0696 suit therapy - aetna better health...number: 0696 *please see amendment for pennsylvania...

Suit Therapy - Medical Clinical Policy Bulletins | Aetna of 20

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Suit Therapy

Policy His tory

Last Review

02/08/2018

Effective: 01/07/2005

Next

Review: 07/26/2018

Review History

Definitions

A dditiona l In form at ion

Clinical Policy

Bulletin Notes

Number: 0696 *Please see amendment for Pennsylvania Medicaid at the end of this CPB.

Policy

Aetna considers suit therapy or home use of a suit therapy

device (also known as the Adeli Suit, Penguin Suit, Polish Suit,

Stabilizing Pressure Input Orthoses, Therapy Suit, Therasuit,

and TheraTogs) experimental and investigational for the

treatment of members with cerebral palsy (CP) or other

conditions (e.g., gait rehabilitation following stroke) because

there is inadequate evidence of the effectiveness of this

therapy in the management of these conditions.

Aetna considers dynamic movement TLSO "brace" (Dynamic

Lycra Suit) experimental and investigational for the treatment

of members with CP or scoliosis because there is inadequate

evidence of the effectiveness of this therapy in the

management of these conditions.

Aetna considers Dynamic Movement Orthoses experimental

and investigational for the treatment of members with CP,

hemiparesis/hemiplegia, scoliosis, and all other indications

because there is inadequate evidence of the effectiveness of

this therapy in the management of these conditions.

http://aetnet.aetna.com/mpa/cpb/600_699/0696.html 10/29/2018

http://aetnet.aetna.com/mpa/cpb/600_699/0696.html

https://www.aetna.com/



Also see

CPB 0405 - Mechanical Stretching Devices for

Contracture and Joint Stiffness (../400_499/0405.html)

.

Background

The Adeli Suit (also known as the Polish Suit, Therapy Suit,

and Therasuit) is a modification of a space suit, called the

“Penguin” suit used by Russian cosmonauts to counter the

effects of long-term weightlessness on the body while in

space. The inner workings of the suit have elastic bands and

pulleys that created artificial force against which the body

could work to help prevent muscle atrophy and osteoporosis.

Although the cause of motor dysfunction between cerebral

palsy (CP) patients and astronauts are different, results of a

treatment trial with the Penguin suit to rehabilitate patients with

CP appeared promising. The Penguin suit was then modified

resulting in an elasticized suit for use in positioning and

stretching muscles during physical therapy. Suit therapy for

CP is currently available at the Euromed Clinic in Poland and

at several other centers in Europe and the United States. The

Adeli Suit is used in the Polish facility as part of a

comprehensive program of intensive physiotherapy

administered 5 to 7 hours per day for 5 to 6 days a week for 4

weeks.

According to the Euromed Rehabilitation Center website: "The

Adeli Suit consists of a vest, shorts, knee pads and specially

adapted shoes with hooks and elastic cords that help tell the

body how it is supposed to move in space. Therapists use the

Adeli Suit to hold the body in proper physical alignment.

During specialized exercises, the therapists adjust the elastic

connectors that topographically mirror flexor and extensor

muscles, trunk rotators and the lower limbs. Additional

attachments correcting the position of the feet, head and other

areas of the body have also been designed. A patient, while

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wearing the Adeli Suit, goes through various exercises

including "how to walk". The Suit works as an elastic frame

surrounding the body and does not limit the amplitude of

movement but adds an additional weight load on it within

designed limits."

There are published anecdotal reports (the majority of which

are published in the Russian language) of children gaining in

speech, fine motor control, as well as movement with suit

therapy, but no randomized controlled clinical trials of suit

therapy have been published. The U.S. Food and Drug

Administration (FDA) has classified the Adeli Suit and other

similar devices as a class 1 limb orthosis (brace). Thus, the

Adeli Suit is exempt from the premarket notification procedures

of the FDA and the manufacturer is not required to provide

evidence of efficacy prior to marketing.

Enough interest has been generated by anecdotal and verbal

reports that the United Cerebral Palsy (UCP) Research and

Educational Foundation (2004) funded 2 studies on suit

therapy. While the results of these studies are not yet

available in the peer-reviewed published medical literature, the

UCP Research and Educational Foundation website is making

the information available due to the current interest in suit

therapy.

