1. SUSPENSION THERAPY
Dr.Satish K Pimpale PT
MPTh in Neurosciences
Assistant Professor
TMV'S Lokmanya Medical College of Physiotherapy,
Kharghar ,Navi Mumbai
2. At the end of the session...
Principle
Suspension Apparatus
Types of Suspension
Effect & Uses
Techniques for individual joints
Dr.Satish K Pimpale PT
5. The pencil pushed
through a circle of
paper demonstrates
that when the pencil is
pivoted the paper
moves in a plane
parallel with the floor,
thus demonstrating
the principle of axial
fixation
10. It is made of stainless steel or
plastic coated steel.
In the top and head end side
presents the 5cm metal mesh
and remaining side kept open.
Fixed Point
11. Ropes should be of 3-ply hemp
so that they will not slip.
1.5m long
There are following three types of
supporting ropes:
1) Single Rope
2) Double Rope
3) Pulley Rope
Supporting Ropes
12. Has a ring fixed at one end
by which it is hung up.
The other end of the rope
then passes through one
end of the wooden cleat
through the ring of a dog
clip and through the other
end of the cleat and then
knotted.
Single Rope
13. Consist of two pulleys at
upper and lower attachments.
So here there is a mechanical
advantage of 2.
Used to suspend the heavy
parts of the body
Double Rope
14. This has a dog clip attached
at one end of the rope which
then passes over the wheel
of the pulley.
The rope then passes
through the cleat and a
second dog clip.
Used for 3dimensional
movements
Pulley Rope
15. There are following four types of
slings:
Single Sling
Double Sling
Three Ring Sling/3D RING SLING
Head Sling
Slings
16. Made of canvas bound with soft
webbing and with a D-ring at
each end.
68cm length and 17cm width.
Used for elbow and knee
Folded to support wrist and ankle.
Single Sling
17. Broad slings with D-rings
at each end.
Used to support pelvis,
thorax or thigh together,
specially when the knees
are kept together.
68cm long and 29cm width.
Double Sling
18. 75cm length 3-4cm width.
Consist of 3 D rings. 2 at the
end of the sling and 1 in the
middle kept moving.
Used for wrist & hand OR
ankle & foot.
Three Ring Sling
21. This is a short, split sling with
its two halves stitched
together at an angle to create
a central slit.
This allows the head to rest
supported at the back under
the lower and upper part of
the skull.
Head Sling
22. Wooden Cleat
It is made of wood
and is used for
altering of the rope.
It has two or three
holes for the rope
passage. The rope
itself hold the cleat
by friction
resistance.
23. Dog Clip
Used to attach
the supporting
rope with
mesh.
To attach the
sling with
supporting
rope.
24. S Hook
An ‘S’ hook which
may be used
either end and
according to the
size of the fixed
point
25. Storage of slings and ropes
on wall frame is done with S
shaped hooks.
Storage Trolley
27. These movements are
produced by an external force
during muscular inactivity is
voluntarily reduced as much
as possible to permit
movements.
Passive Movements
28. when muscle strength or co-
ordination is inadequate to perform
a movement an external force is
applied to compensate for the
deficiency
Assisted Exercises
29. Treatment or therapeutic
exercise given to patients to
increase ROM,
increase muscle power and
support body parts by using
ropes and slings.
Suspension Therapy
31. There are following three types of
suspension therapy:
Axial Suspension
Pendular Suspension
Vertical Suspension
Types
32. It is the most common type.
Joint is taken as point of suspension.
Limb is supported by the slings above the
joint.
Limb will move to both sides parallel to
floor.
Axial Suspension
34. Point of suspension should be shifted
away from the joint axis.
Muscles will be getting resistance while
moving if the axis is shifted opposite to
that movement.
Pendular Suspension
47. References
The Principles of Exercise Therapy-
M.Dena Gardiner
Practical Exercise Therapy by Margaret
Hollis
Notas do Editor
a simple pendulum is a heavy object, suspended by a weightless thread and free to move to & fro..when the pendulum is at rest the thread(rope) is vertical,but if the weight is drwan to one side and then released ,the pendulum will swing to & fro.one complete swing in each directn is called as oscillation,and the extent of swing to any one side from vertical is the amplitude.a force is required to set the pendulum in motion and then the oscillation will continue until it is brought to rest,suddenly,by an opposing force,or progessivy by an opposing force,acceleration is due to gravity.
