The cushion under a wheelchair user and the support behind them decide how long they can sit in comfort, how well their skin holds up and how steady they feel. Many wheelchairs come with a basic cushion or none at all, so choosing the right one is one of the most useful upgrades a wheelchair user can make.
Choosing well comes down to five questions. How long does the person sit each day? How is their skin? How do they sit? How much do they weigh? And what size is the wheelchair? This guide takes them in that order. Every cushion on our cushions and back support page lists its own figures, and the product page is the one to trust for any particular cushion.
Start with how the person sits
The first questions are about the person, and they are worth asking the doctor or therapist who knows them.
| If the person | Look at |
|---|---|
| Sits most of the day, or has had skin redness or pressure sores | An air cushion or a hybrid cushion, which give the most pressure relief. |
| Sits part of the day and wants comfort and a stable seat | A foam cushion or a gel cushion. |
| Slides forward, leans to one side, or needs help sitting up straight | A positioning cushion, often with a back support. |
| Weighs more than a standard cushion is rated for | A heavy duty cushion. |
The kinds of seat cushion
- Air. Rows of air cells shape to the body and spread the weight across the whole seat. Air gives the deepest pressure relief. The air needs checking, usually with a quick hand check under the seat, and the cushion is adjusted to the person.
- Foam. Contoured foam holds its shape and gives firm, steady support. It is light, needs no adjusting and suits everyday sitting.
- Gel. A gel or fluid pad over a foam base spreads pressure under the seat bones, with the stable feel of foam underneath. Some fluid pads need to be checked and kneaded now and then, as the product's own instructions say.
- Hybrid. An air or fluid insert sits in a contoured foam base. The insert takes pressure off the seat bones and the foam holds the hips and thighs steady.
- Positioning. A positioning cushion helps keep the pelvis and thighs in line, for a person who slides or leans. Some do it with a contoured base, leg troughs and hip guides. Others use air compartments that are set separately, side to side or front to back.
Skin protection
A person who sits for long hours, cannot feel the seat well, or cannot shift their own weight is at higher risk of pressure injuries. For them the cushion is a medical choice, not just a comfort one. Look at air and hybrid cushions first, and follow the advice of the person's clinician on the cushion and on how often to shift weight.
Check the cushion every day
Follow the cushion's own instructions for setting it up and checking it. An air cushion that is too soft lets the person sink through to the base, and one that is too firm stops it from doing its job. Check the skin, and the cushion, every day.
Back supports
A back support replaces or sits in front of the sling back of a wheelchair. A shaped shell or contoured cushion holds posture, takes strain off the spine, and some add side support for the trunk. Measure the width of the wheelchair between the back canes and the height of back support the person needs, and check both against the product page. Check how the back mounts, and whether the wheelchair still folds with it on.
Check the weight rating
Every cushion and back has a weight capacity, and it often changes with the size. Standard cushions are commonly rated around 250 to 330 lbs. Our heavy duty cushions are rated 500 lbs. or more. Some carry that rating in every size, and some only in their widest sizes. Pick a size and a rating that fit the person, and check the rating for the exact size on the product page.
Measure the wheelchair
- Width and depth. A seat cushion is sized to the wheelchair's seat, width by depth. Measure the seat and pick the cushion size that matches it.
- Height. A cushion raises the person. A thicker cushion changes how their feet reach the footrests and how they fit under a table, so check the cushion's height on the product page.
- The back. Measure between the back canes and decide how tall the back support needs to be.
Specialty cushions, accessories and covers
- Specialty cushions. Specialty cushions protect the skin on a toilet seat, a commode or a shower chair, and on everyday seats away from the wheelchair.
- Positioning accessories. Foot and leg supports, a seat insert and a lap tray work alongside the cushion and the back.
- Covers. A replacement cover keeps the cushion you already have fresh. Each cover page names the cushion and the sizes it fits.
Medicare and wheelchair cushions
Medicare Part B can cover a wheelchair seat cushion or back as durable medical equipment for a person who has a Medicare-covered manual wheelchair, or a power wheelchair with a sling or solid seat. A scooter or a power chair with a captain's seat does not qualify. A general use cushion can be covered with that wheelchair. A skin protection cushion also needs a current or past pressure ulcer where the person sits, absent or impaired sensation there, or an inability to shift weight. A positioning cushion or back also needs a significant postural asymmetry. Without a covered wheelchair, the cushion is not covered.
Hieline sells direct and does not bill Medicare or any other insurance, so the price you see is the price you pay.
Buying from Hieline
Shipping follows our shipping policy. Financing is available through CareCredit.
Cushions, backs and covers cannot be returned
A cushion or back sits against the body, so once it ships we cannot take it back. Measure the wheelchair and check the size and the weight rating on the product page before you order.
How to decide
- Decide how much pressure relief the person needs: air or hybrid for long sitting and skin risk, foam or gel for everyday comfort.
- Add positioning if they slide or lean.
- Check the weight rating for the size, and look at heavy duty cushions if the person needs a higher rating.
- Measure the seat width and depth, and match the cushion size to it.
- Choose a back support if the sling back does not hold them well.
- Add a spare cover or positioning accessories if they help.
Start on our cushions and back support page, or use Help me choose there to narrow it down in a question or three.