The first study by Dr. Alexander Frank and associates at the

Motion Analysis Laboratory, Assaf Harofeh Medical Center,

Zerifin, Israel, reported the results of 24 children who had CP

and a functional level of II, III or IV according to the Gross

Motor Function Classification System. Patients were randomly

assigned to either a standard physical therapy program or to

the Adeli Suit. Both groups were treated 5 days per week for 2

hours. Marginal improvement was noted in both groups

without any statistical difference in results between the 2

groups.

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A second study by Dr. Edward Dabrowski at the Children's

Hospital of Michigan reported the results of 57 children, all of

whom received 1 hour of physical, occupational, and speech

therapy 3 times a week for 8 to 10 weeks followed by a 4-week

home program. The experimental group wore the Adeli Suit

for the last 4 weeks of their therapy program. Both groups

improved and sustained their improvement without any

statistical difference in results between the 2 groups. The

UCP Foundation concluded that "[t]hese studies show that a

period of intensive therapy in ambulatory children with cerebral

palsy can lead to improvement in a number of disabilities.

However, they did not demonstrate that use of the Adeli Suit

was helpful. Any effect is likely to be minor."

Controlled clinical studies are necessary to determine the

beneficial effects of suit therapy, if any, for the treatment of

CP, especially which patients would benefit the most and how

long any beneficial results would last.

Liptak (2005) reviewed 9 treatment modalities used for

children who have CP including the Adeli Suit. The author

noted that no conclusive evidence either in support of or

against the use of the Adeli suit is available.

Bar-Haim and colleagues (2006) compared the effectiveness

of Adeli suit treatment (AST) with neurodevelopmental

treatment (NDT) in children with CP. A total of 24 children with

CP, levels II to IV according to the Gross Motor Function

Classification System (GMFCS), were matched by age and

functional status and randomly assigned to the AST or NDT

treatment groups. In the AST group (n = 12; 8 males, 4

females; mean age of 8.3 years [SD 2.0]), 6 children had

spastic/ataxic diplegia, 1 triplegia and 5 spastic/mixed

quadriplegia. In the NDT group (n = 12; 9 males, 3 females;

mean age of 8.1 years [SD 2.2]), 5 children had spastic

diplegia and 7 had spastic/mixed quadriplegia. Both groups

were treated for 4 weeks (2 hours daily, 5 days per week, 20

sessions). To compare treatments, the Gross Motor Function

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Measure (GMFM-66) and the mechanical efficiency index

(EIHB) during stair-climbing were measured at baseline,

immediately after 1 month of treatment, and 10 months after

baseline. The small but significant time effects for GMFM-66

and EIHB that were noted after 1 month of both intensive

physiotherapy courses were greater than expected from

natural maturation of children with CP at this age.

Improvements in motor skills and their retention 9 months after

treatment were not significantly different between the 2

treatment modes. Post-hoc analysis indicated a greater

increase in EIHB after 1 month (p = 0.16) and 10 months (p =

0.004) in AST than that in NDT, predominantly in the children

with higher motor function (GMFCS Levels II and III). The

results suggested that AST might improve mechanical

efficiency without a corresponding gain in gross motor skills,

especially in children with higher levels of motor function.

These investigators also stated that "[f]uture studies on the

effectiveness of AST should measure changes in metabolic

efficiency and fitness level, as well as motor skills. It is also

important to determine changes induced by the suit itself, by

having two groups perform the same physical training, with

and without the suit. Future studies should increase the

number of participants and homogenize the participants with

CP to reduce variability …. ".

TheraTogs (TheraTogs, Inc., Telluride, CO) are an orthotic

undergarment that consist of a 2-piece body suit and a

strapping system that is customized for the child. TheraTogs

are worn every day and, according to the manufacturer's

website, are indicated for children with a variety of disorders,

including ataxia, athetosis, low muscle tone, poor postural

alignment and joint deviations. There is a lack of evidence of

the effectiveness of TheraTogs in the peer-reviewed,

published medical literature.