Suspension is the means whereby parts of the body are supported in slings and elevated by the use of variable
length ropes fixed to a point above the body. Suspension frees the body from the friction of the material upon
which body components may be resting and it permits free movement without resistance when the fixation is
suitably arranged relative to the supported part. This is a frame big enough to take a
single bed
Vertical fixation is used primarily to support, e.g. the abducted upper limb when the elbow is to be moved is
supported from above the centre of gravity of the arm and axial fixation is used over the elbow for forearm
movement
Flexion & ext: The starting position is side lying on pillows and quarter turned to the back. Female patients need two pillows under the head and one under the shoulder to allow the forearm to clear their wider pelvis. The slings and ropes are arranged as described above and again the movement may be limited to the glenohumeral joint and the muscles working over it, or movements of the shoulder girdle may be included.If in addition to the angular movements it is desired to perform rotation of the glenohumeral joint, then only one sling should be used at the level of the elbow and a single pulley rope should be attached to the fixed point above the shoulder. The ends of the sling are attached to each end of the pulley circuit and it will then
be possible to perform medial or lateral rotation with two angular movements
abduction & adduction:The starting position is lying, quarter turned towards the arm which is to be moved (Fig. 8.21A). This allows the normal anatomical movement to be performed in the plane of the scapula. Alternatively, the starting position is prone lying, quarter turned towards side lying with a pillow under the trunk on the side of the arm which is to be moved (Fig. 8.21B). The advantage of prone lying is that the therapist can see the movements of the scapula as well as those of the arm.
Two single ropes are required, one attached to a single sling under the elbow and one to a three-ring sling applied to the wrist and hand. The fixation point is over the shoulder joint.
If the movement is to be only of the glenohumeral joint, the therapist must stand on the opposite side with one hand on the point of the shoulder depressing the scapula. In this form of support either abduction and adduction of the glenohumeral joint, or movements of the shoulder girdle, may be mobilized. Glenohumeral rhythm may be re-educated and all the muscles performing shoulder girdle movements may be worked.
Because of the carrying angle of the forearm it is easier to perform these movements when the arm is
suspended in abduction. The starting position is sitting on a low-backed chair. A single sling and rope
supports the arm in vertical fixation, and a three-ring sling and single rope are fixed to a point above the
elbow joint (Fig. 8.15). The therapist should stand behind as she may need to give additional support by
holding the arm with a grasp inside the sling, which will allow palpation of the flexors and extensors which
are covered by the supporting sling. Alternatively, a folded single sling under the palm, attached to a single
pulley rope, will allow pronation and supination to occur with extension and flexion of the elbow joint.
The starting position is side lying with the underneath leg flexed as far as possible. The fixation point and
sling arrangements are as above, with the limb lifted until it is horizontal. If the movement of flexion is to be mobilized the knee and hip must be flexed together to overcome the passive insufficiency of the hamstrings.Equally, when mobilizing extension the knee should be extended to overcome active insufficiency of the hamstrings
The starting position is lying with the opposite leg abducted to its limit, even if the knee has to be bent over
the side of the plinth and the foot supported on a footstool. The fixation point is immediately above the hip
joint. One sling is put under the lower thigh and one three-ring sling on the foot and ankle; each is attached to
a rope hung from the fixation point. The limb is lifted just clear of the plinth. Using this method of support the
movements of abduction and adduction may be mobilized or the abductor or adductor muscles may be
especially worked with or without manual resistance
The starting position is side lying with one or two pillows between the slightly flexed thighs. One three-ring
sling is applied to the foot and ankle and one rope attached to a fixation point above the knee joint. By
keeping the hip slightly flexed on the trunk the foot can be seen each time the knee is extended and part of
the arc of movement is thus observed by the patient. This position may be used to mobilize the knee joint or
to work the flexors or extensors of the knee