What is an immersion style wheelchair cushion?

Part 6 in our Wound Care Guide series.See Part 1, Part 2, Part 3, Part 4, and Part 5. Check out our comprehensive, digital Wound Care Guide here.

Immersion is another method of pressure redistribution, neither better nor worse than offloading. Whether it is better or worse depends completely on the patient’s individualized needs and what you as a therapist are trying to achieve. 

Recall that the principle of offloading is redistributing pressure away from a small surface area onto a greater surface area that can withstand the constant pressure better, making a patient less likely to sustain a pressure injury. 

Immersion, on the other hand, is the principle of conforming to the person’s curvature by “sinking the body in.” We allow the cushion and/or back support to take the body’s shape, alleviating the bony prominences from unwanted peak pressure to maximize pressure redistribution.

What are the benefits of using an immersion style cushion?

• Less firm surface, creating a “softer” end feel for the patient; may be an ideal solution for pain management

• Envelops or captures the exact curvature of the pelvis to increase pressure redistribution over the largest area possible

• Reduces peak pressures at the bony prominences (ITs, sacrum, coccyx)

• Good for any stage or location of a pressure injury

• Less contouring may make independent transfers easier

What are the considerations of using an immersion style cushion?

• Due to less aggressive contouring, may not be suitable for someone with trunk and pelvic weakness during prolonged sitting.

• May not be suitable for someone who desires proprioceptive input from a firmer surface to maintain an upright, midline posture.

• Some immersion style cushions require daily maintenance to ensure that the medium being used (air or gel) does not thin out from under the bony prominences. If not maintained, the cushion may “flatten out,” placing the patient at higher risk for a pressure injury.