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Stabilizing Pressure Input Orthoses (SPIO) are made from a

Lycra-like blend material that are intended to provide deep

pressure through compression to improve positional limb and

body awareness, core muscle and joint stabilization, and

increase precision of muscle activation and movement.

Hylton and Allen (1997) stated that the use of flexible

compression bracing in persons with neuromotor deficits offers

improved possibilities for stability and movement control

without severely limiting joint movement options. This

treatment modality has been explored with increasing

application in children with moderate to severe CP and other

neuromotor deficits with good success. Significant functional

improvements using Neoprene shoulder/trunk/hip bracing led

these researchers to experiment with much lighter

compression materials. The stabilizing pressure input orthosis

(SPIO) bracing system is custom-fitted to the stability,

movement control and sensory deficit needs of a specific

individual. The SPIO bracing system supposedly can provide

an improved base of support for functional gains in balance,

dynamic stability, general and specific movement control with

improved postural and muscle readiness. However, there is

currently insufficient evidence to support the effectiveness of

SPIO.

Autti-Ramo and colleagues (2006) reviewed the evidence on

the effectiveness of using upper and lower limb casting or

orthoses in children with CP. These researchers used

computerized bibliographic databases to search for systematic

reviews without any language restrictions. Identification,

selection, quality assessment, and data extraction were

performed independently by 2 investigators. Of the 40

identified reviews, 23 were selected for closer consideration,

and 5 reviews met the inclusion criteria. The quality of existing

systematic reviews and original studies included in the review

varied widely. The following evidence was found: (i) casting of

lower limbs has a short-term effect on passive range of

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movement; (ii) orthoses that restrict ankle plantar flexion

have a favorable effect on an equinus walk, but the long-

term clinical significance is unclear; and (iii) evidence on

managing upper limb problems with casting or splinting in

children with CP is inconclusive. The author concluded that

there is a paucity of evidence from primary studies on the use

of orthoses in children with CP. They stated that more original,

well-designed research is needed.

Available evidence does not demonstrate durable benefits

from the use of suit therapy for CP (NHSC, 2002; NHS QIS,

2005).

In a case report, Bailes et al (2010) investigated the effects of

intensive suit therapy on gait, functional skills, care-giver

assistance, and gross motor ability in children with CP. Two

children with spastic diplegia classified at level III on the

GMFCS participated. Outcomes were assessed using

dimensions D and E of the GMFCS, the Pediatric Evaluation of

Disability Inventory (PEDI), and instrumented gait analysis.

Each child participated in the Therasuit Method, 4 hours a day,

5 days a week for 3 weeks. Very small improvements in

function were noted in dimension D of the GMFCS and PEDI

Self-care Domain with decreased function in other areas.

Improved walking speed, cadence, symmetry, joint motion,

and posture were found with gait analysis. The authors

concluded that further investigation is needed of the suit itself,

and intensive therapy programs in children with CP.

Bailes et al (2011) examined the effects of suit wear during an

intensive therapy program on motor function among children

with CP. A total of 20 children were randomized to an

experimental (TheraSuit) or a control (control suit) group and

participated in an intensive therapy program. The PEDI and

GMFM-66 were administered before and after (4 and 9

weeks). Parent satisfaction was also assessed. No significant

differences were found between groups. Significant within-

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group differences were found for the control group on the

GMFM-66 and for the experimental group on the GMFM-66,

PEDI Functional Skills Self-care, PEDI Caregiver Assistance

Self-care, and PEDI Functional Skills Mobility. No adverse

events were reported. The authors concluded that children

wearing the TheraSuit during an intensive therapy program did

not demonstrate improved motor function compared with those

wearing a control suit during the same program.

Maguire et al (2012) presented the protocol of

a study designed to investigate the long-term effects on the

recovery of gait, balance and social participation of gait

rehabilitation with TheraTogs compared to gait rehabilitation

with a cane following first time acute stroke. This study will be

a multi-center, single-blind, randomized trial with 120 patients

after first stroke. When subjects have reached Functional

Ambulation Category 3 they will be randomly allocated into

TheraTogs or cane group. TheraTogs will be applied to

support hip extensor and abductor musculature according to a

standardized procedure. Cane-walking held at the level of the

radial styloid of the sound wrist. Subjects will walk throughout

the day with only the assigned walking aid. Standard therapy

treatments and usual care will remain unchanged and

documented. The intervention will continue for 5 weeks or

until patients have reached Functional Ambulation category 5.

