SUSPENSION THERAPY

DR. ABDUL RASHAD

SENIOR LECTURER
DPT,MPHILL(OPT) ,MPPTA, MMTC (NZ), MSTC(AUS),
IASTM(GREECE)
UNITED COLLEGE OF PHYSICAL THERAPY
CONTENTS
Suspension application
Suspension concept of inclined planes
The fixed point suspension
Supporting rope and its types
Sling and its type
Type of suspension: axial &vertical
Methods, techniques of suspension: upper limb &
lower limb
Suspension effect on muscle work and joint mobility
SUSPENSION
•The technique is use to free a body part
from the resistance of friction while it is
moving the part.
•It is suspended in a sling attached to a
rope that is fix to an appropriate point
above the body segment
Guthrie Smith
 -- mesh

---Fixed point
BENEFITS OF SUSPENSION FOR
ROM EXERCISE
Active participation is required thus the patient learn to
use the appropriate muscle for desired movement
Relaxation is promoted through secure support and
smooth rhythmic motion
Little work is required of stabilizing muscles because
the part is supported
Modification can be made to the system to provide
grades of exercise resistance
After instruction the patient can
often work independently of a therapist
Suspension therapy is a form of assisted exercise
The fixed point
• It is made of stainless steel or plastic covered 5 cm metal
mesh around the area of a plinth,
• Its1m or 2m wide x 2m long above it,
• 2m x 2m on the wall at the side of the plinth,
• At the head of the plinth 1m or m x 2m long and2m high.
• suspend the overhead mesh from the ceiling at a height
which will allow about 1.5m
• A free –standing frame may be used. This is a frame big
enough to take a single bed.
• Hooks on the side of the frame allow lateral fixed points
and can be used to keep the small apparatus near at hand.
THE SUPPORTING ROPES
Types of ropes:
A single rope , a pulley rope, a double rope.
Single rope
• A single rope has a ring fixed at one end, by which it is
hung up
• The other end of the rope passes through one end of a
wooden cleat,
• Then through the ring of a dog clip
• And through other end of the cleat and is then knotted
with a half-hitch.
• The cleat is for altering the length of the rope

• And should be held horizontally for movement

• Should be pulled oblique when supporting

• The rope then ‘holds’ on the cleat by frictional resistance

• The total length of rope required is 1.5m

• Further shortening of the rope may be brought about by

knotting is about the cleat.
PULLEY ROPE
• A pulley rope has a dog clip attached to one end of the rope
• which then passes over the wheel of a pulley
• The rope then passes through the cleat and a second dog clip.
• This rope is 1.5m long.
• This arrangement is used for reciprocal pulley circuits:
-- with one sling supporting a limb, and the ends of the sling
attached to the two dog clips, it is used for three-dimensional
movements of a limb,
--i.e. abduction or adduction with flexion or extension and medial
or lateral rotation (combined, oblique, rotatory movements).
Double rope
• A double rope consists of a ring and clip from which the rope is hung
to create a compensating device permitting a certain amount of
swivel on the rope.
• The rope then passes through one side of a cleat,
• around a pulley wheel at the lower end, to the case of which
is attached to a dog clip,
• Through the other end of the cleat and over the wheel of an upper
pulley which is attached to the compensating device.
• The rope then passes down again through a centre hole in the cleat
where it is knotted
• This device gives a mechanical advantage
• Such a rope is used to suspend the heavy parts of the body – the
pelvis, thorax or heavy thighs when these are to be supported
together
Slings
Single slings
•Single slings are made of canvas bound with
soft webbing and with a D ring at each end.
•Used open to support the limbs
•Can be folded in two, and as a figure of eight
to support the hand or foot.
•They measure 68 cm long by 17cm wide
Double slings
• Double slings are broad slings measuring 68 cm long by 29
cm] wide with D rings at each end
• Used to support the pelvis or thorax or the thighs together,

Three-ring slings
• Three ring slings are webbing slings 71 cm long by3-4 cm
wide with three D rings one fastened at each end and one
free in the middle
• The center ring is for attachment to the dog clip
• The webbing is slipped through the end D rings to make
two loops.
• These slings are used to support the wrist and hand or ankle
and foot.
Head sling
•A head sling 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 parts of
the skull
•in the side lying position leaves the ear free
CLIPS
• Karabiner hooks of 70 mm or 100 mm
provide a convenient alternative means of
clipping two pieces of equipment
together.
TYPES OF SUSPENSION
Vertical fixation
• the rope is fixed so that it hangs vertically above the centre of
gravity of the part to be suspended
• The centre of gravity of each part of the body is, at
the junction of the upper and middle third.
• The point of attachment of the rope is over the center of
gravity of the moving segment.
• The part can then move like a pendulum,
• The movement is small range
• This type is used for support
A, A pendulum;
B, The foot, supported at the
center of gravity of the leg,
acts like a pendulum.
Axial fixation:
• This occurs when all the ropes supporting a part
are attached to one ‘S’ hook
• which is fixed to a point immediately above the
centre of the joint
• The point of attachment of the all the rope
supporting the part is above the axis of the joint
to be moved
• The part will move on a flat plan parallel to
the floor this type of fixation allows for
maximum movement of the joint.
•
Axial suspension
A, 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
B, Axial fixation for adduction and
abduction of the hip (·–·–·–· axial
line, X hip joint).
If some resistance to the muscle
work is required
• The whole fixed point is moved away from the
muscles which require resistance.
• For e.g. If abduction is to be resisted the fixed
point is moved towards the adductors.
• On effort the limb will now rise into abduction
brought about by isotonic shortening of the
abductors, resistance being offered by gravity.
• Slow lowering into the resting position is
controlled by isotonic lengthening of
the abductors
Suspension for the Upper
Extremity
Abduction and Adduction:
Elbow Joint:

Flexion and Extension: •

Suspension for the Lower
Extremity:

The Hip: •
Abduction and Adduction: •
Hip Flexion and Extension:
 The Knee
Flexion and Extension:
The Ankle:
It is rarely necessary to use suspension as in this case it
is easier to perform supported movements by using a
polished board.
 37

Infectious or inflammatory process in a joint. •

AROM & PROM
Patient is on medication for pain or muscle relaxation. •
Precautions
Osteoporosis or fragile bones is a factor. •
In assessing hyper mobile or subluxed joints. •
Painful conditions. •
Haematoma in the region, especially in the elbow, hip •
or knee.
If bony ankylosis is suspected. •
After an injury disrupting soft tissue (tendons, muscles •
or ligaments).
In the region of a newly united fracture. •
After prolonged immobilization of a part. •
(Clarkson, 2000)