

Based on the CPG, Permobil created Pressure Management Guide, an extensive resource to better understand the role of support surfaces and wheelchair systems for pressure management
Download Guide

Wheelchair Seating Pocket Guide

Check out the The Wheelchair Seating Pocket Guide, a condensed resource to help select wheelchair seating components for pressure injury management.

Download Pocket Guide