Outcome measures will be assessed the day before begin of

intervention, the day after completion, 3 months, 6 months and

2 years. Primary outcome is Timed "up and go" test;

secondary outcomes are peak surface electromyography of

gluteus maximus and gluteus medius, activation patterns of

hemiplegic leg musculature, temporo-spatial gait parameters,

hemiplegic hip kinematics in the frontal and sagittal planes,

dynamic balance, daily activity measured by accelerometry,

Stroke Impact Scale. Significance levels will be 5 % with 95 %

confidence intervals. Intentio-t-treat analyses will be

performed. Descriptive statistics will be presented. The

authors concluded that this study could have significant

implications for the clinical practice of gait rehabilitation after

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stroke, particularly the effect and appropriate use of walking

aids. The results could be important for the development of

clinical guidelines and for the socio-economic costs of post-

stroke care.

In a case-study, Matthews and Crawford (2006) noted that

treatment of scoliosis has been under discussion in relation to

surgical intervention since the Boston brace was presented by

Hall in 1976. The effects of rigid bracing on thoracic skeletal

integrity and the possible deformation of ribs due to the high

localized pressure due to prolonged wear have been high-

lighted. The lack of compliance has encouraged clinicians to

examine other options for non-surgical treatment. The

Spinecor and Triac bracing systems have been developed as

a result of this research; however, both of these orthoses had

been designed with idiopathic scoliosis in mind. Little research

has been done into the effects of bracing on the neuropathic

curve. The use of dynamic Lycra garments in the treatment of

neurological scoliosis offers the advantage of deformity

correction without the bulk and discomfort of rigid braces.

Recent clinical experience has shown that the Lycra suits have

a positive effect in the treatment of scoliosis. The

authors discussed the treatment of a child presenting with a

spinal tumor and although not truly of neurological

presentation indicates that the garment can be used for the

different scoliotic presentations.

In a phase 1 exploratory study, Matthews et al (2009) aimed to

establish proof of concept of the effects of dynamic

elastomeric fabric orthoses (DEFOs) on the gait of children

with spastic diplegic CP. Replicated single case experiments

employing an ABA methodology were carried out on 8

subjects (median age of 5.5 years, range of 3 to 13 years; 4

girls and 4 boys) utilizing quantitative/qualitative data

collection. Outcome measures were: 10-meter walking test

(10MWT); physiological cost index (PCI); visual analog scale

(VAS) scoring of perceived gait changes; functional mobility

changes using Patient Specific Functional Scale (PSFS);

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subject/carer perceptions recorded in daily diaries. Results

identified following analysis of quantitative data indicated a

treatment effect from the orthoses, which could be

corroborated by participant's subjective impressions and

comments. Statistically significant (p < 0.05) intervention-

related improvements in gait velocity and gait consistency

were identified in 5/8 and 4/8 subjects, respectively. Power

calculations support the feasibility of a larger controlled study

to further investigate this orthotic intervention. This study

indicated that DEFO leggings can confer beneficial effects on

the gait of some children with spastic diplegia resulting from

CP. They noted that these findings have implications for

orthotic intervention with this subject group.

In a pilot study, Jeon et al (2012) evaluated the feasibility of

intensive training using a spring-assisted hand orthosis on

upper extremity in individuals with chronic hemiparetic stroke.

A total of 5 participants for the experimental group and 5 for

the control group were recruited from a local rehabilitation

hospital. Subjects in the experimental group participated in 4

weeks of training using a SaeboFlex orthosis for 1 hour per

day, 5 times per week. Each subject in the control group wore

the same orthosis for 1 hour per day without participating in

upper extremity training. Outcome measures included the Fugl-

Meyer Assessment, Box and Block Test, and Action Research

Arm Test; kinematic parameters were collected using a 3-D

motion analysis system. The Fugl-Meyer assessment and the

Box and Block Test score were increased significantly in the

experimental group after the intervention.

