The Therasuit Movement Method

Therasuit is a movement method focused on reducing movement problems in people with cerebral palsy and similar diagnoses. The method is based on a special Therasuit suit, which originated in space research and enables, through many special attachment points, individual engagement, or conversely disengagement, of improperly functioning muscle groups. In addition, universal exercise units, called “cages,” are used, where clients train according to their health condition. They strengthen weakened and poorly functioning muscles, and train movements whose coordination then produces, for example, steps, or they are fixed by a system of elastic cables in space and train stability and movement in an upright position. The cages also include rails, through which clients can try walking or crawling in the suit and harness. This is a holistic approach that focuses on increasing movement independence.

History
The sources of this therapy are in Russia. It was used there for astronauts who spent a long time in space, where weightlessness and a lack of gravity had a negative impact on muscle trophicity and the development of osteoporosis.

In 1990, the suit was first used with children with cerebral palsy. Seven years later, it was introduced in the USA, and in 2002 it was improved, patented, and registered with the FDA (US Food and Drug Administration – editor’s note) as Therasuit. The development of Therasuit was led by Izabela and Richard Koscielny, originally from Poland. Both are physiotherapists and parents of two daughters. Their older daughter was born with a diagnosis of cerebral palsy, and perhaps for this reason, the Koscielny couple sought to find the best method that could improve their daughter’s life as much as possible.

Therasuit suit
Therasuit is a soft, proprioceptive suit that forms an external supportive frame for patients with neurological disorders. It consists of a cap, vest, shorts, knee guards, and specially adapted footwear. The individual parts of the suit are connected to each other with elastic bands. Through the system of elastic bands, the client’s body is positioned as close to normal as possible. It improves posture and the proper function of postural muscles. This allows the client to learn correct movement patterns or correct those that were previously acquired but incorrect. Pressure from the suit leads to deep proprioception of joints, muscles, and ligaments. This influences muscle tone, balance, and the body’s position in space.

Therasuit provides external stabilization, which creates smoother and more coordinated movement. The uniqueness of this method essentially lies in the intensive, individualized strengthening of neurological clients whose diagnosis limits mobility. Therasuit does not perform movement for a person; it only helps them create it with less effort. Therasuit develops gross and fine motor skills, crawling, upright sitting, standing, and walking.

Universal exercise unit – “cage”
The cage is equipped with elastic lines, pulleys, and a rail. These devices give the cage great flexibility in how it can be used. Through the pulleys, patients strengthen themselves with varying levels of resistance according to their muscular capabilities. Elastic cables keep the trainee in an upright position and help activate the vestibular system. The cage is fitted with a rail, where clients learn their first steps with support straps in a reduced-load position.

Advantages of Therasuit - Provides external body stabilization - Normalizes muscle tone - Supports weak muscles - Supports the development of gross and fine motor skills - Improves bone density - Influences the vestibular system - Improves spatial perception - Improves balance and coordination - Reduces uncontrollable movements (ataxia and athetosis)

Indications of Therasuit - Cerebral palsy - Spasticity - Hypotonia - Patients after stroke - Traumatic brain injuries - Spinal cord injury - Neuromuscular disorders - Ataxia - Athetosis

Kontraindikace Therasuit - Severe scoliosis - Hip subluxation above 50% - Heart disease - Decompensated epilepsy - Hydrocephalus (VP shunt) - Diabetes (decompensated) - Kidney disease - High blood pressure

Therasuit in the world
This method is fully available around the world. At present, there are more than 245 clinics worldwide, and more than 2,000 therapists have been trained here.

Therasuit ALKA
ALKA, o. p. s., was the first to begin providing Therasuit therapy in the Czech Republic. Izabela Koscielny, an instructor and the founder of this method, visited ALKA in Příbram already in 2011 to professionally train therapists in this movement method; before the end of 2011, a pre-pilot operation with two clients also took place.
In 2012, Koscielny continued training and in a patient sample showed the complete diagnosis of each client and helped create individual exercise programs for them. From March 2012, when the company started pilot operation, all therapies have been carefully documented. The goal of the pilot operation is to create a professional study so that ALKA can seek inclusion of the method in partial reimbursements from health insurance and in social services.

Therapy is carried out in three-week blocks. Before each therapy begins, each patient undergoes an initial examination, where a rehabilitation physician, physiotherapist, occupational therapist, special educator, and social worker review them. Based on the results, a rehabilitation individual plan is created for each trainee.
Clients usually train for three weeks, 3–4 hours per day. Each exercise session is preceded by thorough muscle warm-up and massage. After these introductory procedures, the client puts on the suit and begins strengthening different muscle groups according to their needs. We progress from simpler exercises to more complex ones and from a horizontal body position to vertical. After exercise, relaxation is included. At the end of the exercise block, follow-up measurements are again performed by the team.
After each block, a break of 3–4 months is required, and then intensive therapy is repeated as needed until optimal condition is reached. During the break between exercise blocks, clients continue exercises at home; each receives written exercises with photo documentation. Endurance and family cooperation are very important.
During the pilot operation over several months, we have observed many successes. We are all encouraged when a six-year-old girl makes her first independent steps right before our eyes, or when a wheelchair user begins to use crutches for short distances. The effects of therapy are much broader than motor skill improvement alone, because there is also development of cognition, speech, increased self-care level, and thus significant advances in clients’ social competencies.

Simona Černá, DiS.
professional lead therapist for Therasuit and physiotherapy For additional information about Therasuit, visit www.therasuit.cz or email kancelar@alkaops.cz

(This article was published in the journal Sociální služby, issue 12/2012.)

Asociace poskytovatelů sociálních služeb ČR je nezávislým sdružením přímých poskytovatelů sociálních služeb sledujícím jako základní cíl jejich rozvoj a zvyšování jejich úrovně.

Odborný časopis Sociální služby - 12/2012

Odborný měsíčník Sociální služby je nejrozšířenějším periodikem v oblasti sociálních služeb v České republice. Jeho vydavatelem je Asociace poskytovatelů sociálních služeb České republiky (APSS ČR), největší profesní organizace sdružující poskytovatele všech typů a druhů sociálních služeb v ČR. Její členskou základnu v současnosti tvoří více než 720 organizací, což znamená přes 1600 registrovaných služeb.

Časopis Sociální služby vznikl v roce 2009 transformací dosavadního Zpravodaje APSS ČR. Vychází desetkrát ročně na 36–48 stranách formátu A4 v nákladu 3500–4000 kusů pro cca 16 000 čtenářů z řad poskytovatelů, zřizovatelů i uživatelů sociálních služeb, představitelů veřejné správy, studentů i pedagogů vysokých škol jak v České republice, tak na Slovensku.

More information is available on the websites http://www.socialnisluzby.eu and http://www.apsscr.cz.

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