Case Report

Effectiveness of the Therasuit Method in the Management

of Chronic Non-evolving Encephalopathy: Case Report in
Pediatrics
Thaís Alves Andrade 1, *, Bárbarah Carolyne Moreira Rodrigues Antas 2, Géssika Gislainy 1

1 Santa Maria University Center, UNIFCM, Cajazeiras, Paraíba, Brazil.

2 Federal University of Paraíba, UFPB, João Pessoa, PB, Brazil.

* Correspondence: thaisalves527@gmail.com.

Abstract: Cerebral palsy (CP) is a non-progressive neurological condition that affects motor and
postural ability, resulting from a static brain lesion. Early and intensive physical therapy interven-
tion can promote significant improvements in the functionality and quality of life of affected indi-
viduals. To report the case of a girl with GMFCS level IV spastic quadriparesis, highlighting the
Citation: Andrade TA, Antas BCM,
Gislainy G. Effectiveness of the clinical evolution and benefits of an intensive physicaltherapy approach from the first months of
Therasuit Method in the Manage- life. A female patient diagnosed with cerebral palsy started physiotherapy at three months of age,
ment of Chronic Non-evolving En-
with an intervention plan that included sessions two to five times a week. Gross motor function was
cephalopathy: Case Report in Pediat-
rics. Brazilian Journal of Case Re- assessed using the Gross Motor Function Measure (GMFM) scale, as well as qualitative analysis of
ports. 2025 Jan-Dec;05(1):bjcr12. videos and progress records. Through intensive physiotherapy follow-up, the patient showed sig-
nificant improvements in her motor skills, including the ability to crawl, sit without support, and
transfer positions independently. Quantitative and qualitative documentation of her progress
Received: 29 June 2024
demonstrated substantial advances in her functionality and independence. The patient's case report
Accepted: 21 July 2024
illustrates the positive impact of early and intensive physiotherapeutic intervention in children with
Published: 22 July 2024
cerebral palsy. This case underlines the importance of continued follow-up adapted to individual
needs, emphasizing the capacity for neuroplasticity and the functional improvement that can be
achieved, reinforcing the need for personalized and intensive treatment strategies to maximize de-
velopmental potential and quality of life in patients with CP.
Copyright: This work is licensed un-
der a Creative Commons Attribution
Keywords: Cerebral palsy; Spastic quadriparesis; Physiotherapeutic intervention; Neuropsychomo-
4.0 International License (CC BY 4.0). tor development; Neuroplasticity.

1. Introduction
Chronic non-progressive encephalopathy (CNE), also known as cerebral palsy (CP),
encompasses a series of permanent disorders that affect the development of movement
and posture, resulting from non-progressive abnormalities that impact the forming brain
of the fetus or newborn [1-3]. CP can be triggered by a variety of brain injuries in child-
hood, such as hypoxic ischemia, periventricular leukomalacia, intracranial hemorrhage,
hypoxic-ischemic encephalopathy, trauma, stroke and infections. This condition high-
lights the extensive burden it represents, both in personal, medical and socioeconomic
terms globally, as well as highlighting the gaps in therapeutic options available for this
pediatric population [2, 3].

Brazilian Journal of Case Reports 2025, 5, 1, bjcr12. www.bjcasereports.com.br

Effectiveness of the Therasuit Method in the Management of Chronic Non-evolving Encephalopathy: Case Report in Pediatrics 2 of 6

In the treatment of cerebral palsy, physiotherapy plays a crucial role, encompassing

various therapeutic interventions to improve physiological and functional outcomes.
There is moderate evidence of the effectiveness of constraint-induced movement therapy
for upper limb recovery, goal/function-oriented training and gait training to increase
walking speed. However, the evidence is conflicting regarding the impact of exercises on
strength training and cardiorespiratory conditioning. Approaches based on functional
goals have been shown to be effective, suggesting the need for more research to determine
the best ways to improve functional outcomes in children with cerebral palsy [4].
In this sense, the TheraSuit method is an intensive rehabilitation approach designed
for children with cerebral palsy, inspired by a prototype developed for Russian astronauts
for counter-resistance exercises in zero gravity. It uses a system of individually attached
elastic bands that exert traction between the trunk and pelvis and between the pelvis and
lower limbs. Associated with specific treatment protocols, the method includes rigorous
strengthening and stretching exercises, as well as training specific motor activities while
the child is wearing the suit. This method seeks to improve postural alignment, joint sta-
bility and movement efficiency [5-7].
In this article, we present a detailed case report on the success of the TheraSuit
Method in the rehabilitation of a child with cerebral palsy manifesting spastic quadripar-
esis. Through this study, we aim to highlight the effectiveness of TheraSuit in improving
mobility and quality of life in complex cases of cerebral palsy, offering practical evidence
that can inspire other therapeutic approaches and encourage the adoption of similar meth-
ods in analogous clinical situations.

