Reviewing Kalogon’s Orbiter Med Smart Cushion

After six decades as a T11 paraplegic, my expectations of a wheelchair cushion have grown. I’ve tried several different cushions since I switched from my classic feet-on-the-floor pivot transfer to a slide board transfer due to gradual loss of strength from aging and spent shoulders. I also needed a more stable and substantial cushion to protect my geriatric skin from pressure sores. ROHOs did a good job when I could lift myself and get a high-enough boost to clear the 26-inch wheels on my manual chair. I also tried a Jay Union, a Ride Java and a Vicair AllRounder O2. 

But my ideal cushion needs to solve more problems than pressure sores. I had an extremely tender scrotum from multiple epididymitis infections. Eventually a soft abscess had to be surgically removed, which left a huge man-made hole, much like a large ischial ulcer that has to fill in with new granulating tissue. That took a good six months of bed confinement. When I finally got up and rolling again, I noticed a third problem: The neuropathic pain that had from time to time bothered me had increased in both pain level and frequency. What seemed to set it off was any kind of shear force or rough riding. Burning, aching pain punctuated by stabbing, electric pain would often force me back to bed again.  

Right around this time I heard about a new cushion that had a “scrotal well” that could be ordered to size, thanks to New Mobility editor Ian Ruder. Right away he made arrangements for me to trial the new Kalogon Orbiter Med. 

The Trial: Good News 

You may have read about Kalogon’s earlier model, the Orbiter Classic (see Michael Franz’s March 2023 review). The Orbiter Med is similar, but changes have been made in the air bladder configurations. The first thing I noticed was the size of the cushion — large, substantial, with a firm base, dual foam layers, and customized air volume settings. I expected it to be heavy, but since it’s mostly air-filled, it wasn’t. I ordered one that had minimal 1-inch lateral thigh supports, thinking that the taller 2- or 3-inch supports might get in the way when transferring with a slide board. But I found the 1-inch supports were not enough to hold my legs in place. This is probably because the slick, almost friction-free cover material resembles a small, gradual hill when fully inflated. My legs wanted to slide off to the sides. 

I called my Kalogon rep and asked if I could reorder a cushion with 2-inch lateral supports. It took about three weeks for the new cushion to be hand-delivered and exchanged for the original cushion. Now that I’ve been using the new one for at least three months, I’m glad I made the change. The higher supports hold my legs in place with no problem and transferring with my slide board is still relatively easy. An online order form lets you configure all this and more. If you are uncertain what options to choose, a call to your nearest rep should help you decide what’s best for you. 

Transferring to the Kalogon cushion using a slide board was easier than with any of the previously mentioned cushions. It has to do with the cushion cover material combined with inflation. The material is strong and durable as well as having minimal friction, which means less shear. I could easily insert and remove the slide board beneath one butt cheek while sitting in my chair.  

The contours of the cushion combined with the ability to customize your inflation settings makes for a comfortable seating position and ride. I tried the default settings and they seemed to work fine. But the real test comes with getting the cushion pressure-mapped. After playing around with settings, I made a couple of changes. There are two ischial bladders, two trochanter bladders and one dual thigh bladder. Customization is possible for amputees. Because both of my ischial tuberosities have been shaved — the one on the left more than once — I changed my left ischial bladder to inflate slightly more than my right. I also slightly decreased my under-thigh bladder. The pressure-mapping results were similar no matter what I did, and that was good news. No hot spots. Any warm spots were easily changeable and were more about my posture and positioning, which I learned from and made needed adjustments. 

I feel safe from pressure problems when using this cushion. Ideally, the cushion would incorporate its own pressure-mapping feedback system, and since the rehab cushion industry is working on that problem, don’t be surprised if some kind of feedback system is available in the not-too-distant future. In the meantime, arrange with your nearest seating clinic or DME dealer to get pressure-mapped at least once. It is essential. 

Since I started using the Kalogon Orbiter Med, my neuropathic pain level has dropped significantly. I noticed it right away when I started using the cushion, but at times there is still occasional light pain, not nearly as severe as before. In full disclosure, after using the cushion for a week, I also started taking LYRICA to treat the NP and improve my sleep. That, too, seems to be working. To test whether the reduction in pain was mostly due to LYRICA instead of the Kalogon cushion, I switched back to the Jay Union cushion for two days. During that time, my neuropathic pain increased noticeably. Once again, good news. This meant that — in my situation at least — the Kalogon is contributing to the decrease in pain. It also helps that I made a third change just recently. I transitioned to a power chair — a Permobil Corpus M300 with elevating seat, elevating leg rests and tilt and recline. I’m more comfy now in my chair than ever before. 

What about skin protection? So far so good. I’ve been using the Kalogon for about six months, and there has been no indication of irritation. A second pressure-mapping showed no hot spots. Perhaps this is due to Kalogon’s claim, based upon research they commissioned earlier, that the movement of air from bladder to bladder every two or three minutes enhances blood circulation. This could also play into the decrease in my NP. I would like to see further follow-up research from a qualified independent researcher (not paid by Kalogon) that corroborates the original findings. This could be a big deal, since pressure problems cause a decrease in circulation that leads directly to cells dying and the onset of a major pressure sore. 

Potential Drawbacks 

The only drawback of the cushion is the sound of the air pump as it makes adjustments. It’s a smart cushion that adjusts to your movements, but it isn’t smart enough to shut up when you’re in mixed company. At times, quite often, it purrs like a mechanical cat. It doesn’t bother me, but it drives my wife nuts. Truthfully, she is known for superhuman hearing — so she’s not your everyday reviewer. I can testify that she will startle from sleep if I drop a cotton T-shirt on the hardwood floor. But as long as she doesn’t have to hear me moaning anymore from sudden, stabbing neuropathic pain, I think it’s a good tradeoff. 

Some readers will complain about the price of the Kalogon Orbiter Med, and rightly so — it’s roughly $5,000. But since it now has been approved by the Centers for Medicare & Medicaid Services and has a specific code for pricing, most wheelchair users will be able to purchase one for 20% of the contracted price if on Medicare, and perhaps less if on Medicaid.  

Not everyone will need this top-of-the-line cushion. It is Kalogon’s most advanced, most expensive model and the only one called the Orbiter Med. It is engineered and can be configured by the user (earlier Orbiter model was a flat cushion). You can also control the cushion’s inflation via Bluetooth. I found this useful for changing air-pressure levels when transferring or riding on rough terrain in my power chair. For those of us who have a lot of complications to address – like a high risk of skin breakdown, neuropathic pain and complex positioning needs – the Orbiter Med performs better than any other cushion I’ve tried. It allows me to stay in my chair for longer and be more active in my advancing age. It’s hard to ask for more than that.