Walking in Space

A Missouri teen with spina bifida makes progress at a Michigan clinic with technology originally developed for use in outer space.

By Rob Ingraham

Nathan Coleman learns to balance on a ball with the assistance of a physical therapist at the North Oakland Medical Center.

While the relationship of spina bifida to the laws of gravity is not immediately apparent, a Michigan clinic is offering a new type of physical therapy inspired by the Russian space program and a Missouri teen and his family are beginning to see some positive results.

At the suggestion of a colleague whose son has cerebral palsy, Jamie Coleman enrolled her 17-year old son, Nathan, in the North Oakland Medical Center’s Euro-Péds® program in Pontiac, Michigan. Nathan, who was born with spina bifida and has endured over 30 operations to correct numerous physical problems associated with the disability, has completed two, 2-week sessions at the Michigan center so far and he’ll be attending his third session soon. The North Oakland Medical Center (NOMC) is over 600 miles from the Coleman’s home in Auxvasse, Missouri and, as an outpatient program, there are no dormitory facilities available and the Colemans must rent a nearby motel for the full two weeks of Nathan’s treatment.

The program is more rigorous than most physical therapy regimens: four hours a day, five days a week, for two weeks—and the full program generally runs between one year and 18 months. Before the NOMC clinic, Nathan was attending physical therapy three days a week, for about an hour each session. “To me, it didn’t seem like he was really going anywhere,” Jamie said. But with the Euro-Péds program, she’s “definitely seen improvement” in Nathan’s ability to move and “we’re hoping he’ll be able to get out of the wheelchair by the time it’s over.” Nathan agrees: “Yeah, it’s working out pretty good.” In addition to the stress of his therapy and keeping up his grades at high school, Nathan is also in close touch with an older brother, who is serving with the Army in Iraq. “I’m writing to him,” he said. “I’m praying for him, too.”

Effects of Gravity

While most of us barely notice it, all of our movements, from walking to dancing to climbing stairs to lifting a glass, must overcome gravity. In everyday life, this subtle exercise of our muscles against the force of gravity is taken for granted and it wasn’t until the space program began sending astronauts and cosmonauts out of the earth’s gravitational field for extended periods that the physiological importance of our daily waltz with gravity became apparent.

Although the sensation of weightlessness may be euphoric at first, prolonged periods of weightlessness has serious consequences. By not having to counter the effects of gravity to move around, muscles atrophy and subsequent bone demineralization causes osteoporosis. The astronauts lose range of motion (ROM) in their muscles and they lose muscle function. Without a solution to this effect, long range space flight would be impossible.

Russian scientists were the first to devise a special spacesuit to counter the affects of the loss of gravity. Bundles of rubber “shock-absorbers” were hidden under a jacket and trousers which imitated natural gravitational force. Scientists testing the suit under normal gravity moved with a clumsy waddle and were described by colleagues as “penguins,” so the first such outfits were dubbed “penguin suits.”

It was soon recognized that children with cerebral palsy, spina bifida, traumatic brain injury, and other disorders suffered many of the same effects that weightlessness produced in astronauts: decreased range of motion, muscle weakness, and difficulty moving against gravity.

A prototype suit, based on the penguin concept, was created in 1992, consisting of an outfit rigged with a series of bungee-type rubber cords that cause deep compression in the body’s joints and resistance to muscles when movement occurs. Improvements were made upon the initial prototype and in 1994 a workable suit for children was developed consisting of a vest, shorts, a headpiece and knee piece. Euro- Péds made further improvements in the suit by adding padding for comfort and protection.

The bungee cords are designed to produce tension similar to the tension produced by elongation and shortening in human muscles. The suit is designed so that the bungee cords can be re-arranged to assist weak muscles or placed to strengthen other muscles. The bungee cord placement can also correct abnormal body positions or movement patterns.

Retraining the Joints

The body is full of sensory organs that report information about what our body is experiencing, where our body is in space (proprioception), and if our body is actually doing what our brain is telling it to do. The “SUIT Therapy” developed by Euro-Péds focuses on the proprioceptive and sensory organs in the joints. Wearing the suit causes compression of all major joints and Euro-Péds claims that the suit causes deep pressure at these joints, “awakening all the sensory and proprioceptive information at that joint.” Euro-Péds literature says that “By applying the bungee cords and bringing the way the body moves as close to normal as possible, real changes can be made in the rewiring and normalizing of information of the brain. You cannot undo the damage done to the child’s injured part of the brain, but the brain is capable of making new connections, rewiring, and becoming more efficient.”

Nathan said that the SUIT takes some getting used to. “It feels tight and hot and it’s a little painful at first, but after two or three days I get used to it. It helps me move my muscles more.”

Euro-Péds Communications Coordinator Anne Mancour explained that Euro-Péds is the first, and so far the only, clinic in the US to offer SUIT Therapy. The program was started in 1999 and has treated about 700 children so far. She said that the NOMC clinic is entirely focused on the pediatric population, whereas, in Europe, where the program was first developed, the approach is primarily used to treat adult stroke victims.

“We try to keep up with the children as they grow and prevent musculoskeletal imbalance,” Mancour said. “The earlier we can begin treatment with a child the more effective we think it can be.” Mancour added that the SUIT Therapy does not work with progressive diseases such as multiple sclerosis.

The Cost of SUIT Therapy

Mancour noted that while insurance companies will cover the Euro-Péds program, so far the SUIT Therapy component of the treatment is not covered. “Insurance companies want to see more research before committing to covering this therapy and most of the current research on SUIT Therapy has been done in Europe—mainly Russia and Poland.” She added that Euro-Péds expects that insurance companies will cover SUIT Therapy as soon as more US-based research has been completed and that there is a long-term research project currently underway at Oakland University in Michigan, on the effects of Euro-Péds intensive therapy for children with neuromuscular disorders.

In order to help parents cover the cost of SUIT Therapy, the North Oakland Foundation—the fundraising arm of NOMC—has established the “Adopt a EuroKid Program” which provides scholarships for needy families. Jamie Coleman noted that “Lots of parents try to hold fundraisers in their home towns and send the money directly to the program. Contributions are all tax-deductible and we were told that if Nathan completes his treatment without using all of the money donated, it can be used for other needy children.” Jamie added, “My husband is involved with several clubs around Auxvasse who have said they’re going to make some kind of contribution, which will help.”

Mancour also noted that the organization is eager to expand the Euro-Péds program nationwide but administrators are remaining cautious to ensure that physical therapists seeking to employ the technique are properly trained. “We’re doing all of our own training so far because the system is not yet available in therapy schools and, without more specially-trained therapists, we don’t want to expand too quickly.” Maintaining the quality of the Euro-Péds program was paramount, Mancour added.

Jamie Coleman feels confident that, thanks to Euro-Péds and the SUIT Therapy program, Nathan will someday be out of his wheelchair “They don’t know 100%, but they feel that if he continues to progress like he has there should be no reason for it.”

For more information on the Euro-Péds SUIT Therapy program, please visit www.europeds.org. To help cover Nathan’s treatment, or to support the SUIT Therapy program, contributions should be sent to the North Oakland Foundation, Adopt a EuroKid Program, North Oakland Medical Center, 461 West Huron, Pontiac, Michigan. 48341.

Rob Ingraham is senior editor.