Our Dynamic Movement Orthoses (DMO) Experience – Age 4

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DMO Bodysuit

E has just recently outgrown her DMO bodysuit, so I thought I would drop a quick note to the pediatric stroke community to share our experience!

Originally when we ordered the suit, they stated that it is usually a 2-3 year commitment of daily wearing.  Usually one suit lasts 9-12 months (in growing children).  The benefits expected, from their website, are as follows:

Our orthoses work using strategically placed panelling which correctly aligns the body. This new positioning stimulates sensory systems throughout the body and re-programmes the brain, ensuring muscles operate in their new optimal state.

We use a unique Lycra® blend designed to give the best combination of flexibility and comfort, enabling freedom of movement.

In addition to this we incorporate reinforcement panelling to provide strength and stability where needed, realigning muscles so that they work in an improved biomechanical position, influencing body alignment and proprioception.

 All these benefits work towards a single goal – to improve function and encourage independence for the user.

E wore her bodysuit (short sleeves, down to the knees) for 11 months before outgrowing it.  It came to us very long – which I was ok with since I thought it would last longer.  Our orthotist/certified fitter was ok with the fit.  I am actually hoping she may fit it again in the future if she grows upwards instead of outwards!  (UPDATE: she didn’t)

Changes we noticed (immediate, and ongoing when wearing):

  • it improved her posture – straightening her back, especially noticeable when seated for play
  • it improved her balance – she was able to do stairs up and down much more confidently, independently

Overall, it was comfortable and easy to put on (2 minutes).

Disappointments:

  • I was hoping that it would improve her gait a bit.  It didn’t change it at all.
  • Cost.  It was over $2400 CDN.

Recommended?

  • Yes, if you have assistance with the cost (insurance).

DMO Wrist/Hand Splint

I really wanted to get E into a DMO wrist splint.  I had the opportunity to try an adult-sized demo on and it ABSOLUTELY encouraged supination.  !!!  This is one motion that is difficult to achieve through other methods.  We have tried kinesiotape briefly but found it to be not that effective.  We have also tried the supinator strap with the McKie which didn’t do a lot for us either.

(We are, however, fans of the McKie splint as well as the Ottobock wrist splint for other motions – getting the thumb out of fist and getting the wrist up.  Both are very reasonably priced – under $50 – and can be ordered directly online from their respective company websites).

We ordered the DMO wrist splint (and paid our deposit) in November.  It didn’t come in until January.  It was MUCH too small and pinched her hand so tightly that the fingers started turning purple.

The orthotist remeasured and got the same measurements (so she hadn’t grown).  The DMO measured much smaller than her hand.  We sent it back to be adjusted (free).

It came back in March.  With no apparent changes made.  Still much too small, very uncomfortable, and inhibiting motion (plus taking forever to get on).

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In the end, they reimbursed us our deposit and we may try again when she is much older.

Recommended?

  • Cautiously for older children and adults.  It has great potential and I personally can witness to its’ supinating power (from a demo on myself).
  • It also is pricey (~$1400CDN)

ALTERNATIVES 

Due to the cost of the DMO, we are pursuing an alternative this year.

  • Theratogs is a great alternative, but is warm (neoprene) for summer and the strapping is a little…cumbersome.  I think we might try it again when E is a little older and able to assist with the strapping, as it does pop off throughout the day with motion, pottying, etc.
  • SPIO also carries a line of therapy garments.  I ordered the TLSO Vest and the lower body shorts, as well as the wrist/hand splint.  The total cost of these 3 SPIO pieces was $450CDN.  If you didn’t need as supportive a garment on top, the shirt is about $100 cheaper than the vest.
    • The TLSO vest is great – easier to apply than the Theratogs, and in my opinion just as effective as the DMO/Theratogs.  The back is neoprene (warm) and the front is lycra (breathable).  It is adjustable via velcro.  Application takes 1-2 minutes.  It does come with a strap that goes around the crotch to keep it from riding up; however, this interferes with independent toileting so we have been leaving that piece off.  It seems to stay down ok as long as it is done up tight enough.  HIGHLY RECOMMENDED
    • The lower body shorts didn’t seem to make any difference in gait or trunk support for E.  They are also *very tricky* for her to get up and down herself, so she is unable to go potty independently while wearing them.  EHHHH, neither here nor there for us.  We haven’t been using them due to the toileting issue.
    • The Wrist/Hand splint is great for getting thumb out of palm (better than the McKie), but does reduce palmar sensations.  It only mildly helps with wrist support, and does nothing for supination.  I do recommend it as a thumb splint.  RECOMMENDED.

I strongly believe that in this life, nothing happens by accident or coincidence – things aren’t determined by fate or luck (good or bad).  I believe there is an overarching story – a beautiful picture of love, loss, and redemption – and that there is Someone who cares and is in control.  You are already a part of this story, whether you know or believe it or not.  While the end of the story has already been written, your own part lays open before you for you to choose your ultimate destiny.  Perhaps our coinciding struggles have been finely orchestrated to lead you to this one moment: The Bridge to God.

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“Praise be to the God and Father of our Lord Jesus Christ. The Father of compassion, the God of all comfort, who comforts us in all our troubles so that we can comfort those in any trouble with the comfort we ourselves have received from God. For just as the sufferings of Christ flow into our lives, so also should the comfort of Christ overflow.” (2 Corinthians 1:3-5)

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