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Pediatric Therapy Center
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TheraSuit® Orthosis

 

I. The History and Development of TheraSuit® Orthosis:

TheraSuit® , defined by FDA as a soft, dynamic, proprioceptive orthotic, is a full-featured dynamic correction clothing. The invention of the Therasuit TM can be tracked back since the 1960s BC, the United States and the Soviet Union compete to develop space science and technology (the so-called Space-Age). The Soviet Union's space science laboratories found that astronaut's physical and neurological condition had been changed after staying in a gravity-free environment for an extended period of time. Without the affect of gravity, the astronaut's spinal cords had been elongated about 2 inches. There was no doubt that the astronauts suffered a neurological change in their body, as well as a musculoskeletal change of not using their muscles to fight against the gravity in order to move around for their activities of daily living. After returning to the earth, the astronauts suffered muscle atrophy, loss of muscle strength, osteoporosis (bone demineralization), decreased cardiopulmonary function, reduced joint mobility, and change in proprioception.

So the Soviet space scientist designed and developed a fully functional prototype of the dynamic correction clothing- called "PENGUIN SUIT". By wearing this "Penguin Suit", it provided deep compression force on the skin, muscle, and bone even in weightlessness. So the astronauts would not suffer from the effects of extended staying in the gravity-free environment. And the scientists and the rehab-medicine team also developed a set of intensive training program to restore and build up the astronauts' physical and sensor-motor function.

In 1971, Professor Siemionowa, the Soviet space medical expert, improved and modified the "PENGUIN SUIT", called "ADELI SUIT" which is still used by the astronauts. The astronauts and children with cerebral palsy, or neuro-muscular and developmental disorders have the same physical and neurological changes in decreased range of motion of joint mobility, reduced muscle strength, and difficulty of movement against the gravity. At the Pediatric Institute of the Russian Academy of Science, a team developed and modified the first "Adeli Suit"- renamed the " LK Adeli 92". This was the early prototype "suit" developed and used for the various populations with cerebral palsy or neuro-muscular disorders. They soon discovered the " LK Adeli 92" work well for the children with cerebral palsy, and mainly designed for the functional movement in an upright position liked standing and walking due to the way of original setting and design of the bungee cords. The bungee cords provided the resistance only in the upright position.

In 1994, because of the limitation of the "LK Adeli 92", an improved "Suit" was re-developed and called "LK Adeli 94". It consisted of a vest, shorts, headpiece, knee pieces, padding, and special shoes with hooks for wearing. In 1997, the trained Poland physical therapist couple, Richard and Izabela Koscienlny- parents of a disabled child, first introduced the "Adeli Suit", "Universal Exercise Unit", and the "Intensive Training Program" into the United States, and used these devices in pediatric physical therapy rehabilitation. Later in 2002, further improvement of the re-designed "Suit" by Richard and Izabela was named "TheraSuit®". The further improvement was added in padding for comfort, Velcro closure for increased efficiency in application, and covering with variety of hooks in optimal locations for more options of bungee cord attachments. TheraSuit® is the only one of these kind of devices in United States registered with FDA (defined as a soft, dynamic proprioceptive orthotic) and meeting all requirements and regulations (U.S. Patent US 7,153,246, International Patent PCT/US2008/051458). In 2007, Kevin Huang, PT, MA, , the trained and certified instructor (by TheraSuit® LLC), first introduced the " TheraSuit®", "Universal Exercise Unit (UEU)", and "Intensive Therapy Program" into Taiwan, and used in pediatric physical therapy rehabilitation. Later in 2009, further registered and approved with Department of Health in Taiwan, R.O.C. - "TheraSuit® Orthosis " (DHA04400754801), as well as registered Patent of " TheraSuit®" in Taiwan (Patent # 01337168) and in China(Patent # 6538085).

 

II. The Components of the TheraSuit®:

  • Cap
  • Vest
  • Shorts
  • Knee Pads
  • Shoe Attachments
  • Elastic Bands
  • Plastic/Metal Hooks
  • Arm Attachments


All the mentioned above elements of the TheraSuit
® are connected with each other through a system of elastic bands.

