SUSPENSION THERAPY

Definition:

                    Suspension is defined as suspending a  part of the body or whole body with the supported slings and pulleys.

Principle :

                  Friction

                  Pendulum

                  Gravity eluminating movement

Friction:

  It is the force  which  restrict the movement

 of an object. In the suspension the same principle followed, less friction causes the smooth and easy movement.

Pendulum:

 Pendulum is heavy material suspended by

the weightless thread. If the force is applied on it 

results in to and fro movement. (oscillation) 

E.g. shoulder & hip in walking

Same mechanism used in the suspension

Therapy to maintain the muscle property, 

increase the ROM & strengthening the

 muscles

Gravity eliminating movement:

The person should have the muscle power 

2 for the suspension exercises.( Less cant do himself). Grade 3 muscles person should go for antigravity rather then the suspension

 therapy exercises for strengthening.

           

   ADVANTAGES 

It reduces the burden for the therapist Easy to lift the limbs Active movements can be performed easily with minimum friction.

          Suspension Instruments

 

1 Suspension frame

2 Supporting Ropes

3 Pulleys

4 Slings

5 S-hook and dog clips

6 Wooden cleat

Suspension frame:

It is made up of steel or plastic coated steels.

In the top and the head end side is the metal mesh and the remaining sides are kept open.

In the middle of the frame couch is placed for the patient’s accommodation.

Supporting Ropes:

       3-ply hemp ropes are used for
       the suspension to avoid slipping .
       One end of the rope consist of
       a fixed ring and another end of
       the rope passes through the
       wooden cleat and is knotted
       in half-hitched manner Or
       without cleat.

 Three types: 

 primary, secondary and vertical rope

Primary:

Axis  as the point of suspension and it supports the distal join

Secondary:

Added with primary to support the proximal joint.

Vertical:

Used for vertical suspension and support the mid portion of the body

Pulleys:

It is the grooved wheel, which moves around an axis and the rope or the iron cable passing through the groove.  It gives the mechanical advantage.

It can be single or double. Reduced the burden  of lifting whole body or body parts.

Types: 

1. Fixed pulley 

2. Moveable pulley

Fixed Pulley: 

 The pulley is attached to the fixed point and acting as the first-order lever (weight on one side and effort on another  side  and the axis or fulcrum  in midline Used to alter the  direction of force by which the resistance  or the traction can be applied to the body parts.

  Example: lateral malleolus ( peroneus longus muscle  tendon)

Moveable Pulley: 

 One  end of the rope  is attached to the fixed point and  another end is passed through the fixed pulley . The moveable pulley  is attached in between the fixed point and the fixed pulley.  It acts like the second order of lever. It reduces the restricted force into half.

 Slings:

The slings are made up of canvas.

Types:

Single Sling:

Both the ends are having the D-rings for the attachment with the dog clip or S-hook. Used for  elbow and knee and for wrist  and ankle support in 8 manner .

Double Sling:

Bigger then single and more then two sides with the D-rings .Used for supporting the bigger parts  like thorax, trunk and thigh.

Three-ring Sling:

It consist of three D-rings. Two at the both end  of the sling and one in the middle kept moving. Used for  wrist and ankle.

Head Sling:

Both the ends are having the D-rings for the attachment with the dog clip or S-hook. 

S-hook and dog clips :

The s-hook and dog clips are used to attach the supporting ropes with the mesh and sling  with the supporting ropes.

Wooden Cleat :

It is made up of wood and is used for altering the length for altering the length of the rope. 
 It has two or three wholes for passage.

 It is used horizontally for adjusting the rope length and  oblique for friction resistance by the rope to avoid slippery.

              Types of suspension

Axial suspension

Pendular suspension

Vertical suspension

             Axial suspension

It is the most common type.

Joint is taken as point of suspension.

Gravity eliminated.

Limb is supported by the sling above the joint.

Limb will move to both sides parellel to floor

                 Uses

Relaxation.

