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Thread: ROHO cushion air/pressure retention

  1. #21
    Quote Originally Posted by crags View Post
    I have a high profile quadtro and barring any obvious problem, every 2-3 weeks I put in about 1-1.5 pump strokes with the chamber communication valve open, then sit in it, redistribute, and close the valve.
    For what it is worth, a seating specialist (occupational therapist) advised against sitting on the cushion while the valve was still open and then closing the valve while you a sitting on the cushion. He said this method was allowing your heavier, bony parts to displace too much air, so that you were sitting IN the cushion, not ON the cushion. ROHO cushions rely on floatation to eliminate pressure.

  2. #22
    Senior Member pfcs49's Avatar
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    Quote Originally Posted by gjnl View Post
    For what it is worth, a seating specialist (occupational therapist) advised against sitting on the cushion while the valve was still open and then closing the valve while you a sitting on the cushion. He said this method was allowing your heavier, bony parts to displace too much air, so that you were sitting IN the cushion, not ON the cushion. ROHO cushions rely on floatation to eliminate pressure.
    I think that is 100% wrong. My understanding was to open valve (grn/in), inflate, sit in normal posture, close valve (red/in), then check ischial clearances.
    If sitting too low or high, repeat, adding or emptying air.
    https://www.aci.health.nsw.gov.au/__...5/useroho3.pdf

    When I had my seating clinic and pressure mapping, I was amazed at how much I was "sitting IN the cushion when we got the best results! The thing was nearly bottomed out. Given how rarely I check my clearances, I haven't the courage to run it so low! I do, however run much deeper/lower than before the clinic.

    Incidentally, the deep quad Roho absolutely blew away the Jay Deep Comfort with +10% fill and custom +1" base the same seating clinic at Kessler had mapped and spec'd for me in 2012 when I had had my flap surgery!
    I had wandered off the reservation and purchased the Roho independently; they were astonished? when their cushion still had high pressure points and the Roho none. So, that's what I got with the new chair, of course.
    Only problem is I can't safely roll around with a glass between my legs any more!
    Last edited by pfcs49; 01-13-2019 at 04:09 PM.
    69yo male T12 complete since 1995
    NW NJ

  3. #23
    Quote Originally Posted by pfcs49 View Post
    I think that is 100% wrong. My understanding was to open valve (grn/in), inflate, sit in normal posture, close valve (red/in), then check ischial clearances.
    If sitting too low or high, repeat, adding or emptying air.
    https://www.aci.health.nsw.gov.au/__...5/useroho3.pdf

    When I had my seating clinic and pressure mapping, I was amazed at how much I was "sitting IN the cushion when we got the best results! The thing was nearly bottomed out. Given how rarely I check my clearances, I haven't the courage to run it so low! I do, however run much deeper/lower than before the clinic.

    Incidentally, the deep quad Roho absolutely blew away the Jay Deep Comfort with +10% fill and custom +1" base the same seating clinic at Kessler had mapped and spec'd for me in 2012 when I had had my flap surgery!
    I had wandered off the reservation and purchased the Roho independently; they were astonished? when their cushion still had high pressure points and the Roho none. So, that's what I got with the new chair, of course.
    Only problem is I can't safely roll around with a glass between my legs any more!
    Yes, I understand, and the method of closing the valve after the person sits on the cushion is exactly the recommendation in the Roho Dry Floatation Wheelchair Cushions instruction manual. I questioned the OT about the discrepancy between his method and the method in the instruction manual. His rational is that most people do not follow the instruction to "inflate the cushion until it begins to slightly arch upward." By failing to follow this part of the instruction, there will never be enough air in the cushion to float the heavier and bonier parts of the body. He went on to say, it is probably better to be sitting on a slightly over inflated cushion, closing the valve after inflation, instead of after a person sits on the cushion. That said, when he inflated the cushion, he did use his hands to distribute the air through all sections of the cushion and then closed the valve. Then I got in the chair.

    After a person is sitting on the cushion, the instructions go on to say,
    "Slide your hand between the cushion's surface and the user's bottom. Lift their leg slightly and feel for their lowest bony prominence. Then lower their leg to a sitting position."

    "Open valve to let out air, while keeping your hand under the person's lowest bony prominence." (This is probably a job for two people, one to feel the pressure and one to operate the valve. It seems a single person almost has to be a contortionist to have one hand under the weight of a person and manage opening and closing the valve at the same time.)

    "Release air until you can barely move your finger tips."

    "Turn valve to close."

