TEACHING THE BODY - Cerebral Palsy Patient Strengthens Muscles With Suit

06-15-2005

Courtney Fuller looks as if she could either be undergoing some medieval torture or training to become an astronaut. Actually, elements of both scenarios apply as the 9-year-old girl stands inside a metal cage, her body encased in a corset-like suit that's tethered to the bars by elastic cords.

The Lakeland girl, who was born with cerebral palsy, is in the midst of an intensive, four-hour therapy session that can seem torturous as it challenges the innate weaknesses of her body's muscles. The therapy resembles astronaut training in that Courtney's body is given a new conception of balance -- as if she were being introduced to a different level of gravity.

"It helps me to put my feet flat," Courtney says. "I can walk a lot better."

American society tends to regard disorders like cerebral palsy only in terms of the need for a cure. But for Courtney and others born with cerebral palsy and a wide range of other disorders, living with an ailment is not an either/or situation, with a complete cure or hopeless resignation as the only alternatives. The three-week session of intensive therapy Courtney recently completed at Pediatric Therapy Services, a Lakeland clinic, shows the possibility of improvement through a combination of innovative therapy techniques and strenuous effort. Courtney hopes the therapy will help her advance from the wheelchair and walker she now uses to crutches.

Such a change could allow Courtney to handle "transfers," such as getting out of bed or into the tub -- that now require help from her grandmother, Lynn Williams. (Williams has had custody of Courtney since the girl was born prematurely, weighing 2 pounds, 9 ounces.)

Cerebral palsy is a category of mostly congenital disorders that impair movement and bodily control. Like many people with cerebral palsy, Courtney has difficulty with balance and fine motor skills that the rest of us take for granted.

Courtney has received physical therapy weekly since she was 1. The recent three-week session gave therapists a chance to use a TheraSuit, a $2,500 outfit that helps simulate the balancing system of a healthy muscle system, according to the clinic's co-owner, Denise Kilburn.

Kilburn says scientists in Poland designed the suit based on studies of Russian cosmonauts, who used similar suits to offset the damaging effects of weightlessness on their bones.

"(Patients) are unable to experience the normal give-and-take of the muscle moving against and through the force of gravity," Kilburn says, "so if you can't do that you don't understand how your foot should push into the floor to make yourself stand up."

The canvas suit consists of vest, shorts and knee sleeves, all of which can be connected by an intricate web of red elastic bands. On a recent morning, therapist and clinic co-owner Kathy Shufflebarger straps the suit over Courtney's turquoise pants and white T-shirt, patiently attaching dozens of bands to the suit's plastic hooks.

Shufflebarger connects bands from the knee sleeves to a pair of black tennis shoes fitted with their own plastic hooks, specially designed accessories to the suit. She pulls a pink cap over Courtney's light-brown hair and connects the headgear to the vest with a few more bands.

The therapist explains that the suit helps teach Courtney's muscles to work more efficiently while correcting bad habits caused by muscle weakness, particularly on the right side of her body.

The suit compresses a patient's body in a way that can be disorienting, and Shufflebarger says Courtney reacted angrily her first few days in the suit before getting used to the sensation.

Shufflebarger guides Courtney through some crunches, holding her left arm down as the girl curls upward with her right side. Courtney next does a set of pushups on a bench as Shufflebarger holds her elbows in place and then straddles the bench in an attempt to strengthen and loosen the adductor muscles in her legs and reduce her tendency to "scissor" as she walks.

After a while Shufflebarger hooks Courtney to "the spider" -- aptly named for the eight orange stretch cords the therapist attaches to the suit and then to bars of the metal cage. The cords hold the girl in an upright position.

Courtney says the spider is her favorite part of therapy.

Why? "Because I can jump."

Another therapist tosses a yellow ball at Courtney, who bats it back with both hands. The therapist rolls the ball, forcing Courtney to bend and pick it up, then lift it over her head and throw it back. With help from Shufflebarger, Courtney bounces from left to right, pushing off the sides of the cage, and rocks forward and back, braced by the stretch cords. Her face relaxes into a gleeful smile.

Shufflebarger puts Courtney back to work by making her practice rising from her knees, an action that is difficult for her. After a few attempts, Courtney asks, "Can I quit this?"

The therapist relents, removing the suit and hooking Courtney to the spider cords with just a wide belt around her waist. Courtney does a few little hops, and Shufflebarger lifts her into a Superman flying position as the girl giggles in delight. The therapist then grants Courtney's request to put her stuffed bear, Elizabeth, in the harness, and the girl yanks at the cords to make the bear dance in midair.

Such moments help offset the sometimes grueling nature of the therapy. Williams says the fourhour sessions leave her granddaughter physically spent.

"Some days I'll take her home from here and give her lunch and her nap, and she'll lie down and sleep for four hours," Williams says.

After completing the threeweek session with the TheraSuit, Courtney will continue her standard regimen of physical therapy three times a week at the clinic. The third-grader at Medulla Elementary strives to be increasingly able to do the same things as her classmates.

"They wanted to put her in a special P.E. class, and she didn't want any part of that," her grandmother adds. "She cried and cried."

But crying is not a common activity for Courtney, who smiles frequently even during the stress of her therapy sessions. Williams describes her granddaughter as "a happy child," and the girl's hazel eyes flash as she talks of an upcoming trip to Vero Beach and her plans to ride a horse owned by one of the therapists.

Williams says the therapy has changed Courtney's body alignment -- and more.

"A while ago she was eating a snack and she was sitting in a position we didn't want her to sit in," Williams says. "I asked her to sit in a different position, and she said, `Yes, the new Courtney has to sit a different way.' "

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