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EquaGel vs ROHO

EquaGel vs ROHO

EquaGel vs ROHO – This could be the healthcare matchup of the century.  Even though the EquaGel® wheelchair cushion using buckling gel technology was introduced in 2011 (five years ago) it is still unknown to many healthcare professionals who continue to use the old technology of foam or air. It is time for all to understand the true comparisons between EquaGel® cushions and ROHO® cushions.For many years healthcare professionals have thought that the standard cushion to address skin integrity issues is the ROHO® cushion. The ROHO® is a cushion that is inflated with air to provide some comfort to the client. By releasing some of the air in the cushion, the client is further immersed into the cushion. When additional air is inserted into the cushion, the client is less immersed into the cushion. Because of this adjustability, healthcare professionals have been led to believe that ROHO® cushions will protect against the development of pressure injuries (pressure wounds, skin wounds, skin breakdown, etc.).

Medical science understands that many factors may be involved in the development of a pressure injury. Diet and blood circulation are among those factors. But the wounds are called “Pressure Injuries” not “Diet Injuries” or “Blood Circulation Injuries”. These injuries are called Pressure Injuries because medical professionals understand that at the point that a wound occurs, there typically are three (3) factors involved:

  • Pressure – constant pressure on an area of the skin
  • Heat – the elevation of body heat at the point of contact
  • Moisture – the perspiration that the body creates to help cool the area where the body temperature is elevated.

These same three (3) factors inhibit the healing of an existing pressure injury. Let’s compare how EquaGel® handles these three factors and how ROHO® handles them.


We all become uncomfortable when sitting in one position after a while. Many times that uncomfortableness is caused by the two bones that protrude from our pelvis. The medical term for those two bones is ischial tuberosity’s , or ischial’s or IT’s for short. The common generic term is “Butt Bones”.

Because the ITs protrude downward from the pelvis, they put additional pressure on the butt muscles at those points. Consequently, for a cushion to truly provide pressure relief, that cushion must give additional pressure relief in the area of the ITs.

ROHO® – The ROHO® cushion is an air cushion where the air is divided into numerous conical chambers. When a client puts their weight on the ROHO®, the air is displaced and the client is sitting on a cushion of air that is perfectly shaped around their butt but not giving additional relief to the ITs.

EQUAGEL – EquaGel® cushions work on a structural engineering principle called “Column Buckling”. Simply put, column buckling refers to the way EquaGel® behaves under weight. Each wall of gel is capable of supporting only a light load. When that threshold is exceeded, the wall of gel buckles into the hollow area between walls and passes the weight to the surrounding walls for support. This buckling and weight passing happens instantly and repeatedly until the maximum surface area of pressing weight is evenly supported by largely equalized pressure.

The peak pressure points of the ITs and coccyx/sacrum buckle into the EquaGel cushion feeling almost as if they are free-floating within the cushion while the thighs and buttock of the client are supported.


When one sits for an extended period on a surface that provides no ambient air, the body temperature begins to elevate at that point. Since elevated body heat is one of the major factors in the development of pressure injuries, a wheelchair cushion should be so designed as to not increase body temperature.

ROHO® – As an air cushion, the material in a ROHO® that holds the air does not breathe. If it did, it could not hold the air that provides the cushioning. In a recent presentation titled “Wheelchair Cushion Considerations” and given by Elizabeth Cole, Director of Clinical Applications at ROHO®, the following question was asked:

As someone sits for an extended period, their body heat tends to build-up at the point that they are in contact with their seat cushion. How does ROHO® maintain a temperature neutral environment?” 

The ROHO® answer: “Yes, unfortunately this is a problem… Aside from putting a little fan in the cushion to circulate the ambient air, there is going to be heat build-up. So if someone is able to perform a weigh-shift, that can allow the cushion to cool to some degree. “

Hence ROHO® admits their cushions will cause heat build-up and the only solution is weight shifting. Many people confined to wheelchairs cannot shift their own weight.

EQUAGEL® – EquaGel® is a dry-polymer gel, almost rubbery to the touch. The buckling column design of an EquaGel® cushion leaves open cells that allow for air-flow under the client.  As such a client may sit on an EquaGel® cushion for many hours without any increase of the body temperature at the point of contact. An EquaGGel Backgroundel® cushion will maintain a temperature neutral surface for as long as the client remains seated.


As stated above, moisture is the perspiration that the body creates to help cool where the body temperature has increased. As such, if a cushion is able to provide a surface that does not cause an increase in the body temperature, then there is little chance that perspiration (moisture) will result.

ROHO® – As indicated by Elizabeth Cole of ROHO® above, a client sitting for a period of time on a ROHO® cushion will experience an increase of the body temperature. The increased body temperature can result in creating perspiration (moisture).

EQUAGEL – With the open cell design, an EquaGel® cushion provides enough air-flow under the client to maintain a temperature neutral environment. Hence, the client’s body temperature remains constant and there is little chance that perspiration will occur.

In conclusion, it is apparent that the best seating solution for someone sitting in a wheelchair or confined to a wheelchair is an EquaGel® cushion. While the ROHO® cushion has been around for many years, it no longer should be considered as the de-facto standard for protected comfort. EquaGel® has set a new standard that no other cushion can match. EquaGel® provides extended comfort while also providing superior protection against the development of pressure injuries.