2. Case Report
Patient female, 8 years and 4 months old, started physiotherapy in February 2016,
with a clinical diagnosis of cerebral palsy, specifically GMFCS level IV spastic quadripar-
esis (Figure 1). The condition was diagnosed as the result of a static lesion in the central
nervous system during the structural and functional maturation phase, significantly af-
fecting the patient's posture and movement (Functional mobility scale 1-1-1) (Manual abil-
ity classification system level 4). Born at 36 weeks' gestation by caesarean section, weigh-
ing 2.695 kg and 47 cm long, the child presented cyanosis and neonatal jaundice, requiring
hospitalization for a week shortly after birth. During this period, intracranial differences
and a cyst were identified through imaging tests, leading to the diagnosis of ischemia of
the left cerebral hemisphere with more than 70% impairment, configuring chronic non-
progressive encephalopathy, known as cerebral palsy (CP) (Figure 2). At the age of three
months, she had a seizure, but no changes in her brain's electrical activity, as shown by
the electroencephalogram.
Initially, the intervention consisted of physiotherapy sessions twice a week, lasting
less than 90 minutes each due to the patient's diet (Figure 3). Subsequently, the frequency
was increased to five times a week, as well as the duration, which became one hour and
30 minutes, with the aim of integrating persistent primitive reflexes, acquiring age-appro-
priate motor skills, strengthening the core, preventing contractures and deformities and
improving balance and coordination. At the age of 2 years and 6 months, she began inten-
sive 3-hour protocols interspersed with maintenance 5 times a week for an hour and 30
minutes. The initial assessment highlighted difficulties in integrating reflexes, postural
asymmetry and limitations in limb mobility and functionality. With intensive treatment,
significant progress was seen in the patient's motor capacity, as she was able to perform
previously impossible movements, such as crawling, sitting without support and trans-
ferring from a lying to a sitting position independently. The quantitative assessment of
gross motor function, carried out regularly, showed consistent improvements over time.
Effectiveness of the Therasuit Method in the Management of Chronic Non-evolving Encephalopathy: Case Report in Pediatrics 3 of 6

Figure 1. Graph of the patient's Gross Motor Function Classification System (GMFCS-5)
data.

Figure 2. A. Axial FLAIR. B. Axial T2 showing extensive areas of cystic encephalomalacia

affecting practically the entire irrigation territory of the left middle cerebral artery and
both anterior cerebral arteries, determining a significant volumetric reduction in the white
matter of the left cerebral hemisphere, associated with thinning of the corpus callosum
and volumetric reduction of the left cerebral peduncle.

This case reinforces the need for continuous, intensive physiotherapy adapted to the
individual needs of children with CP, with the potential to achieve substantial motor gains
and improve patients' independence and functionality.
Effectiveness of the Therasuit Method in the Management of Chronic Non-evolving Encephalopathy: Case Report in Pediatrics 4 of 6

Figure 3. A. Patient in unipodal support position under spider support. B. Patient in active
orthostatic position, with anterior support on walker using suit.

