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Spasticity causes frequent, involuntary movements that continuously alter how pressure is distributed under the pelvis. A cushion must maintain consistent pressure relief and minimize shearing during these unpredictable shifts. An air-filled cushion relies on maintaining even air pressure across many cells; when the patient moves, air redistributes quickly, creating uneven pressures and potential hotspots or shear at the ischial area. This dynamic interface makes air-filled cushions particularly vulnerable to spastic movements and, in a patient with a history of ischial ulcers needing maximum pressure relief, poses the greatest concern.

In contrast, contoured foam, gel with a foam base, and honeycomb cushions provide more stable, less movement-dependent interfaces, distributing load more consistently even with involuntary leg motions, and thus are less likely to amplify spasticity-related pressure changes.