The resultant velocity of the wrist joint for the reach-to-grasp

task decreased significantly, and the resultant velocity of the

shoulder joint while performing a reach-to-grasp task at

acromion height decreased significantly in the experimental

group. The authors concluded that spring-assisted dynamic

hand orthosis training is feasible in recovering the movement

of the hemiparetic upper extremity.

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In a pilot study, Barry et al (2012) compared the effect of

therapy using a wrist-hand orthosis (WHO) versus manual-

assisted therapy (MAT) for individuals with chronic, moderate-

to-severe hemiparesis. The relationship between the

repetitions during therapy and functional change was also

examined. A total of 19 participants were randomly assigned

to either the WHO group (n = 10) or the MAT group (n = 9).

The WHO group performed therapy while wearing a dynamic

WHO (SaeboFlex), the MAT group performed therapy with

manual assistance of a therapist. Both groups participated in

1 hour of therapy per week for 6 weeks and were prescribed

exercises to perform at home 4 days per week. Pre- and post-

training assessments included grip strength, the Action

Research Arm Test (ARAT), Box and Blocks (B&B) test, and

Stroke Impact Scale (SIS). There were no significant

between-group differences for any of the measures. Within-

group differences showed that the WHO group had a

significant improvement in the ARAT score (mean = 2.2; p =

0.04). The MAT group had a significant improvement on the

percent recovery on the SIS (mean = 9.3 %; p = 0.03) and

approached a significant improvement on the ARAT (mean =

1.4; p = 0.08). When analyzing all participants together, the

relationship between the number of exercise repetitions and

functional improvement was moderate for the ARAT and the

B&B test (r = 0.55, p = 0.02, and r = 0.30, p = 0.10,

respectively). The authors concluded that small improvements

in function and perception of recovery were observed in both

groups, with no definite advantage of the WHO.

van der Heide and colleagues (2015) stated that numerous

dynamic arm supports have been developed in recent

decades to increase independence in the performance of

activities of daily living. Much effort and money have been

spent on their development and prescription, yet insight into

their effects and effectiveness is lacking. These investigators

performed a systematic review of evaluations of dynamic arm

supports. The 8 technical evaluations, 12 usability

evaluations, and 27 outcome studies together make 47

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evaluations. Technical evaluations were often used as input

for new developments and directed at balancing quality, forces

and torques, and range of motion of prototypes. Usability

studies were mostly single-measure designs that had varying

results as to whether devices were usable for potential users.

An increased ability to perform activities of daily living and

user satisfaction were reported in outcome studies. However,

the use of dynamic arm supports in the home situation was

reported to be low. Gaining insight into why devices are not

used when their developers believe them to be effective

seems crucial for every new dynamic arm support developed.

The authors noted that the methodological quality of the

outcome studies was often low, so it is important that this is

improved in the future.

In a systematic review and meta-analysis, Martins and

colleagues (2016) evaluated the effectiveness of suit therapy

on functioning in children and adolescents with CP. These

researchers performed a comprehensive search of peer-

reviewed articles on electronic databases, from their inception

to May 2014. Studies included were rated for methodological

quality using the Physiotherapy Evidence Database scale.

Effects of suit therapy on functioning were assessed using

meta-analytic techniques. From the 46 identified studies, 4

met the inclusion criteria and were included in the meta-

analysis. Small, pooled effect sizes were found for gross

motor function at post-treatment (g = 0.46, 95 % confidence

interval [CI]: 0.10 to 0.82) and follow-up (g = 0.47, 95 % CI:

0.3 to 0.90). The authors concluded that the small number of

studies, the variability between them, and the low sample sizes

were limitations of this review. Findings suggested that to

weigh and balance benefits against harms, clinicians, patients,

and families need better evidence to examine and prove the

effects of short intensive treatment such as suit therapy on

gross motor function in children and adolescents with CP.

Therefore, the authors stated that more research based on high-

quality studies focusing on functioning in all dimensions

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of the International Classification of Functioning, Disability and

Health perspective is needed to clarify the impact of suit

therapy.

