Making Sense, Part D

By “give more shape to…a disordered product landscape” I mean look for ways to group and classify the on-body devices I've been referencing since Making Sense, Part A. 

Here’s a listing of said devices: 

1. Benik vest 
2. elastic therapeutic tape 
3. TheraSuit (a.k.a., PediaSuit and NeuroSuit)
4. compression sportswear 
5. SPIO (Stabilizing Pressure Input Orthosis)
6. TheraTogs
7. wearable robot 

What are these things? Can we make broad generalizations about their forms and functions?

One of the first things to jump out at me is the fact that these are orthoses, devices designed to “support or correct the function of a limb or the torso.” All but one of 'em, that is. The wearable robot, as conceived by Miguel Nicolelis, has orthotic properties but it's more of a neuroprosthetic device. I’m going to de-list it now for that reason.

Let’s focus, then, on the first six devices -- starting with their forms, i.e., their physical characteristics, and looking for common threads.

Threads.
Hmm...
Fabrics.

These are technical textiles. Maybe homing in on their MATERIAL makeup could help us make sense? Here are some key words and phrases associated with each: 

1. Benik vest: vented neoprene; Terry lined; thermoplastic or aluminum panels 
2. elastic therapeutic tape: cotton strip with adhesive back 
3. Therasuit: breathable; soft; dynamic; hooks and elastic connectors 
4. compression sportswear: form-fitting; made from spandex 
5. SPIO (Stabilizing Pressure Input Orthosis): Lycra; dynamic and multidirectional stretch 
6. TheraTogs: inner foam layer; Velcro sensitive outer layer for affixing elastic strapping

Generalizing: We’re talking about things that are breathable, that have elastic--stretchy--rebound--compression--characteristics, and that, in a couple of cases, have the capacity to have other stretchy things attached to them. 

What about SIZES and SHAPES? Over which areas are they applied?  

1. Benik vest: whole trunk/ torso 
2. elastic therapeutic tape : supplied in rolls and can be applied practically anywhere
3. Therasuit: can cover whole body if all components (e.g., optional arm attachments) are used 
4. compression sportswear: shorts, tights, t-shirts, socks, sleeves and /or underwear 
5. SPIO (Stabilizing Pressure Input Orthosis): up to full-body coverage
6. TheraTogs: also up to full-body coverage

I made an earlier connection between these devices and a pair of hands. Hands have their own material and size-and-shape properties. The fact, for example, that I used to be able to safely align my daughter’s trunk using both hands -- but now that she's twice as tall, I can't -- is a SIZE thing. The fact that my hands can make subtle, real-time adjustments relative to her place in space is a more of a MATERIAL thing.

What am I getting at? Orthotic devices are like hands, but they're different. They’re different than things we call "clothes". They’re different than body casts. They're different than tattoos and other stuff with which we adorn ourselves.

Form follows function. 

Trying to make sense of the functions these forms serve will be the subject of the next post.

Making Sense, Part C

SO:

We’ve got these nouns-with-modifiers: a Benik vest, elastic therapeutic tape, the so-called suit method, and so on. What, if anything, do these have significantly in common? 

For one, they’re proffered and promoted as helpful for kids with CP -- which is quite a claim. I should say right off the bat that the couple of PTs I know aren't as "gung ho" as the marketers of these products are about the promises they hold. Nor am I completely sold either, especially after reading some pretty un-scientific explanations as to how they work.

NEVERTHELESS:

I’m willing to suspend disbelief and be open to the possibility that one or more of the above products could make a difference. Why? Primarily due to something I've experienced firsthand while trying to help my own daughter. 

SPECIFICALLY: 

Some time ago I recognized that when I immobilize my daughter's shoulder girdle she’s able to consistently pick her head up. Fairly easily. I don’t know all the mechanisms involved* but I'd bet there's a basic biomechanical explanation along the lines that I must be supplying some (compensative) force that she hasn’t figured out yet how to supply on her own.

Shouldn't it follow, then, that these devices -- also external to and in contact with the body -- could do the same work as a pair of hands in helping a child move and/ or support herself? It seems worth looking into. And worth trying to give more shape to what strikes me as a disordered product landscape.

That to follow.

* I’m sure there are lots and lots of people who could explain. Any wise physiatrist, for example. Or the folks behind the Rifton Elbow Anchor…

Making Sense, Part B

Before I venture into things like if and how the previously mentioned (see Making Sense, Part A) devices and methods work, the promises they may or may not hold, etc., let's start with some definitions.

Note: What follows is based on stuff I was able to readily grab from the Web. I haven't critically reviewed it or made much effort to make it my own. Ergo you ought to look at these as provisional, i.e., tentative. At best. 

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• Benik vest: a neoprene orthosis that's meant to provide upper trunk support (to help a child remain in a sitting position, for example, for an extended period of time) and proprioceptive input. Available with malleable aluminum stays or moldable thermoplastic panels for additional support and protection. [ www.benik.com ]

• Kinesiology tape (more generally known as elastic therapeutic tape): a cotton strip with an acrylic adhesive used for treating athletic injuries and a variety of physical disorders. For our purposes, the product is used therapeutically to facilitate underused muscles or to limit or encourage a specific motion at a joint.

• TheraSuit. NeuroSuit. PediaSuit: a breathable, soft, dynamic orthosis based on the Adeli Suit. Consists of a vest, shorts, knee pads and specially adapted shoes with hooks and elastic connectors that topographically mirror flexor and extensor muscles, trunk rotators and the lower limbs. The suit works as an elastic frame surrounding the body to hold it in proper physical alignment. It also serves to facilitate or inhibit certain movements, assist with the development of optimal posture, help with or supplement the restoration of proprioception, and provide resistance (to increase the strength of the patient).

• Compression sportswear: form-fitting garments usually worn by athletes. They may be shorts, tights, t-shirts, socks, sleeves or underwear and are often made from a spandex-type material. Among other things, these purportedly reduce muscle movement and vibration, and focus the direction of the muscle.

• SPIO (Stabilizing Pressure Input Orthosis): a dynamic bracing system made of a special Lycra blend material that provides a multi-directional stretch with a strong rebound factor. Uses patented compression ratios and design. SPIO is designed to assist stability and provide feedback through deep pressure and tactile stimulation. Advertised to improve functional movement possibilities, limb and body position sense, and general stability and balance.[ www.spioworks.com ]

• TheraTogs: "a live-in exo-muscular system". Made from a patented, proprietary material with an inner foam layer that grips the skin and underlying soft tissues, and a Velcro-sensitive outer layer to which clinicians can affix elastic strapping, a.k.a., the external muscle of the system. Typically worn under normal clothing, TheraTogs replicates successful manual sensorimotor training techniques and enables the wearer to engage in routine activities with improved joint alignment, all day long. [ www.theratogs.com ]

• Wearable robot: a neuroprosthetic device that will allow paralyzed patients to use a BMI (brain-machine interface) to control movements of a full-body exoskeleton. Motor signals will control actuators distributed across the joints of said exoskeleton. Force and stretch sensors distributed throughout the exoskeleton will generate a continuous stream of artificial touch and proprioceptive feedback signals to inform the patient's brain of the device's performance. As for the details of the silk-thin suit itself, I'm having a hard time finding any. I'll keep my eyes open.

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There. We're makin' progress. Some pictures are probably in order soon.