Body orthoses are types of dynamic compression or orthotic garments that are designed to improve posture and alignment, manage tone and support functional movement, especially in children with neurological or developmental conditions like cerebral palsy, autism spectrum disorder, or hypotonia.
The difference between these garments can be confusing, so knowing what your child needs can feel overwhelming. The difference between garments such as TheraTogs, SPIO (Stabilizing Pressure Input Orthosis), DMO (Dynamic Movement Orthoses), and Second Skin is the level of support provided and their clinical purpose, as well as their ability to be customised to the child.
When looking at what would be appropriate for your child, we think about the child’s diagnosis, their age, tone, and functional goals, as well as their comfort, ease of use, and practicality of the garment. We will generally look at the least level of support they need to achieve their goals and maintain their functional independence. Here’s a breakdown of each one:
These suits are a good option for mild hypotonia or sensory processing challenges. They are easy to put on, can be worn every day, and give tailored compression, creating a consistent calming sensory input to support regulation. SPIOs can also support mild postural control difficulties as they can improve core and trunk stability, but will offer limited support for children with increased or altered tone.
Offers dynamic and adjustable support with lots of options to place strapping to support your child and offer sensory feedback where it’s needed. Theratogs are often used in clinics and are ideal for therapeutic use, as it is important to be correctly applied and adjusted as required. Theratogs can also be worn at home and throughout the day if training is provided to caregivers regarding a personalised set-up for the child, as it supports alignment and fatigue management throughout the day. Theratogs tend to be easy to use and are very well tolerated, though the strapping components need to be set up for each use.
These suits are more structured and supportive than a SPIO, though they provide a similar amount of support to the Theratogs and are customised for your child. A DMO is ideal for children with mild to moderate postural concerns, hypotonia, and asymmetry. They offer dynamic postural support where the child needs it and is often prescribed with additional reinforced Lycra panelling to help improve midline alignment and limb symmetry. This could include panelling over the shoulders to improve shoulder retraction, panelling over the hips to improve their alignment in sitting and standing, or lateral panelling that can aid with trunk stability and control, to help improve alignment and fatigue levels throughout the day.
DMO suits are recommended to be worn daily, and time in the suit is gradually built up until it can be worn for most of the day for maximum benefits of supporting postural control and fatigue management. The suits are easily donned with customised zipper options that allow for the changing of diapers or an open crotch to allow for independent toileting.
These are the most structured and supportive option, customised for each wearer. These suits are used for long-term postural or tone management and are ideally worn daily throughout most of the day. The Second Skin suits are similar to a DMO, however, they can contain rigid structures or boning, which offer increased support throughout the trunk, to support developing scoliosis and reduce the risk of increased curvature developing. The boning can be placed through the trunk panels and is always customised to where the wearer requires support. While these offer significant support through the trunk, they can reduce the amount of active movement in this area and are often used for more complex postural changes and significant tone management.
If you have concerns about your child’s daily postural management, speak to one of our Occupational Therapists or Physiotherapists to see if your child would benefit from a body orthosis.
