Suspension therapy

When do we use suspension therapy?

• active assisted exercises to improve the ROM and muscle strength with minimized friction

• It helps in positioning the patient in a gravity eliminated position (grade 2 )

What are the types of suspension?

static suspension: facilitates standing and walking functions. It decreases the effect of gravity on the lower limb and enables the child to control less body weight

Dynamic suspension - e.g. a suspension walker

Vestibular suspension - hammock

What is a Guthrie smith apparatus/ falcons frame?

What are the benefits of suspension for rom exercises?

• active participation of the patient is required to use the appropriate muscle for desired movement

• Relaxation is promoted through secure support and smooth rhythmic motion

• Little work is required from stabilizing muscles because the part is supported

• Modification can be made to the system to provide grades of exercise resistance

What is the fixed point in suspension therapy?

It is made of stainless steel or plastic covered 5 cm metal mesh around the area of a plinth

It is 2m x 2m x 2m mesh cube (3 sides and a ceiling)

The sides of the frame allows lateral fixed points

What else is required for suspension therapy?

• storage trolley

• Suspension unit

what are the types of non-slippery supporting ropes?

1. A single rope

2. A pulley rope

3. A double rope

Describe single rope:

• a single rope has a ring fixed at one end by which it is hung up, the other end passes through a wooden cleat then through the ring of a dog clip

• The cleat is for altering the length of the rope and should be held horizontally for movement

• The cleat should be pulled obliquely when supporting the rope as it holds on the cleat by friction

• The total length of the rope is 1.5 m further shortening the rope may be brought by knotting the cleat

What is a pulley rope?

a pulley rope has a dog clip attached to one end which then passes over the wheel of a pulley. The rope then passes through the cleat and a second dog clip

The rope is 1.5 m long

This arrangement is used for reciprocal pulley circuits - with one sling supporting a limb and the ends of the sling attached to the 2 dog clips it is used for 3 dimensional movement of a limb

What is a 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

This device gives mechanical advantage

It is used to suspend heavy parts of the body - the pelvis, thorax, or heavy thighs when these are to be supported together

What is an s hook?

what are the types of slings?

• single sling: made of canvas bound with soft webbing and with a D ring at each end, it supports the limbs

• Can be folded in two and as a figure of 8 to support the hand and foot

They measure 68 cm long by 17 cm wide

• double slings: broad (68 cm by 29 cm wide) with D rings at each end to support the pelvis, thorax or thighs together, support the wrist, hand, ankle and foot

• three ring sling: webbing slings (71 cm long by 3-4 cm wide) with 3 D rings one fastened at each end and one free in the middle

• The center ring is for attachment to a dog clip and the webbing is slipped through the end D rings to make 2 loops Which are used to support the wrist and hand or ankle and foot

• Head sling: short, split sling with its two halves stitched together at an angle to create a central sling - allows the head to rest supported at the back under the lower and upper parts of the skill in the side lying position leaving the ear free

Describe the clips used in suspension therapy:

karabiner hooks of 70 mm or 100 mm provide a convenient alternative means of clipping 2 pieces of equipment together

What are the indications of suspension therapy:

• To increase muscle power 2 according to MRC grading

• Any post operative orthopedic conditions

• Spastic limbs -rhythmic movements helps reduce spasticity

• Degenerative joints

• LMNL

• To mobilize joints

• Pressure sores

What are the contraindications of suspension therapy?

• active joint infections

• Skin infections

• Recent fractures

• Shoulder subluxation

What are the advantages?

• more comfortable

• Gravity eliminated

• Friction free technique

• The limb is completely supported And is made weightless

• Provides rhythmic relaxation to the muscle

what are the disadvantages?

• not applicable for smaller joints

• Traction cannot be given

• Cost effective

• Time consuming

• Patient effort is minimised

what is vertical suspension?

• vertical fixation the rope is fixed vertically above the centre of gravity of the part to be suspended

• It is primarily used for providing support and to find the centre of gravity

• Provides general body relaxation and is effective for bed sores

describe axial suspension:

• This provides all the ropes supporting the part attached to a S hook above the centre of the joint

• The part will move of a flat pan parallel to the floor

• This type of fixation allows to increase rom

What are the suspension points of the upper limb?

Joint	Movement	Position of pt.	Point
Shoulder	Flexion & ext.	Side lying	Greater tubercle of the humerus
	Abduction & add.	Supine lying	Acromion process
	Medial & lat. rotation	supine lying with 90* elbow and shoulder flexion	Olecranon process of ulna
Elbow	Flexion & ext.	Side lying	Lateral epicondyle of humerus

What are the suspension points for the lower limb

Joint	Movement	Position of pt.	Point
Hip	Flexion &ext.	Side lying	Greater trochanter
	Abduction & add.	Supine lying	½ inch below the ASIS
	Med.& lateral rotation	Supine with hip & knee flexed 90*	Apex of patella
Knee joint	Flexion & ext.	Side lying	Lateral condyle of femur

Describe pendular suspension?

• increases muscle strength

• The suspension point (s hook) is shifted to the side opposite the muscle action

• The muscle has to take effort to overcome the resistance by the gravitational force due to shifting of the suspension point