Which cushion is best for sitting long periods, pain relief, preventing pressure sores?
Regarding the ROHO family of products, the high profile (4" cells) line of products are going to offer the most immersion (sinking in) into the cushion. This greater immersion will increase the force (weight) redistribution of the client thus decreasing peek pressures and improving comfort, decreasing pain and preventing pressure ulcers. Through this immersion, you are better able to redistribute (equalize) the weight (force) of the client onto their thighs, greater trochanters (hips), and the ischial tuberosities (buttocks). Through immersion into the 4" cells, a ROHO cushion aims to reduce the extrinsic risk factors of peak pressures, shear and friction, and microclimate in pressure ulcer development; however, it is important to assess the client individually for other risk factors including, but not limited to, nutrition, circulation, and previous history of pressure ulcers which NO cushion is able to affectively address.
Can I place an incontinence pad, towel, drawl sheet or hoyer lift sling over top a ROHO cushion and/or a ROHO mattress?
Unfortunately, anything that you place over a ROHO cushion or mattress, actually any cushion or mattress, can interfere with the effectiveness. A ROHO cushion/mattress works by increasing the contact area of the individual when they immerse (sink) into the product thus redistributing the force so there is limited peek pressures at one specific landmark. When anything is placed between an individual and the cushion/mattress, surface tension is increased and thus they have a more difficult time immersing (sinking) into the cushion/mattress effectively.
However, since each and every individual needs to be treated individually and a plan of care needs to be considered based upon that individualís specific circumstances, we also realize that other needs like incontinence, safety during transfers etc. need to be considered. A licensed healthcare professional should weigh the risks of placing a pad, towel or Hoyer lift sling, thus reducing the effectiveness of the cushion/mattress, versus the risk of not placing these items.
If an incontinence pad or drawl sheet is required while the individual is sitting on the cushion or lying on the mattress, it is our recommendation that the least amount of layers are used and these pads/sheets are put overtop the cushion/mattress in a fashion where they are very loose and NOT tight.
If the removal of a Hoyer lift sling from underneath a patient, who was transferred onto the cushion, is going to cause increased shear and friction, which may be detrimental to an individuals skin, a licensed healthcare professional should weigh the risks of keeping the client on the cushion WITH the sling in place, versus removing the sling.
Can I use my ROHO cushion without the cover?
It is true that anything that you place over a ROHO cushion, actually any cushion can interfere with the effectiveness. A ROHO cushion works by increasing the contact area of the individual when they immerse (sink) into the product thus redistributing the force so there is limited peek pressures at one specific landmark. When anything is placed between an individual and the cushion, even a ROHO cover, surface tension is increased and thus they have a more difficult time immersing (sinking) into the cushion effectively. However, ROHO has gone to great lengths to provide a cover, which still allows immersion with the least amount of surface tension created. Mr. Graebe, the inventor of the ROHO cushion, from a scientific standpoint, would recommend a ROHO cushion actually be used without the cover.
As previously stated, our covers are made to be used so that there is little if any interference with pressure distribution when they are being used. When other things are used instead of our stretchable, breathable cover, like a pillowcase, a sheet, a quilted chuck, or another wheelchair cushion cover, there is less effectiveness of the cushion due to increase tension. Bottom line, the person has less immersion and envelopment of the body, thus reducing the pressure redistribution characteristics.
So bottom line . . . can a ROHO cushion be used without the cover? Absolutely. Particularly if there is no risk that the cells may become caught in something. Should the cushion be used with something other than the cover it comes with? NO, it will significantly reduce the benefits of the cushion.
How can I choose the right cushion?
Seek the assistance of a clinical professional who can assess your clinical requirements. In many countries, occupational and physiotherapists have the expertise; however, your personal physician can advise and offer referrals.
How often should the ROHO DRY FLOATATION Cushion be checked for proper inflation?
The hand check should be performed daily with the patient's ADLs (Activities of Daily Living). The entire adjustment procedure needs only to be done when necessary. It only takes a few seconds.
If I currently have pressure ulcers, can I sit on my ROHO DRY FLOATATION cushion?
Yes. It is appropriate for individuals with a stage 1, 2 or 3 ulcer to sit directly on a ROHO DRY FLOATATION cushion provided they, or their caregiver, monitor the wound frequently. In conjunction with proper care and nutrition, it is proven that an ulcer can heal on a ROHO cushion. Due to our unique ability to redistribute pressure, enhance blood flow, and decrease edema, we are thereby able to enhance healing. A stage 4 ulcer usually requires surgery and presents numerous complications for the client.
Does neoprene rubber promote heat buildup?
No. The ROHO DRY FLOATATION cushions are air filled. Air has a very low specific heat making it a poor conductor of heat (less transfer of heat than with water or gel). Less transfer of heat from patient to cushion results in increased energy levels of the end-users.
I need a very stable cushion. Which one should I choose?
We have a variety of models which offer positioning and stability. Examples include the SELECT Family line, which includes the QUADTRO® SELECT® and the CONTOUR SELECT™ cushion, the nexus® SPIRIT® cushion and the new HARMONY™ cushion. A clinician trained in seating can assist you in choosing the appropriate model for your needs.
How can I get literature on the ROHO product line?
To receive literature on the ROHO product line in the US or Canada, please call 800-851-3449, or fax at 888-551-3449, or to receive literature outside the US and Canada call 1- 618-277-9150 or fax 1-618-277-6518. We would be glad to send you information on the various company programs, products or distributors nearest you. Click here to send an email to the Help Desk.
