Foam: Familiar, Functional, but Falling Behind in Custom Seating

For decades, foam cushions have been the trusted standby in wheelchair seating. They are affordable, accessible, and familiar to nearly every clinician and supplier. But familiarity is not the same as effectiveness, especially as technology and user needs evolve.

In this first installment of the Beyond Foam series, we take a closer look at what foam does well, where it falls short, and why it may be time to rethink what “good enough” really means.

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Foam cushions are popular for a reason. They are lightweight, simple, and offer immediate comfort. The cells within polyurethane or viscoelastic foam compress under load and rebound when pressure is removed, creating that soft and familiar feel.

For short-term sitting, foam may be adequate. But for individuals who spend hours seated every day, the story changes.

Over time, foam begins to lose resilience. The same material that once felt supportive slowly starts to collapse under repeated compression. This process, known as compression set, reduces support, changes posture and increases pressure concentration over time. (1)

Foam also traps heat and moisture. As body heat builds beneath the seated surface, skin temperature rises and moisture accumulates, creating a dangerous microclimate for fragile tissue. (2) 

What starts as comfort can gradually become risk.

Modern seating requires more than softness. It requires consistency, durability, airflow, and protection that lasts beyond the initial fitting.

That is where the AIREZ 2.0 cushion changes the conversation.

Unlike foam, AIREZ 2.0 uses a 3D printed medical grade elastomer lattice engineered to maintain support over time. Its structure flexes and rebounds repeatedly without collapsing, helping preserve posture, pressure redistribution, and comfort long term. (3)

The future of seating is not about what feels soft on day one. It is about what still performs months and years later.

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(1) (International Pressure Injury Guideline — Seating, 2025)

(2) (Kottner, J., Black, J., Call, E., Gefen, A., & Santamaria, N. (2018). Microclimate: A critical review in the context of pressure ulcer prevention. Clinical Biomechanics, 59, 62–70.)

(3) (Yang, Y., Zhang, A., Zhou, X., Ling, S., Wu, L., & Huang, H. (2025). Bio-inspired elastomer lattices with multi-stage mechanics and fatigue resilience. International Journal of Mechanical Sciences, 111125. https://doi.org/10.1016/j.ijmecsci.2025.111125)

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Ana Endsjo, MOT/R, CLT

Director of Clinical Education and Marketing

Ana Endsjo is the Director of Clinical Education & Marketing at Matrix Seating USA and a contributing faculty member at University of St. Augustine for Health Sciences. With over 20 years of experience in occupational therapy, seating and mobility, and clinical education, she specializes in custom seating, assistive technology, and clinician training. Ana is passionate about advancing client outcomes through education, innovation, and practical clinical solutions within the complex rehabilitation technology industry.