Some Notes on Adeli Suit Therapy for Cerebral Palsy
Stephen Barrett, M.D.
The Adeli Suit is a set of garments that provide resistive exercises to specific muscles. It is a modified version of the "Penguin" that was originally designed to prevent muscle atrophy (wasting) and bone demineralization in Soviet cosmonauts during gravity-free periods of space travel . Since the mid-1990s, proponents have been claiming that Adeli Suit therapy can help children and young adults with cerebral palsy and other neuromuscular disorders .
The Euromed Rehabilitation Center in Mielno, Poland, which owns the licensing for the Adeli Suit, states that the prototype for the suit was developed in 1971 by the Russian Center for Aeronautical and Space Medicine and that:
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 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 .
The Web site further claims:
Research studies confirm that patients exhibit improved brain-to-muscle communication through increased blood flow to the brain and central artery, increased bio-electrical functions of the muscles (EMG readings), increased activity in the brain cortex (EEG readings), increased bone calcification, decreased ataxia (lack of coordination) and a decrease in the intensity of daystar (speech fluency disorder). With Adeli Suit therapy new elements of stability occur, the lack of coordination decreases and speech articulation improves .
Euromed offers a 4-week rehabilitation program that includes about 220 minutes of exercise per day for six days a week, including 80-120 minutes of the Adeli Suit application. Programs are also available in other centers in Europe and the United States. The FDA consider the Adeli Suit and other similar devices (such as the TheraSuit™) as Class 1 braces, which means that premarketing approval is not required as long as no claims are made for special effectiveness in medical conditions.
Reports of individual cases and uncontrolled studies have claimed that the Adeli Suit has helped with cerebral palsy to improve their speech, fine motor control, and general movement with suit therapy. These reports have generated enough interest that the United Cerebral Palsy (UCP) Research and Educational Foundation funded two studies. The results of these studies have not yet been published in a peer-reviewed scientific journal, but the Foundation has summarized them this way:
- Dr. Alexander Frank and associates at the Motion Analysis Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel, reported on 24 children with various levels of disability. The 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 between the two groups.
- Dr. Edward Dabrowski at the Children's Hospital of Michigan reported the results of 57 children, all of whom received an hour of physical, occupational, and speech therapy three times a week for 8-10 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.
- "These 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." 
The key questions in evaluating suit therapy are whether treatment with the suit is more effective than other types of intensive exercise programs and whether any apparent benefit is temporary or permanent. So far, no special or lasting benefit has been demonstrated by a controlled study.
In January 2005, the Aetna Insurance Company, which dies not cover Adeli Suit treatment, concluded that, "Controlled clinical studies are necessary to determine the beneficial effects of suit therapy, if any, for the treatment of cerebral palsy, especially which patients would benefit the most and how long any beneficial results would last." 
- The Adeli Suit. United Cerebral Palsy Research Foundation fact sheet, March 1999.
- SUIT Therapy. North Oakland Medical Center Web site, accessed Feb 15, 2005.
- Suit. Euromed Web site, accessed Feb 15, 2005.
- The Adeli Suit Update. United Cerebral Palsy Research Foundation fact sheet, Nov 2004.
- CBP 0696: Suit Therapy for Cerebral Palsy. Aetna Clinical Policy Bulletin, Jan 7, 2005.
This article was posted on February 15, 2005.