The EquaGel cushion is a relative newcomer to the Australian wheelchair pressure cushion market from Utah, USA. The "EquaGel" name was trademarked in 2011. It is on the Queensland Medical Aids Subsidy Scheme (MASS) Standing Offer Agreement (SOA) for wheelchair cushions, and costs about $250-$300.

I first encountered this product at the Occupational Therapy Australia 2015 national conference trade display. The man at the EquaGel stand, let's call him Bob, had an EquaGel General cushion sitting on a regular plastic chair. There were a set of car keys on the cushion. "Sit down," Bob said. "Sit on the cushion and tell me if you can feel the keys." I was sceptical and uninspired by the idea of hard car keys jabbing my gluteus maximus. However, I took Bob up on his challenge, and gently lowered myself into the seat. I was pleasantly surprised. The keys were not uncomfortable to sit on; I couldn't even locate them!

Equagel General cushion in 16x16in (40x40cm)

Bob went on to explain that the cushion is made from a patented polymer gel. It is a synthetic product; latex free. The key to EquaGel's pressure redistribution qualities, though, is the column buckling effect. The Equagel website explains this in detail, but basically the cushion has two layers, the top has a grid of 1cm cells, and the bottom layer has a grid of 2.5cm cells. When a certain amount of pressure is applied to a column from the top, it collapses, allowing the weight to be shared across to adjacent columns, and the user to sink into the cushion. However, the elastic quality of the gel is always wanting to help the columns reform to their proper shape, which provides an upwards force, preventing bottoming out.

View from top, grid of 1cm columns

View of underside, grid of 2.5cm columns. The columns underneath have more robust walls, lending structural stability to the easily conforming top layer columns.

The cushion has been moulded to included a sacral/ischial well at the rear of the cushion. The well assists with redistributing pressure from high risk areas to the thighs and greater trochanters. It also assists with positioning and maintaining posture, preventing the user from sliding forward. Overall, I've rated the EquaGel general cushion as providing moderate pressure redistribution qualities, and moderate postural support due to the well and the amount of immersion. See how it compares to other in the OT Equipment Info Quick Guide to Wheelchair Cushions.

The two layers thin at the back to create a well. General cushion height: 5.1cm, Well height: 3.4cm.

The cushion cover has been thoughtfully designed. It has a label on the left side to assist users to orientate the cushion correctly (assuming the cover has been put on correctly), a zip and a handle on the back, and Velcro on the base to keep it in place. The outer fabric is soft and stretchy. The inside top of the cover has a course-weave cotton lining.

So far I've used this cushion much more without the cover. Uncovered, the cushion lends itself nicely to use in the shower. The open column design means that water can easily drain though, and the distributer assured me that the warm water will not damage the gel polymer. I have even cut a hole out of the middle so it could be used on a mobile shower commode. This was a quicker, easier, and more accurate solution than ordering a custom shower commode seat of another brand (e.g. ROHO). The columns maintain their structural integrity, and the centre piece can be used for other applications, such as heel protection, or reinserted to be used on a wheelchair or standard shower chair. The weight and slight stickiness of the gel has meant it stays in place on the commode seat without adhesives, though it needs to be well positioned before the user sits on it, as it can tend to stretch or move out of shape.

Things I like about the EquaGel cushion:

• The design is innovative, very clever, and effective for moderate pressure redistribution.
• It is versatile: it can be used on a regular chair/wheelchair, and in the shower or other wet areas (allowing adequate drying time in the shade to prevent it becoming mouldy).
• The design allows for air flow through the cushion, providing assistance with moisture management. It would do well at protecting the skin from incontinence, however it wouldn't protect the wheelchair.
• It is good value, priced similar to a high quality foam cushion, but I suspect it is more durable than foam.

Possible drawbacks for the EquaGel cushion:

• It is rather heavy, which is a common issue for gel cushions.
• Its ability to easily conform can make handling difficult (it's very floppy). This can make it difficult to get the cover on and off.
• The two points above would make me think twice before considering suggesting this cushion to a user with low hand strength who would need to manage the cushion independently.
• Smallest size is 16x16in (40x40cm), no paediatric sizes available.
• Note: MASS won't fund the cushion for shower use, especially if you're going to cut a hole in it!

What are your thoughts on the EquaGel cushion? Now it's your turn to share…