    We have done cushion inflation both ways, and I've not noticed a lot of difference. As long as I am stable on the cushion and I don't have pressure points, I'm good.

  4. #24
    Senior Member pfcs49's Avatar
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    I think you're talking about the cushions that only have an inflation valve.
    The cushion I am referencing also has a shuttle valve in the front which isolates the four quadrants of air pockets. When it is opened, the pressure will equalize across the cushion. When closed, no air will move from quadrant to quadrant.
    Nevertheless, my experience at the seating clinic and seeing the display of the pressure distribution makes it clear to me that the performance of the Roho improves uniformly as your seating goes deeper (up to the point that there's possibility of bottoming out).
    69yo male T12 complete since 1995
    NW NJ

  5. #25
    Senior Member Oddity's Avatar
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    The issue with unlocking the 4-way valve while seated is that while it allows your ischials to sink deeper it pushes your femurs up. The process I was taught by my seating OT says you can achieve BOTH the proper immersion at the ischials as well as having immersion and shearing protection for your trochanter and femur using the following process as a starting point:

    Open the 4-way
    Overfill the cushion
    Remove pump
    Allow cushion to equalize
    Close the 4-way

    If this is too low, repeat but don't quite allow the cushion pressure to fully equalize, leave a little extra in it. The main point is, locking the valve before sitting gives the proper immersion across the entire surface of the cushion, not only at the ischials. Having an overfilled front 2 quadrants compromises on some shearing protection as well as immersion for the entire leg.


    If you have some pelvic asymmetry issues, the process is different.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

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  6. #26
    Senior Member Oddity's Avatar
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    In the end, there is no one "right way". Proper immersion can be achieved a few different ways to accommodate lots of different bodies and preferences.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

  7. #27
    I don't have to add air to my cushion more than maybe every 6 -8 weeks. However, I have had a string of bad luck with these cushions. I have had about four cushions develop a hole in the last year or so. ROHO warranty and customer service is GREAT and they send a new one right away but I wonder if any one else has noticed their cushions don't last as long. My first ROHO lasted at least two years before it got a hole but the last three I have had only last a few months. The last one I had only lasted 5 weeks! The holes seem to be in the creases where the top of the cell comes together and always in the back quadrants.

    Anyone else notice a shorter life span? Maybe they got a batch of bad rubber...

  8. #28
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    Quote Originally Posted by Tom Borcherding View Post
    automation, contact me with your name / address and I'll get some ROHO inflation pumps sent out to you on Monday so your clients can have what they need with the cushions you deliver.

    tom.borcherding@permobil.com
    Thanks for the offer, Tom. I managed to find another "pump" in a "plastics" Gaylord (would have been trash, had I not spotted it). That one, plus the one I've normally used (and retained) to set-up cushions along with a personal "spare" will get me through this batch of chairs.

    I was mainly asking for "guidance" so I can finish writing up guidelines for whomever takes over this role (I'll be moving on to other activities that make better use of my skillsets).

    As an aside, one of my pet peeves you can, perhaps, feed to your design team:
    - add a coloumb counter to the chair so you can more accurately predict remaining battery capacity and battery health. The battery never experiences any deliberate drains or charges without the chair electronics "seeing" them! I.e., make "battery management" more of an issue.

  9. #29
    I hope i am not causing my roho qaudro life span to be shorter but I just got one two months ago and i leave the valve open because my seating feels better for me. I have always used the old standard one with the one valve for 38 years. Never had a sore from them and they always lasted a long time. The last one lasted five years and never had a leak.
    But the sales person sold me on the qaudro so i am trying it out and like the feel with the valve open.
    Should i stop leaving the valve open?

  10. #30
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    Hi Rainman, Let me first clarify to all readers that you are not leaving the inflation valve open (which would lead to immediate deflation of the cushion), rather you are leaving the ISOFLO control valve (AKA the slider valve on the QUADTRO SELECT and CONTOUR SELECT cushions) in the open position. This is fine to do, and won't have any impact on the product lifespan. The impact of leaving this control valve in the open position is that the air circulates throughout the entire cushion as opposed to being segmented into 4 chambers. Some reasons that you may choose to move the control valve to the closed position would be 1) to increase the overall stability of the cushion, since you would be isolating the air into 4 defined chambers; 2) to lock the air into the 4 chambers in such a way that it supports any asymmetry in your seated posture; or 3) if you use a chair with a tilt / recline function, it maintains the air in the rear quadrants of the cushion as your weight shifts during a tilt / recline action. Thank you for being a ROHO customer for 38 years! Tom

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