SUSPENSION THERAPY

History
• 20th century- sling table

• Guthrie smith frame

• BJL frame

• Employs mechanical
principles combined
with principles of
therapeutic exercise.
 Definition
• Suspension is the means whereby parts of the
body are supported in slings and elevated by the
use of variable length ropes fixed to a point
above the body

• Effects of gravity and friction upon motion have

been modified or eliminated.
PRINCIPLE

• Gravity

• Friction

• Active assistance

• Resistance
Suspension unit
 The Fixed Point.
• Stainless steel or plastic covered 5 cm metal
mesh around the area of a plinth, i.e. 1 m or 2 m
wide × 2 m long above it, perhaps 2 m × 2 m on
the wall at the side of the plinth, and at the head
of the plinth 1 m or 2 m × 2 m long and 2 m high
 Supporting Ropes
• Ropes should be of 3-ply hemp so that they will
not slip, and they can be of three arrangements:
a single rope, a pulley rope or a double rope.

• 1. Single rope

• 2. Double rope

• 3. Pulley 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, through the ring of a dog clip and
through the other end of the cleat andis then knotted with
a half-hitch. 1.5m long
 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
 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,
round a pulley wheel at the lower end, to the case of
which is attached 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
 Slings
• Single Slings
– Single slings are made of canvas bound with soft
webbing and with a D ring at each end. They are
used open to support the limbs, or folded in two
and as a figure of eight to support the hand or
foot.

– They measure 68 cm long by 17 cm wide.

• Double Slings
• Double slings are broad slings measuring 68 cm
long by 29 cm wide with D rings at each end.
• 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, or in the side lying position leaves the ear
free.
• Three ring slings are webbing slings
71 cm long by 3–4 cm wide with three
D rings, one fastened at each end and
one free in the middle.
Wooden
Cleat
Dog Clip / S
Hook
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.

• Limits the movement of the part to a

small-range pendular movement on each
side of the central resting point

• Used to support proximal part of limb

while distal part is moving.
• Axial Fixation
• 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 which is to be moved
• e.g. if the lower limb is to be
moved at the hip joint, two ropes,
one to the foot and one to the
area of the knee, will be used
and fixed at a point immediately
over the axis of the hip joint.
• If some resistance to the muscle work is required, then
the whole fixed point is moved away from the muscles
which require resistance.

• If abduction is to be resisted the fixed point is moved

towards the adductors and the limb then falls towards
that side, i.e. into adduction.
Advantages
Uses
 Suspension Exercises
Lower Extremity Upper Extremity

Hip Shoulder

Knee Elbow

Ankle Wrist
HIP- Abduction and
Adduction

Starting positon- Supine lying

opposite leg abducted

Fixation point- Directly above the hip

join(ASIS)

One sling on the thigh and one three

ring sling on the foot and ankle
Hip- Flexion and Extension
Starting positon- Side lying opposite
leg flexed at knee

Fixation point- Directly above the hip

join(Greater trochander)

One sling on the thigh and one three

ring sling on the foot and ankle
The Knee- Flexion and
Extension
Starting positon- Side lying with one
or two pillows between the slightly
flexed thighs.

Fixation point- Directly above Knee

joint

One three ring sling on the foot and

ankle

Vertical suspension can be put on

thigh.
 The Shoulder Joint-
Abduction and Adduction
Starting positon- lying, quarter turned
towards the arm which is to be moved

Fixation point- Directly over the

shoulder joint

One single sling on elbow.

One to a three-ring sling

applied to the wrist and hand
The Shoulder Joint- Flexion
and Extension
Starting positon- Side lying

Fixation point- Directly over the

shoulder joint

One single sling on elbow.

One to a three-ring sling

applied to the wrist and hand
Elbow- Flexion and
Extension
Starting positon- Sitting

Fixation point- Directly over the lateral

tubercle of elbow

One single sling on elbow.

One to a three-ring sling

applied to the wrist and hand
 SUMMARY
• Suspension therapy- Frees the body by hanging the
body parts

• Principles- Gravity, friction, Assistance and Resistance

• Types- Axial, Vertical

• Uses- Muscle reeducation, strengthening, Relaxation

etc.
Questions?