Related Resources—Compression Garments

Nancy Hylton PT, LO, was instrumental in the very early years of DAFO development, and we have had much congenial contact with her since then. This article, excerpted from a longer one she and Katy Schoos wrote, tells you what she’s doing now.

Stabilizing Pressure Input Orthosis (SPIO) is a highly flexible stabilizing system made from specialized multi-directional stretch Lycra with excellent rebound and memory. SPIO is designed to provide and enhance deep pressure sensory input around and toward the midline of the body to improve dynamic stability and postural activation.

Patient Selection

Children’s Therapy Center (CTC), where we work, in Kent, Washington, has found the SPIO garment to be most beneficial for children who exhibit a primary or secondary sensory deficit that impairs dynamic stability, postural activation or movement control. CTC has found SPIO to be most helpful for children with: 1) moderate to severe hypotonia, particularly axial hypotonia, 2) deficits in dynamic stabilization, tone fluctuations and unpredictable movement control from dyskinesia, 3) moderate-to-severe hypertonia that is compensatory for poor deep sensation, 4) whole body sensory awareness deficits and 5) some types of sensory integration problems.

For the best outcome, CTC recommends that practitioners exercise great care in the selection and utilization of SPIO for specific individuals.

Styles of SPIO

Vest—double- or triple-layer compression around the shoulder, trunk, pelvis and hips. The SPIO vest is ideal for children with poor core muscle activation, stabilization or weakness.

Pants—single- or double-layer compression from the lower rib cage to the calf or ankles. It has proven beneficial for children and adults with spastic diplegia who demonstrate deficits in sensory awareness and stability.

Pants and Vest—double- or triple-layer compression to the trunk, pelvis and hips, as well as single or double layer compression to the lower extremities. This style evolved from the vest, used when children with sensory deficits had difficulty managing independent standing and walking.

Pants and Shirt—single-layer compression to the arms, trunk and legs (Figs. 1 and 2). It is best suited for children with primary sensory awareness deficits. Based on individual need, the orthosis can cover to the wrist and ankle or to the elbow or knee.

Shirt and Unitard—Different from the shirt and pants combination, the shirt and unitard combination provides double-layer compression to the shoulder, trunk, hips and pelvis while providing only single-layer compression to the arms and legs.

Other forms of compression include compression wraps and compression gloves.

CTC strongly believes that in most cases, a stable base of support must be provided prior to the implementation of any SPIO flexible compression system. Most children at CTC wear either DAFO FastFit or DAFO 4 orthoses to improve the biomechanical alignment and sensory awareness of their feet.
In addition, CTC continues to use Benik products in conjunction with the SPIO system, especially where greater mechanical stability is required.

CTC has recently begun fabricating SPIO orthoses in the U.S. and offers seminars on the function, selection and measurement of this flexible compression system. For more information, call 877/997-SPIO (7746) or visit www.spioworks.com.

Nancy Hylton PT, LO, is a pediatric physical therapist and licensed orthotist and Katy K. Schoos PT, MHS, PCS, is a pediatric physical therapist at Children’s Therapy Center in Kent, Washington. Nancy can be reached at nhylton1@comcast.net; Katy can be reached at kschoos@comcast.net.

This is an excerpt of a more comprehensive article originally published in Neuro-Developmental Treatment Association (NDTA) Network. The full text of the article is available at www.spioworks.com.

Fig. 1. Six -year-old girl with Rett Syndrome. Head and trunk control are very poor in supported sitting without the SPIO shirt and unitard. Fig. 2. The SPIO system unitard (skin-colored) provides deep pressure input and increased shoulder/trunk/hip stability to improve functional head and trunk control, as well as improved visual attention and tracking.