With a Posey straitjacket, it makes sense to also have more medical restraints to go with it. My boy purchased some Humane Restraint ankle cuffs with a locking belt a while back. They do get plenty of use. In this case, he was hooded, strapped into the straitjacket, and his ankles were put into the restraints. For extra security, leg irons were also added. Cuffs were also added to his arms as anchor points. Chain was added at his arms and ankles to keep him secure. Looks like a great way to spend an afternoon, or longer.