 

III. The Concepts of TheraSuit®:

The TheraSuit®is defined by FDA as a soft, dynamic, proprioceptive orthosis constructed of a breathable but highly durable fabric. It is derived from the space rehabilitation medicine, and is a safe and effective treatment tool that acts as an external set of muscles. By way of adjusting the length of the elastic bands (tension and force adjustment) and the location and direction of the elastic bands' attachment (three dimensional correction of posture and movement), the TheraSuit® provides three major goals: 1) to provide support and stability during positioning and posture,2) to provide dynamic assistance or resistance during muscle strengthening, and 3) to promote facilitation or acceleration in functional skill training.The TheraSuit® provides proper and dynamic compression and loading force on the body, skin, muscles, joints to correct body alignment to as close to normal as possible in static posture and during dynamic transitions, and to re-train the central nervous system and to normalize the muscle tone for the new functional skill learning (below- picture 2). It also reduces abnormal pathological reflexes, restores proper physiological synergy movement pattern. All of the above proper tactile and propriocetive stimulations normalize afferent vestibular-proprioceptive inputs to the vestibular system. The vestibular system processes, integrates all the information afferent from skin, muscles and tendons, joints and ligaments, etc (below- picture 1). The central nervous system conducts normal and proper efferent message to muscles, tendons, and joints for correct posture, proper transitions, and graded functional skill. It influences muscle tone, balance, coordination, body awareness and the position of the body in space.

 
Picture 1 Picture 2

 

According to the "Motor Learning Theory", the more correct proprioceptive inputs the central nervous system receives from the joints, ligaments, muscle, tendons, joint's capsule, etc., the more correct alignment, proper posture, and graded movement pattern our body can perform. The vicious cycle can be interrupted, and incorrect information is replaced by "new" corrected information. A patient diagnosed with cerebral palsy and other neuro-motor disorders requires hundred of repetitions of any particular movement. We believe that as individuals, we all have a "magic" number. For example, a baby that is trying to push-off the floor will need to repeat this movement a few hundred times in order to master it. Another one may need either more or less repetitions to learn the same skill. For the Cerebral palsy child, however, this fairly low "magic" number grows to a thousand or more repetitions to learn and master new skills. TheraSuit® worn over a prolonged time will correct proprioception and accelerate the progress. The TheraSuit® can help to practice the skills and becomes more fluent, and require less and less effort. Therefore, the TheraSuit® facilitates the development of new gross and fine motor skill like sitting standing, and walking.

 

 

EEG also studies had been done on the brains of children who had been participating in therapy with the TheraSuit®. They found abnormal EEG signals at the start of the therapy and actually found normalizing EEG signals as the therapy progressed. The research had also made claims that this normalizing can help to normalize muscle tone.


IV. The Benefits of TheraSuit
®:

  • Provide the dynamic tactile and proprioceptive inputs to influence the vestibular system and normalize the muscle tone.
  • Improve the body awareness and spatial orientation.
  • Reduce the abnormal pathological reflexes and stereotyped movement pattern.
  • Provide the dynamic correction of body alignment to as close to normal as possible in static posture and dynamic transitions.
  • Provide the external support/stabilization to the weak muscles or muscle groups.
  • Reduce the compensatory movement pattern to lower the energy consumption during transitions and locomotion.
  • Re-train the central nervous system.
  • Improve the graded balance and coordination control.
  • Speed up the new movement patterns and functional skills learning and development.
  • Decrease involuntary and uncontrolled movements in Ataxia and Athetosis.
  • Improve the fluency of airway and speech production.


V. The Indications of TheraSuit®:

  • Cerebral Palsy
  • Neuro-muscular Disorders (Spasticity/ Hypotonia)
  • Muscular-skeletal Disorders
  • Post Stroke (CVA) Patient
  • Spinal Cord Injuries and Spina Bifida
  • Traumatic Brain Injury
  • Ataxia
  • Athetosis


VI. The Contraindications of TheraSuit
®:

  • Hip subluxation greater than 50%.
  • Severe scoliosis.
  • Fixed joint contractures in hip joint and lower extremities.


VII. The Precautions of TheraSuit
®:

  • Heart conditions
  • Uncontrolled seizure activities
  • Hip subluxations
  • Hydrocephalus (VP shunts)
  • Diabetes
  • Kidney problems
  • High blood pressure


The TheraSuit
® meets all requirements of FDA regulations and is FDA listed and registered. There is no age limit to use TheraSuit® (please review the contraindications and precautions of the TheraSuit®). Although the clinical concepts of TheraSuit® to be very simple, professional certified training is require to ensured the safety of the patient and quality of treatment.

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