Effects of interventions with therapeutic suits (clothing) on impairments and functional limitations of children with cerebral palsy: a systematic review

Background: Therapeutic suits or clothing whether associated with intensive protocols or not, became popular in the rehabilitation of children with cerebral palsy. Studies have reported positive effects of these suits on children's posture, balance, motor function and gait. A summary of current literature may help guide therapeutic actions. Objective: To evaluate the available evidence on the effects of interventions based on the use of therapeutic suits in the treatment of impairments and functional limitations of children with cerebral palsy. Method: Three independent reviewers searched for experimental studies on MEDLINE, SciELO, BIREME, LILACS, PEDro and CENTRAL databases, between October and December 2015 and updated in May 2016. The reviewers evaluated the methodological quality of selected studies using the Checklist for Measuring Quality. The Grading of Recommendations Assessment, Development and Evaluation was used to synthesize the quality of evidence and strength of recommendation. Results: From the 13 studies, two evaluated the Full Body Suit, two tested the Dynamic Elastomeric Fabric Orthose, three evaluated TheraTogs and six tested the TheraSuit/AdeliSuit protocols. The quality of evidence for the Full Body Suit, the Dynamic Elastomeric Fabric Orthose and the TheraSuit/AdeliSuit protocols was very low for body structure and function outcomes, while the evidence for TheraTogs was low quality. Regarding the activity outcomes, the Full Body Suit and TheraSuit showed very low quality evidence while the evidence for TheraSuit/AdeliSuit protocols were of low quality. Conclusion: Enthusiasm with new therapeutic approaches that argue modifications in the neu-romusculoskeletal impairments and functional limitations of children with cerebral palsy need to be guided by scientific evaluation. The low quality of evidence suggests caution in recommending the use of these therapeutic suits. New studies could change the findings of this review. (C) 2017Associaco Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by ElsevierEditora Ltda. All rights reserved.