How long does a ROHO DRY FLOATATION cushion last?
On average, three to five years. The amount of wear and tear an individual user subjects their cushion to will effect the life of the cushion. Using the cover supplied with the cushion will extend the life of your cushion. ROHO, Inc. offers a two-year limited warranty on the ROHO DRY FLOATATION cushion product line and a three-year limited warranty on the SELECT cushion product line. In addition, each cushion is supplied with a patch-kit.
What makes the ROHO DRY FLOATATION cushions better than other cushions?
Durability. Optimal reduction of shear and friction on the client's skin. Adjustability. Light weight. Proven performance over time. Click here for additional details on ROHO DRY FLOATATION technology.
Do the ROHO cushions only prevent pressure ulcers, or can the patient actually have an existing pressure ulcer?
The range of ROHO DRY FLOATATION cushions were designed to either prevent or heal. Both cushions and mattresses can and should be used in conjunction with proper care and nutrition to enhance the healing process over a period of time. (A clinician should assess the intrinsic and extrinsic factors of skin breakdown particular to you, to determine what effect a ROHO cushion might have.)
Pull or attempt to carry the cushion by the cells, valve, or ISOFLO®.
Expose the cushion to petroleum based solutions (e.g., lanolin).
Sit on cushion with sharp items in your pockets.
Follow the operating and cleaning instructions.
If using a ROHO cushion, can I sit longer than two hours, or do I still need to have some movement anyway (pressure reliefs)?
Many users increase their overall sitting times throughout the day, but you still need to have periodic weight shifts. ROHO suggests you follow the routine of pressure relief procedures recommended to you by your clinician. By consistently monitoring your skin, you may be able to determine what period of time must pass before you begin to experience redness.
What is the weight limit of the ROHO DRY FLOATATION cushion?
Only the cushion size will cause a limit. Therefore, it is imperative that each individual receive the proper size for his or her stature and chair. Custom cushions are also available.
Do you offer custom cushions, and how do I order one?
Yes. We do offer custom cushions. The advice of a rehab specialist would be most helpful in designing a specific custom cushion. Our Customer Care department also has a staff available to assist you in custom orders. Simply call, fax or e-mail ROHO with your questions.
Do I need a rigid base underneath the cushion, or is a sling seat okay to use with the ROHO cushion?
ROHO suggests all of our seating products be used with a solid seat insert, unless the wheelchair sling is designed not to hammock or sag over time. ROHO offers two types of solid inserts which can be inserted between the cushion and cover for convenient transportation.
Can I tie down cells to create a no pressure area?
In the past, there have been many proponents of tying down cells to create no pressure areas under the seated surface. However, unless medically necessary, we recommend not tying down cells, as the cushion performs best when distributing pressure over the entire contact area.
When a no contact area is incorporated into a cushion, a high pressure perimeter surrounding the no contact area is created. This variance in pressure between the perimeter and no contact area tends to cause shear, deformity and trauma to the tissue, thus increasing risk of ischemia. In addition, there is the possibility for pooling of interstitial fluids (edema) at the no contact area reducing efficient cellular nutrient transfer. Enhancing blood flow and nutrient transfer is essential and the DRY FLOATATION® cushion allows for this healing process to occur. If you tie down cells, you run the risk of delaying healing or actually increasing the size of a wound.
What about cushion toxicity?
When people ask or talk about LATEX TOXICITY what they are really asking or talking about is a severe allergic reaction to proteins found in Natural Rubber. Natural Rubber comes from the sap, a white milky fluid (latex), of the Hevea brasilienis or rubber tree. The proteins are Mother Nature’s way of keeping the sap from coagulating as it moves through the tree carrying moisture and nutrients from roots to leaves and back. All products made from Natural Rubber contain some amount of these proteins. The amount depends on how the latex was processed and how well the products made from it were leached and washed. Not only are rubber like products, gloves, condoms, catheters and tubing made from Natural Rubber, but, also adhesives and sponge foams.
Almost everybody will have some kind of a reaction to these proteins. Depending on the number of times exposed and the duration of the exposure the reaction can be anything from a mild dermatological rash to anaphylactic shock. Certain groups of people appear to be more susceptible to developing anaphylaxis. Healthcare workers for example, may develop severe dermatological reactions because of the daily repeated exposure and Myelodysplasia (spina bifida) patients seem to be particularly at risk, especially under anesthesia.
ROHO Incorporated products are manufactured from man-made materials. The cushions themselves are made of Neoprene, a synthetic rubber material that contains no protein, the covers are made of Nylon, Lycra, Polyurethane, and Polyvinyl chloride, and pumps are made of polypropylene.
When discussing specific allergy problems with healthcare workers we should be careful not to forget that a very small percentage of the population will have a reaction to contact with our cushions. People develop hypersensitivity to all sorts of things. Some people develop hives and severe itching when they come into contact with wool clothing. Others develop reactions to detergents and soaps or citrus fruits. Because the cushion is made from a chemical polymer and contains other chemicals used to produce a cure and render it resistive to UV light and the effects of ozone etc. means that a few rare individuals will have a dermatological allergy reaction to our product. This can be a serious problem but it should not be confused with the protein toxicity associated with Natural Rubber.
For more information go to: