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ROHO Co-Authored Study Finds That Adjustability and Adaptability Are Critical Characteristics of Pediatric Support Surfaces in the Prevention of Pressure Injuries

A research team, including a director from ROHO Inc., a division of Permobil, recently completed two groundbreaking studies that determined that the adjustability and adaptability of pediatric support surfaces – characteristics of ROHO cushions and mattresses – are critical in the prevention of pressure injuries, which are now referred to as “pressure injuries” by the National Pressure Ulcer Advisory Panel. This work represents the first biomechanical analysis of “medical device related pressure injuries” specific to these youngest of patients. The first study was peer-reviewed and published in 2015 in Advances in Wound Care, followed by the publication of additional analysis in 2016 in the Journal of Tissue Viability. The research was financed in part by a grant from New England Pediatric Device Consortium (NEPDC), a non-profit consortium that provides infrastructure, expert consultation to innovators, and execution of technology translation and commercialization of pediatric technologies.

Kara Kopplin, senior director of efficacy research at ROHO, Inc., co-authored the studies with Professor Amit Gefen and his Ph.D. student, Ayelet Levy, from the Department of Biomedical Engineering at Tel Aviv University in Israel.

Key findings of this research include:

  • Mattresses that are being used in neonatal and pediatric intensive care units must be able to respond to frequent movements and changing positions, and also be able to effectively adapt and conform around such things as misplaced tubing or wires, which might contact the body, deform soft tissues, and lead to pressure injuries.
  • The medical devices that are often needed for critically ill pediatric and neonatal patients, such as electrodes, wires, and doughnut-shaped headrests, greatly increase the risk of pressure injuries to these delicate patients, especially when used on the back of the head, since their geometry and stiffness can greatly elevate the tissue stresses, further increasing the risk of injury.
  • Air-cell based technology mattresses provide considerably better protection against pressure injuries than regular mattresses in such cases, as the air-cells are able to locally buckle and conform around objects that are stiffer than the pediatric tissues (e.g., wires, tubes, electrodes). This adaptable environment minimizes exposure to tissue deformations.

Each year, the NEPDC partners with parents, clinicians, and advocacy groups to select a significant pediatric medical need and issues a Target Challenge to identify and solicit novel device concepts from academic and clinical institutions, industry, and the general public. In 2014 the Target Challenge called for proposals of novel technologies to reduce, treat, or prevent, pediatric pressure injuries that can result in viable products for clinicians. ROHO was one of two Target Challenge grant recipients in 2014.

“We are excited to work closely with ROHO to rapidly advance their technologies towards commercialization,” said Rick Greenwald, PhD, co-director of NEPDC. “It is critically important to develop and deploy medical devices that reduce the incidence and severity of pediatric pressure ulcers”.

“There was very little previous research on how to prevent tissue injury in newborns, especially those in intensive care. We were honored to receive the NEPDC grant and contribute to the understanding of how these precious patients can be better protected in their care environments,” said Kara Kopplin, senior director of efficacy research at ROHO, Inc.

Read more about this ground-breaking discovery in the March 2015 issue of Advances in Wound Care, “Adjustability and Adaptability Are Critical Characteristics of Pediatric Support Surfaces,” and the 2016 Journal of Tissue Viability, “Device-related Pressure Ulcers from a Biomechanical Perspective.”


ROHO, a business unit of Permobil, has been committed to enhancing the lives of the physically challenged for over 40 years. ROHO fosters independence for individuals with disabilities through the relentless advancement of shape-fitting, tissue protection solutions, so they may overcome everyday challenges and explore life without compromise.

Founded in Sweden, Permobil has its North American headquarters in Lebanon, Tennessee. Permobil acquired ROHO, the global leader in skin protection and positioning solutions for individuals with disabilities, in April 2015 and TiLite, a leading manufacturer of innovative and customized manual wheelchairs, in May 2014. More information regarding Permobil’s storied history and complete product line may be obtained at

"Every disabled person has the right to have his or her handicap compensated as far as possible by aids with the same technical standards as those we all use in our everyday lives"
-Permobil’s founder Dr. Per Uddén 1967

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