Maintain muscle property.

Increse blood circulation.

Increase venous and lymphatic drainage

          Pendular Suspension

Point of suspension should be shifted away from the joint axis.

Movement usually takes place  against  gravity. 

Muscles will be getting resistance while moving if the axis is shifted opposite to that movement.

              Uses

Increase the muscle strength.

Increase the muscle endurance.

 Vertical suspension

COG of the body part or the body is taken as point of suspension. 

Used to provide support to the body parts of the patient

          Uses 

Relaxation. 

Prevent pressure sore.

 TECHNIQUES OF SUSPENSION

Position of the patient 

Point of suspension

Needed accessories

Procedure

EXAMPLES OF  TECHNIQUES OF SUSPENSION

Shoulder Joint:

Abduction and Adduction

Position of the patient : 

Supine lying

Point of suspension:  

one inch below the acromion process

Needed accessories:  

3 S-hooks, 1 Three  ring sling,  1 Single sling,  

 and 2 Supporting – rope   with wooden cleat

Procedure: 

For Strengthening of abductors  and adductors; performing abduction   and adduction.

Shoulder Joint:

Flexion and Extension

Position of the patient : 

Side lying Point of suspension:  Greater tuberosity  

Needed accessories: 

 3 S-hooks, 1 Three ring  sling,  1 Single sling,   and 2 Supporting – rope with wooden cleat

Procedure:

  For Strengthening of flexors and    extensors; performing    Flexion and Extension.

Shoulder Joint:

Medial and Lateral Rotation

Position of the patient : 

Supine lying

Point of suspension:

  Olecranon Process

Needed accessories:  

4 S-hooks, 1 Three ring sling,  1 Single sling,  and 2 Supporting – rope  with wooden cleat

Procedure:  

For Strengthening of Medial and Lateral rotators    performing  both Rotations

Elbow Joint:

Flexion and Extension

Position of the patient : 

 Sitting

Point of suspension:  

Lateral  epicondyle  of  the humerus   

Needed accessories:

  4 S-hooks, 1 Three ring- sling,  1 Single sling,   

  and 2 Supporting – rope with wooden cleat

Procedure: 

 For Strengthening of flexors and  extensors  performing Flexion and Extension.

Hip Joint:

Abduction and Adduction

Position of the patient : 

 Supine lying

Point of suspension:  

Two inches below the ASIS

Needed accessories:  

3 S-hooks, 1 Three ring sling,  1 Single sling,   and 2 Supporting – rope   with wooden cleat

Procedure:  

For Strengthening of abductors and adductors   performing abduction and  adduction.

Hip Joint:

Flexion and Extension

Position of the patient :  

Side lying

Point of suspension:  

Greater trochanter 

Needed accessories:  

3 S-hooks, 1 Three ring sling,  1 Single sling, and 2 Supporting – rope with wooden cleat

Procedure: 

 For Strengthening of Flexors and Extensors

 performing Flexion and Extension

Hip Joint:

Medial and Lateral Rotation

Position of the patient :

  Supine lying

Point of suspension:

  Apex of the patella

Needed accessories:  

4 S-hooks, 1 Three ring sling,  1 Single sling,    and 2 Supporting – rope with wooden cleat

Procedure: 

 For Strengthening of Rotators ;  performing both rotations.

Knee Joint:

Flexion and Extension

Position of the patient :

  Side lying

Point of suspension: 

 Lateral Joint Line

Needed accessories: 

 4 S-hooks, 1 Three ring sling,  1 Single sling,  

                                   and 2 Supporting – rope

                                   with wooden cleat

Procedure:  

For Strengthening of Flexors and 

                     Extensors; performing flexion and Extension.

                     

Whole Body:

The separate slings are suspending each and every limb in the vertical suspensions with the supporting ropes
. 

 The upper trunk,

 Lower trunk, 

 Head, 

 Upper limbs, 

 Lower limbs