1. SUSPENSION THERAPY

2. 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

3. Guthrie Smith

4. --  mesh ---  Fixed point

5. 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

6. 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.

7. 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.

8. 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.

11. 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).

13. 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

15. 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

17. 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.

19. 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

21. Clips Karabiner hooks of 70 mm or 100 mm provide a convenient alternative means of clipping two pieces of equipment together.

23. 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

24. A, A pendulum; B, The foot, supported at the center of gravity of the leg, acts like a pendulum.

26. 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.

27. Axial suspention 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).

28. 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

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