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Suspension Therapy of upper and lower limb

KINESIOLOGY 2 CREDIT H. 3
SUSPENSION FOR THE LOWER EXTREMITY

The Hip
Abduction and Adduction
 The starting position is lying with the opposite
leg abducted to its limit

 The fixation point is immediately above the hip


joint
ABDUCTION AND ADDUCTION OF HIP

 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

 May be utilized for the mobility or facilitation of


abduction and adduction or resistance can be
given manually of by shifting the point of
fixation
THE HIP FOR ABDUCTION & ADDUCTION
HIP FLEXION EXTENSION

 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.
HIP FLEXION EXTENSION

 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
FLEXION AND EXTENSION OF HIP

 .
FLEXION AND EXTENSION OF KNEE

 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.
KNEE FLEXION AND EXTENSION

 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
KNEE FLEXION 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.
SUSPENSION FOR UPPER EXTREMITY

The shoulder joint


ABDUCTION & ADDUCTION
 The starting position is lying, quarter turned
towards the arm which is to be moved
 This allows the normal anatomical movement
to be performed in the plane of the scapula.
ABDUCTION & ADDUCTION OF SHOULDER

 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 The advantage of prone
lying is that the therapist can see the
movements of the scapula as well as those of
the arm
ABDUCTION & ADDUCTION OF SHOULDER

 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.

 Glenohumeral rhythm may be re-educated and


all the muscles performing shoulder girdle
movements may be worked.
ABDUCTION & ADDUCTION OF SHOULDER
FLEXION & EXTENSION OF SHOULDER
 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.
SHOULDER EXTERNAL ROTATION & INTERNAL
ROTATION
 If 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
FLEXION AND EXTENSION OF ELBOW
 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.
 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
FLEXION AND EXTENSION OF ELBOW
FLEXION AND EXTENSION OF WRIST

 This is more usually and conveniently


performed on a polished board or table.
FLEXION AND EXTENSION OF ARM

 As a functional movement this may be


performed with the patient in the sitting
position, e.g. practising taking the hand to the
mouth may be done by using two single slings
attached to two single pulley rope circuits.
FLEXION AND EXTENSION OF ARM

 One sling is placed round the arm and one


round the forearm. If the ropes are sufficiently
tightened the patient can grasp, supinate and
flex the elbow and shoulder while adducting
and laterally rotating

 Utilized for patients having problem in


performing personal feeding, turning pages of
book at eye level
REVIEW
 Suspension for the lower extremity
 Abduction and adduction of hip
 Flexion and extension of hip
 Flexion and extension of knee
 The ankle
 Abduction and adduction of shoulder
 Flexion and extension of shoulder
 Shoulder internal and external rotation
 Flexion and extension of elbow
 Flexion and extension of wrist
 Flexion and extension of arm

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