Pediatric Therapy Services, Inc.
Lakeland Florida
TheraSuit Training Session
Sept 23, 2013 through October 10, 2013
SUMMARY FOLLOWING QUEENA’S COMPLETION OF THERASUIT TRAINING OF 36 HOURS: 4 DAYS PER WEEK FOR 3 HOURS PER DAY FOR 3 WEEKS.
Queena was introduced to therapy techniques during this TheraSuit session that were unfamiliar. She demonstrated reduced latency time in establishing awareness/acceptance of these technique. Queena demonstrated active flexion/extension of L.E. up to 5-7 complete cycles with bungee supported bilateral LE while in semi-supine position. With repetition of the pattern she showed ability to reduce tone overflow and increase active hip/knee flexion of right and left. She responded best with auditory cue of metronome for the rhythm of the pattern and with tactile cues over the muscle belly. She was able to resume the pattern following rest periods. Queena appeared to enjoy her success with repeating and improving the quality of her pattern of movement with each new trial that she initiated. Her active effort was realized by the changes in her autonomic system, i.e. sweating, overall affect and intention.
Queena showed improved pelvic/lumbar position after active work and positioning in prone with moderate assistance for spinal extension without head thrust. She was able to reduce lower back tone to allow hip flexion after 3 repetitions of assisted movement into sitting 75% of the time.
It was noted that with improved shoulder girdle/upper extremity mobility that upper body torque was more noticeable. Right shoulder and right trunk were forward, left pelvis was posterior with left LE locked in extension with genu-recurvatum. Weight line is posterior of hips. Head is held strongly tilted to the left. This torqueing greatly impedes any active or assisted weight shifting in the frontal/sagittal planes.
Overall this, alignment and position improve when Queena is wearing the TheraSuit. She is able to maintain some more appropriate alignment following treatment, yet is unable to sustain alignment over greater periods of time, i.e. over a period of 3-4 days. The final week of treatment emphasized loading bilateral UE and LE to surface. Queena was able to keep her hands on hand grips while weight bearing on elbows at platform walker. The first trials required maximal assist to place hands to grips most specifically if not supported by the TheraSuit. With repetition of 2-3 trials hands were placed with mod to min assist. Increasing stance times were accomplished. Queena demonstrated her best effort when her left knee was supported with a knee splint and while wearing the TheraSuit. She became relaxed and tolerated assisted weight shifts through her pelvis and knees.
Queena experienced a trial in a LiteGait on 10/14/2013. She had approximately 30 minutes of physical preparation prior. The LiteGait is a supporting-unloading gait training device. She was able to be brought to stand off of a table surface with approximately 40 % of her weight initially supported. She was able with maximal assistance to begin to complete cycled strides across the ground and later over a treadmill moving at .5 to .8 MPH. The longest sequence accomplished was for a cycle of 8 with therapists maximally assisting bilateral LE through the gait cycle. Queena’s pattern improved with repetition yet was overridden by clonus and LE tone. At the end of the session approximately 85% of her weight was supported. Suggestion was made to have further training and trials with the Litegait to assist unloading and free effort of movement and provide controlled repetition. Care must be taken to provide knowledgeable handling and technique to provide Queena with the best outcome and safety.
With the progress that Queena made during this session:
It is recommended that future therapies focus on reducing torque to improve bio-mechanical/postural alignment for improved muscle function/strengthening.
Queena showed extreme effort during this entire TheraSuit training. She responded with awareness, engagement, physical effort and humor.
Queena is always a joy to challenge and progress.
We appreciate the opportunity to grow with Queena.
Denise Kilburn PT
Kathy Shufflebarger PT
Pediatric Therapy Services
