Movement System Impairment Syndromes

Movement System Impairment Syndromes are the focus of an approach to physical therapy that was developed by Dr. Shirley A Sahrmann, PhD, PT and her associates at the Program in Physical Therapy at Washington University School of Medicine in St Louis, Missouri. The analysis and treatment of movement systems impairments are founded in principles of kinesiology, biomechanics, muscle physiology, and physiologic adaption-to-use history. Physical therapists trained in this approach will undertake...

What do TheraTogs do, exactly?

A properly fitted TheraTogs system provides orthotic support to improve postural stability, to enhance functional alignment, and/or to enhance (or inhibit) specific movements. The GoldTone™ garments give the wearer a comfortable, breathable, latex-free “second skin” over his/her trunk and selected limb segments. The fabric is designed to provide vertical stiffness to reinforce trunk stability, and lateral flexibility to grip the soft tissues and provide a comfortable fit. The garments then serve as a Velcro®-sensitive field for attaching elastic TogRite™ strapping, in virtually any configuration, to address the clinician’s rehab objectives.

How do TheraTogs work?

TheraTogs are specialized undergarments and straps customized for the wearer to create a live-in system that provides either neuromotor or postural training, or prolonged proprioceptive input.

  • For wearers with biomechanical or neuromotor issues, TheraTogs work by allowing the clinician to set the patient’s body in proper functional alignment, and letting them re-train their body through the ‘practice’ of daily activities. By applying prolonged, gentle forces during activity, TheraTogs can actually change the muscle and connective tissue – and for infants and young children, bone and joint development as well – in favor of better function and better alignment.
  • For wearers with sensory and sensorimotor issues, TheraTogs work by applying consistent, gentle compression and proprioceptive input across the entire trunk, and by offering stability and support in a dynamic system that moves with the wearer.

Using TheraTogs as ‘wearable therapy’, your client can gain the experience and the benefits of an all-day clinical therapy session. This is what we mean when we tell clinicians they can “send their hands home” with TheraTogs.

What kinds of conditions can TheraTogs address? How do I know if TheraTogs can help my client (or my child?)

TheraTogs are so adaptable, it would be challenging to list all their potential applications and uses here. Instead, here are a few guidelines:

If the therapist/practitioner can effect a change in the client’s stability, alignment, mobility, or motor control through unforced handling during a therapy session, it’s likely that this change can be replicated and supported outside the session by a properly configured TheraTogs strapping system.

If you or your therapist feel you’re “running out of hands” and could use a few more to effectively manage problems related to positioning (in a wheelchair or on other devices), or to client handling during therapeutic exercise sessions, you’ll also find in TheraTogs very helpful adjunct to your current management strategies.

If your client (child) presents any of these problems, TheraTogs has been shown to be effective in addressing related stability, alignment, and movement issues:

  • Ataxia
  • Hypotonia
  • Athetosis
  • Core or Trunk Weakness • Intoed gait
  • Out-toed gait
  • Joint deviations
  • Joint laxity
  • Muscle recruitment problems
  • Sensory integration issues
  • Postural mal-alignment
  • Muscle imbalance

See our TheraTogs by Indications web page for more specifics.

How do I know what product and size to order?

The attending clinician identifies the best product model based on the client’s indications and his/her rehab objectives. For our recommended product matchups, see the TheraTogs by Indications web page, or download the Product Selection chart.

TheraTogs are sized according to a combination of weight and specific dimensions. The correct sizing is determined by measurements taken by the clinician, which are then compared to the Sizing Chart appropriate for the desired product.

How do I buy TheraTogs?

In the US: As an FDA Class I medical device, TheraTogs are not an off-the-shelf product, and can only be used under the guidance of a rehab clinician. If reimbursement is a factor, request or obtain TheraTogs through your local DME or O&P Provider; a physician’s prescription may be required by the reimbursing agency. If you or your clinic is buying, you can order from any of the catalog distributors that carry TheraTogs. If the caregiver or client is buying out-of-pocket, he/she can participate, with the attending clinician, in the Research Partner Program. (See the Research Partner Program information for details.)

Outside the US: TheraTogs are available from leading distributors in over 40 countries. See our Global Distributors webpage for details.

Upcoming Events

Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ University of Minnesota - Conference Center
Oct 9 – Oct 10 all-day

Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives (Two-Day Workshop)

This workshop covers therapeutic evaluation & treatment of pediatric equinus gait (“toe walking”).  It is common for the practitioner to feel lost when a child presents with a toe walking gait pattern. Both evaluation and treatment of these children are often frustrating for all involved and frequently results in inaccurate evaluation with ineffective intervention and poor achievement of results. Long term results are rarely achieved with either resultant surgical intervention and/or a reoccurrence of the problem. However, establishing a specific approach to treating this type of patient can be made less frustrating and more rewarding by asking the right questions and forming a deliberate approach.

This course teaches effective management techniques and is excellent for alleviating a chaotic approach to the treatment of pediatric toe walking. Through an organized evaluation procedure, specific data will be used to direct the clinician to potential etiologies. Causes and appropriate intervention strategies are identified in order to utilize a systematic approach to developing an effective treatment plan.

Often toe walking is a result of postural mal-alignment. When appropriately used, TheraTogs effectively improve posture and can result in an improvement or even a resolution in the toe walking.


Posture & Torso Alignment for Pediatric Neuromotor Training (CTF Level 1) @ Mercy Children’s Hospital St. Louis
Oct 16 all-day
Posture & Torso Alignment for Pediatric Neuromotor Training (CTF Level 1) @ Mercy Children’s Hospital St. Louis | Saint Louis | Missouri | United States

Posture & Torso Alignment for Pediatric Neuromotor Training

Review the basic principles and management of torso and posture alignment, then spend over two hours of supervised hands-on practice using the TheraTogs Posture & Torso Alignment (PTA) system to address torso alignment, posture, and stability issues.

Pediatric In-toeing & Out-toeing Management Strategies (CTF Level 2) @ Mercy Children’s Hospital St. Louis
Oct 17 all-day

Pediatric In-toeing & Out-toeing Management Strategies

Review pediatric orthopedic lower-extremity (LE) skeletal and joint development (transverse plane) and the deviations of in-toeing and out-toeing. Learn and practice three LE musculoskeletal assessments that pertain to TP alignment and gait problems, plus practice the TheraTogs strapping procedures applied to improve functioning alignment of the femur at the hip joint and of the leg at the knee joint.

Watch: TheraTogs Mom


I have a patient who has cerebral palsy, diplegia, autism and sensory defensiveness.  I requested the family start using the TheraTogs they received the previous year.  (They previously were not committed to donning the system.)  I asked that they wear them for three straight weeks before deciding the benefits vs. the challenges of donning it.

Within a week they had noted not only was their child more stable for standing and walking, but he was less irritable, increased eye contact, and tolerated handling more.  Great success.  Recently we had them do the Wilberger brushing program, with further improvement noted.  We have just recently ordered the next size up, and we are awaiting their arrival.

Thanks for the great product.

— Peter, PT