3. Discussion
Intensive neurofunctional strengthening therapy - TheraSuit Method is an intensive
rehabilitation approach aimed at children and adults with neuromotor and sensory dis-
orders [8, 9]. The theory and practice of the Therasuit method are based on scientific evi-
dence from exercise physiology, epigenetics and neurology [10]. In intensive therapy with
the Therasuit method, an assessment is initially carried out to identify the deficits and
alterations that the patient has, and the exercises needed so that the patient can develop
and improve new motor skills. Each intensive therapy module usually lasts 4 weeks, 5
days a week, with 3 to 4 hours of training per day. The combination of the pulley system,
the activity cage (spider) and the therapeutic suit combined with a good treatment plan
of individualized exercises promotes gains in muscle strength, endurance and resistance,
joint stability, deep proprioceptive input, activation of postural muscles, improving the
quality of motor function performance [12, 13].
In the specific case of a patient with spastic cerebral palsy, the use of the TheraSuit
demonstrated a significant protective effect on the progression of the disease [9, 11]. In
this case, early and intensive intervention provided substantial improvements in the pa-
tient's motor functionality and independence, highlighting the importance of continuing
intensive physiotherapy tailored to individual needs, which is in line with findings in the
literature [12]. The neuroplastic capacity of the developing brain was evidenced by the
continuous improvements observed in the patient, who began to perform previously im-
possible movements, sit without support and transfer from a lying to sitting position in-
dependently and from sitting to kneeling with support. This case highlights the potential
of TheraSuit to slow down the progression of clinical signs and comorbidities in cerebral
palsy, reinforcing the need for personalized rehabilitation programs to maximize patients'
development potential and quality of life.
Effectiveness of the Therasuit Method in the Management of Chronic Non-evolving Encephalopathy: Case Report in Pediatrics 5 of 6

In the case of the patient with spastic quadriparesis, the motor gains obtained with
the intensive use of the TheraSuit Method were remarkable, similar to those found by
Bailes and colleagues [9]. From the start of treatment, the patient showed significant pro-
gress in her motor skills, managing to perform movements that were previously impossi-
ble, such as crawling, sitting without support and transferring from a lying to a sitting
position independently. These advances were evidenced both by regular quantitative as-
sessments, using the Gross Motor Function Measurement Scale (GMFM), and by qualita-
tive analysis of videos and progress records (Figure 02). The integration of persistent
primitive reflexes, the strengthening of the core, and the improvement in postural sym-
metry and limb mobility contributed to the overall improvement in motor functionality.
The maintenance of the patient's functional level, without worsening symptoms, demon-
strates the protective potential of TheraSuit in the progression of cerebral palsy. This case
emphasizes the importance of early and intensive intervention, adapted to the specific
needs of each patient, and reinforces the ability of neuroplasticity to promote significant
motor gains, improving the independence and quality of life of children with cerebral
palsy.
Maintaining the clinical condition of the patient with spastic quadriparesis, without
significant worsening, was a crucial aspect of the treatment in the case presented. In neu-
rological conditions such as cerebral palsy, it is common to observe the progression of
musculoskeletal deformities and the exacerbation of functional limitations over time.
However, in this case, early and intensive intervention not only promoted substantial mo-
tor gains, but also stabilized the patient's clinical condition. The absence of worsening in-
dicates that the method not only contributed to the acquisition of new motor skills, but
also played a key role in preventing secondary complications, such as contractures and
joint deformities. This result underscores the effectiveness of TheraSuit in offering a pro-
tective effect against the progressive deterioration often observed in children with cere-
bral palsy, highlighting the importance of intensive, personalized rehabilitation programs
for maintaining functionality and quality of life in the long term.

4. Conclusions
The follow-up of the patient, diagnosed with GMFCS level IV spastic quadriparesis,
reveals the critical importance of early and intensive physiotherapeutic intervention in
cerebral palsy. The significant improvements in her functionality and independence, doc-
umented quantitatively and qualitatively, demonstrate not only the effectiveness of this
therapeutic approach, but also the potential for neuroplasticity in the developing brain.
This case underscores the need for personalized and adaptive rehabilitation programs,
grounded in a deep understanding of the individual capabilities and challenges faced by
children with cerebral palsy. The patient's experience underlines the value of focused ther-
apeutic strategies, which not only seek to improve patients' quality of life, but also explore
the vast potential for motor recovery and development, reinforcing the vital role of phys-
iotherapy in maximizing functionality and well-being in individuals with CP.

Funding: None.
Research Ethics Committee Approval: We declare that the patient approved the study by signing
an informed consent form and the study followed the ethical guidelines established by the Declara-
tion of Helsinki.
Acknowledgments: None.
Conflicts of Interest: None.

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