Introduction
When we talk about orthoses, many people automatically think of rigid devices designed to hold or immobilise a joint. However, there are other ways of supporting the body. Sensory Dynamic Orthosis (SDO®) garments by Medigarments are made-to-measure textile orthoses (dynamic elastomeric fabric orthoses) that use dynamic compression, sensory and proprioceptive feedback and strategically placed reinforcement panels to encourage better musculoskeletal alignment without preventing functional movement.
And this last part is especially important: an SDO does not simply aim to “place” the body in a particular position. The proprioceptive input and resistance the garment provides can help the wearer take an active part in their own postural control. That is why, depending on the goals, we may seek greater symmetry, improve proximal stability or make upper and lower limb function easier.
There is no such thing as “the SDO”: there is an orthosis designed for each person
SDOs are individualised products. The choice of garment, its measurements and, above all, the selection and placement of the different reinforcement panels are based on a clinical assessment and specific functional goals.
We can use garments covering the trunk and pelvis to work on postural control, alignment and symmetry; trousers, leggings or socks to act on the lower limbs; and also sleeves, gloves and other configurations for the limbs. The SDO® range itself includes specific panels for suits, gloves and socks.
In the hand, for example, we are not always simply trying to maintain a position. We may want to improve wrist stability, encourage a more functional thumb position or provide a better base for using the hand during play, writing, handling objects or activities of daily living.
In the lower limbs, the goal may be different: improving alignment, influencing certain rotations, providing stability or encouraging a more efficient movement pattern. Panels are selected according to what we want to facilitate or prevent, which is why two garments that look the same can have completely different prescriptions.
Scoliosis and deformities: looking at the whole 24 hours
This concept becomes even more important in people with severe motor disabilities, especially when there is altered postural tone, postural asymmetry, neuromuscular scoliosis or a risk of developing deformities.
A person does not stop needing good positioning when their physiotherapy session ends. The body is subject to forces 24 hours a day: sitting in their chair, during transfers, when standing, while they play, eat or move around and, of course, during the many hours they spend lying down and sleeping.
That is why we increasingly talk about 24-hour postural management: it is not about keeping the person “straight” all the time, but about analysing what happens to their body throughout the day and combining movement, activity, changes of position, positioning, orthoses and rest.
During the day, an SDO can be worn while the person is sitting, standing, doing transfers or taking part in functional activities. Because it is flexible, it allows the rib cage and pelvis to keep moving and makes it possible to take part in activities that can be more limited with some rigid orthoses.
And at night?
Here it is important to tell the garments apart. A daytime SDO should not be worn at night unless it has been specifically prescribed for that. There are SDO® Sleep Suits designed expressly to be worn during rest.
The Sleep Suit is also made to measure and is designed to help manage the risk of trunk deformities developing, and hip alignment, during rest in people with altered tone. It can include panels aimed at postural control and hip rotation, and can be used together with a night-time positioning system when indicated.
In this way we can take a truly global approach: activity and alignment during the day, positioning and protection during rest, always adapted to each person's needs.
And what does the research tell us?
Precisely to better understand the role of these orthoses in patients with neuromuscular scoliosis, we have recently published a multicentre study carried out in collaboration with the Hospital Universitario de Cruces in Bilbao and the Hospital Infantil Universitario Niño Jesús in Madrid, in which 30 paediatric patients with neuromuscular scoliosis were initially enrolled and the use of SDO® Advanced textile orthoses was assessed over six months.
The results are particularly interesting because the study did not stop at assessing photographs or clinical impressions: radiographic measurements were taken with and without the SDO.
When patients were wearing the orthosis, a statistically significant reduction in the Cobb angle was observed: initially the median difference compared with not wearing it was 2.6°, and at the end of the six months it reached 4.0°. Coronal balance also improved significantly, by 2.1 cm initially and 1.8 cm at the final assessment.
It is important to interpret these results correctly: the study does not show that the SDO cures scoliosis or stops it progressing. It is a pilot study with no control group, and the authors explicitly point out the need for controlled trials and longer follow-up. What the results do suggest is that the SDO may help improve alignment and postural balance while it is worn, as part of a broader conservative strategy.
Tolerance and adherence were also good: participants wore the garment for a median of 8.5 hours a day on around 85% of the study days, and no serious adverse events related to the orthosis were recorded.
Families also reported improvements mainly in posture, attention and hand use, as well as making transfers and daily care easier for carers, and improvements in school activities. Satisfaction levels were also high and the orthosis was well tolerated.
Study reference: Gandarias-Mendieta I, Galán-Olleros M, Martínez-González C, Egea-Gámez RM, Martínez-Caballero I. Use of sensory dynamic orthosis in paediatric neuromuscular scoliosis: a pilot single-group pre–post study. Journal of Pediatric Rehabilitation Medicine, 2026. doi:10.1177/18758894261469491.
One more tool within an overall plan
Textile orthoses do not replace movement, physiotherapy, a good seating system, standing, rigid orthoses when they are indicated or, of course, surgery when it is needed. They are one more tool within an individualised approach.
Nor does everyone respond in the same way. Compression or sensory input may not suit some users, and in some it may even reduce movement or cause fatigue, hence the importance of individually assessing both the design and the hours of wear.
But when they are correctly indicated, designed and reviewed, SDO® garments offer us something particularly interesting: the chance to carry part of the postural work beyond the therapy session and into everyday life.
Because postural care goes far beyond an hour a week on a treatment table. It is present at every moment of the day: when we sit, play, study, eat, move and sleep.
And when there is a risk of scoliosis or other deformities, thinking in terms of the full 24 hours can make a big difference.
We'll let you know when the next guide is out.
Occasional updates and guides for families. Unsubscribe whenever you like.
Would you like us to review it with you?
We guide you on the best option for your case, without obligation.