Dynamic Movement Orthoses:

Serrao and colleagues (2017) noted that patients with

cerebellar ataxia show increased upper body movements,

which have an impact on balance and walking. In a

longitudinal, uncontrolled study, these researchers examined

the effect of using dynamic movement orthoses (DMO),

designed as elastic suits, on trunk motion and gait

parameters. A total of 11 patients (7 men, 4 women; mean

age of 49.9 ± 9.5 years) with degenerative cerebellar ataxia

were enrolled in this study. Linear over-ground gait of patients

was recorded using an opto-electronic gait analysis system

before DMO use (DMO-) and during DMO use (DMO+). Time-

distance parameters, lower limb joint kinematics, body sway,

trunk oscillations, and gait variability (coefficient of variation,

CV) were recorded. Patient satisfaction with DMO device was

measured using Quebec user evaluation of satisfaction with

assistive technology. When using the DMO, patients showed

a significant decrease in stance phase duration, double

support phase duration, swing phase CV, pelvic range of

movements (ROMs), body sway, and trunk ROMs. A

significant increase was observed in the swing phase duration

and knee joint ROMs. Of the 11 subjects, 10 were either quite

satisfied (8 points) or very satisfied (2 points) with the assistive

device. The authors concluded that the DMO reduced the

upper body motion and improved balance-related gait

parameters. These researchers proposed that DMO be used

as an assistive/rehabilitative device in the neuro-rehabilitation

of cerebellar ataxia to improve the trunk control and gait

stability. They stated that DMO may be considered a

prototype that can be modified in terms of material

characteristics, textile layers, elastic components, and

diagonal and lateral seams. These preliminary findings need

to be validated by well-designed studies.

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CPT Codes / HCPCS Codes / ICD-10 Codes

Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":

Code Code Description

ICD-10 codes will become effective as of October 1, 2015:

CPT codes not covered for indications listed in the CPB:

There is no specific CPT code for suit therapy or Dynamic Movement Orthoses:

There is no specific HCPCS code for suit therapy device:

ICD-10 codes not covered for indications listed in the CPB (not all-inclusive):

G80.0 -

G80.9

Cerebral palsy

G81.00 -

G81.94

Hemiplegia and hemiparesis

I69.00 -

I69.998

Sequelae of cerebrovascular disease

M40.00 -

M41.9

Kyphosis and scolliosis

The above policy is based on the following references:

1. Rosenbaum P. Controversial treatment of spasticity:

Exploring alternative therapies for motor function in

children with cerebral palsy. J Child Neurol. 2003;18

Suppl 1:S89-94.

2. Shvarkov SB, Davydov OS, Kuuz RA, et al. New

approaches to the rehabilitation of patients with

neurological movement defects. Neurosci Behav Physiol.

1997;27(6):644-647.

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3. Semenova KA. Basis for a method of dynamic

proprioceptive correction in the restorative treatment of

patients with residual-stage infantile cerebral palsy.

Neurosci Behav Physiol.1997;27(6):639-643.

4. Sologubov EG, Iavorskii AB, Kobrin VI, et al. Role of

vestibular and visual analyzers in changes of postural

activity of patients with childhood cerebral palsy in the

process of treatment with space technology. Aviakosm

Ekolog Med. 1995;29(5):30-34.

5. Semenova KA, Antonova LV. The influence of the LK-92

'Adeli' treatment loading suit on electro-neuro-myographic

characteristics in patients with infantile cerebral paralysis.

Zh Nevrol Psikhiatr Im S S Korsakova. 1998;98(9):22-25.

6. Iavorskii AB, Kobrin VI, Sologubov EG, et al. Changes in

individual profiles of cerebral hemispheric asymmetry

during somatosensory stimulation due to wearing of

G-suits by healthy adults and children. Aviakosm Ekolog

Med. 1997;31(6):18-23.

7. Shvarkov SB, Davydov OS, Kuuz RA, et al. New

approaches to the rehabilitation of patients with

neurological motor defects. Zh Nevropatol Psikhiatr Im S

S Korsakova. 1996;96(3):51-54.

8. Semenova KA. The validation of a method of dynamic

proprioceptive correction for the rehabilitative treatment

of patients with the residual stage of infantile cerebral

palsy. Zh Nevropatol Psikhiatr Im S S Korsakova.

1996;96(3):47-50.

9. Iavorskii AB, Sologubov EG, Kobrin VI, et al. The

influence of space loading suits on interhemispheric

asymmetry of the brain in infantile spastic cerebral palsy.

