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.
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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.
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.
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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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