When a 6-year-old boy with cerebral palsy came to Innovative Children’s Therapy Inc. in Winter Park, Fla., he had a crouched gait pattern and required a posterior walker. He was fearful of falling and grasped for supportive surfaces whenever he took steps. His parents has flown from overseas to try a novel technique called Suit Therapy.

For three weeks, the boy came to the center for intensive therapy four hours a day, and for a portion of that time he would wear a TheraSuit, made by TheraSuit LLC, consisting of a vest, shorts, knee pads, shoes and a cap attached to more than 20 bungee cords.

Ariana Watson, OTR/L, a therapist at Innovative Children’s Therapy, had high hopes for the boy. Therapists throughout the country are experimenting with innovative ways of treating children with cerebral palsy, and use of these strategies is spreading as therapists witness results they cannot ignore.

Suited Up

The concept used in the TheraSuit can be traced back to Russia where astronauts wore something similar in space to counteract the harmful effects on the body from a weightless environment. The suit later was modified to help patients with cerebral palsy, and a Polish couple began using this modified suit to help their daughter who had the disorder. The couple, Richard and Izabela Koscielny, were both physical therapists.

They moved to the U.S. and began using their expertise in physical therapy to improve the suit they had used in Poland, and the TheraSuit was born. The bungee cord system improves postural alignment and applies compression throughout the body to improve proprioception and strengthen areas that are weak.

Children wear this suit during a program the Koscielnys established called the TheraSuit Method — an exercise program that typically lasts several weeks and includes several hours of therapy each day.

There are about 115 clinics in the U.S. that offer the TheraSuit Method and an additional 45 internationally.

At Innovative Children’s Therapy, children who participate in Suit Therapy start out with muscle preparation, which may include massage, NDT elongation techniques and stretching. The therapist then begins focused occupational therapy time. The therapist puts the TheraSuit on the child to work on transitions from crawling to sitting and standing, dynamic sitting with reaching, and gait training, while also incorporating play activities like soccer and baseball. The child spends about an hour in the Universal Exercise Unit, which includes two types of “cages.” The Monkey Cage consists of a system of pulleys and weights to target specific muscles. In the Spider Cage, a belt and bungee cords are used to provide dynamic assistance to maintain an upright position.

In the case of the 6-year-old boy, after three weeks, he was walking with a cane for the first time instead of using the posterior walker. His crouched gait pattern was much improved. He also started to dress himself for the first time.

“He was more exploratory and not always asking for help,” Watson says. “His parents were amazed because he’d been receiving treatment for a long time, and they had never seen this level of change.”

Intesar Taye, OTR/L, director of the children’s services program at United Cerebral Palsy of Greater Cleveland, also has witnessed impressive results in patients who use the TheraSuit during intensive therapy.

“In traditional therapy you see kids once a week and they seem to make little progress,” Taye says. “With the intensive therapy model, I’m seeing kids who have worked for years with little gains all of a sudden be able to do things like sit upright more, or take their first steps. It shows parents that with intensity, their children can do better.”

Supportive Environment

The concept of intensive therapy for children with cerebral palsy also is gaining momentum at Nationwide Children’s Hospital in Columbus, Ohio. A year-and-a-half ago, the hospital started a training program using a device called the LiteGait, from Mobility Research, which uses a harness and straps to help support the weight of patients as they walk on a treadmill. Children come in for one hour of therapy three times a week for eight weeks.

“When you eliminate the fear of falling and set them up in a positive environment, you get a lot more patient confidence and compliance because you are setting them up for success,” says Michelle Sveda, PT, Nationwide Children’s Hospital.

Through the program, Sveda has seen children with cerebral palsy transition from using an assistive device to walking independently, or from walking with short strides or a crouched gait pattern to longer strides and less of a crouched gait pattern.

Hulet Smith, OTR/L, founder of the Special Needs Discovery Center in Athens, Ga., also has seen the benefits of using the LiteGait for an extended period of time for children with cerebral palsy. He worked with an 8-year-old boy who was gaining weight and losing functional mobility. When the boy first came to Smith, he could walk only five to 10 feet with a walker. Smith helped the family secure funding to purchase a LiteGait to use at home, and he trained the family how to use it. Now the boy walks on the treadmill with the LiteGait five days a week. When off the treadmill, he can walk several hundred feet at a time using forearm crutches.

“It helps patients in terms of building endurance,” Smith says. “You can then go on to have a greater amount of functional mobility.” •

Heather Stringer is a contributing writer for Today in OT.