Zh Nevrol Psikhiatr Im S S Korsakova. 1998;98(9):26-29.

10. Sologubov EG, Iavorskii AB, Kobrin VI. The significance

of visual analyzer in controlling the standing posture in

individuals with the spastic form of child cerebral

paralysis while wearing 'Adeli' suit. Aviakosm Ekolog

Med. 1996;30(6):8-13.

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11. Nemkova SA, Sologubov EG, Iavorskii AB. New

possibilities of the use of space technologies in the

treatment of children with injuries of the central nervous

system. Aviakosm Ekolog Med. 2002;36(3):55-58.

12. United Cerebral Palsy (UCP) Research & Education

Foundation. The Adeli Suit, 3/99. Research Fact Sheets:

Diagnosis/Treatment. Washington, DC: UCP; March

1999. Available at:

http://www.ucp.org/ucp_generaldoc.cfm/1/4/24/24-

6608/82. Accessed November 17, 2004.

13. United Cerebral Palsy (UCP) Research & Education

Foundation. New: The Adeli Suit Update, 11/2004.

Research Fact Sheets. Washington, DC: UCP;

November 2004. Available at:

http://www.ucp.org/ucp_generaldoc.cfm/1/4/24/24-

24/5896. Accessed December 1, 2004.

14. North Oakland Medical Centers (NOMC), Euro-Peds

Program. SUIT Therapy. Pontiac, MI: Euro-Peds; 2004.

Available at: http://www.europeds.org/epp_st.htm.

Accessed November 17, 2004.

15. Euromed Rehabilitation Center. Adeli Suit. Mielno,

Poland: Euromed; 2004. Available at:

http://www.euromed.pl/en/index.php. Accessed

November 17, 2004.

16. Free Motion Rehabilitation Center. History of the

therasuit. Howell, NJ: Free Motion Rehabilitation Center;

February 15, 2003. Available at:

http://freemotionrehab.com/History%20Of%

20TheraSuit.pdf. Accessed November 18, 2004.

17. Therasuit LLC. Intensive Suit Therapy for Cerebral Palsy.

Keego Harbor, MI: Cerebral Palsy Pediatric Fitness

Center; 2004. Available at: http://www.suittherapy.com/.

Accessed December 2, 2004.

18. Nicholson JH, Morton RE, Attfield S, Rennie D.

Assessment of upper-limb function and movement in

children with cerebral palsy wearing lycra garments. Dev

Med Child Neurol. 2001;43(6):384-391.

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http://www.ucp.org/ucp_generaldoc.cfm/1/4/24/24-6608/82


http://www.europeds.org/epp_st.htm

http://www.euromed.pl/en/index.php

http://freemotionrehab.com/History%20Of%20TheraSuit.pdf

http://www.suittherapy.com/



http://freemotionrehab.com/History%20Of%20TheraSuit.pdf



19. Rennie DJ, Attfield SF, Morton RE, et al. An evaluation of

lycra garments in the lower limb using 3-D gait analysis

and functional assessment (PEDI). Gait Posture. 2000;12

(1):1-6.

20. Blair E, Ballantyne J, Horsman S, Chauvel P. A study of a

dynamic proximal stability splint in the management of

children with cerebral palsy. Dev Med Child Neurol.

1995;37(6):544-554.

21. Chauvel PJ, Horsman S, Ballantyne J, Blair E. Lycra

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10/29/2018



Copyright Aetna Inc. All rights reserved. Clinical Policy Bulletins are developed by Aetna to assist in administering plan

benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial,

general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care

services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors

in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely

responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is

subject to change.

Copyright © 2001-2018 Aetna Inc.

http://aetnet.aetna.com/mpa/cpb/600_699/0696.html 10/29/2018


AETNA BETTER HEALTH® OF PENNSYLVANIA

Amendment to Aetna Clinical Policy Bulletin Number:

0696 Suit Therapy

There are no amendments for Medicaid.

www.aetnabetterhealth.com/pennsylvania Updated 02/08/2018

http://www.aetnabetterhealth.com/pennsylvania

0696 suit therapy - aetna better health...number: 0696 *please see amendment for pennsylvania...

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