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Suspension Therapy - Coggle Diagram

- - - - • In using vertical fixation, the rope is fixed so that it hangs vertically above the center of gravity of the part to be suspended
        
        • Point of suspension is away from the jnt axis
        
        • Centre of gravity of the body part or the body is taken as point of suspension
        
        • The center of gravity of each part of the body is, on the whole, at the junction of the upper and middle third.
        
        • Vertical suspension is used for support as it tends to limit the movement of the part to a small range perpendicular movement on each side of the central resting point.
        
        • It is advisable to carry out an experiment suspending the lower limb, for eg, frm 2 points, the leg frm above the tibia and the thigh from above the femur, and then attempting movement.
        
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    - - Eg: adduction/aBD of the hip jnt
        
        1 Rope supports the foot
        
        Another rope supports the area of the knee
        
        Both ropes are attached to one ‘S’ hook which is fixed to a point immediately above the hip jnt
        
        Suspension for the lower extremity
        
        eg
        Hip flexion & extension
        
        The starting position is side lying with the underneath leg flexed as far as possible.
        .
        
        The fixation points and sling arrangements are as below, with the limb lifted until it is horizontal
        .
        
        If the movement of the 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.
        
        Suspension for the upper extremity
        
        eg:
        Shoulder flexion and extension
        
        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 jnt and the muscles working over it, or movements of the shoulder girdle may be included
    - - Relaxation- eg in rigidity
        
        For ms groups with MMt grade 1 or 2
        
        Improves blood & lymphatic circulation
        
        Axial suspension to provide resistance
        
        Axial suspension to provide resistance
        
        point of suspension is away from the joint axis
        
        ms groups are provided with minimal resistance when movement is done in a direction opposite to where the axis is placed
        
        can be used for concentric & eccentric strengthening of a ms group
        
        to stimulate antigravity movement
        
        to improve ms endurance
- - - - • It is usual to suspend the overhead mesh from the ceiling hoists at a height which will allow about 1,5 M clearance between mesh and plinth top
        
        • Hooks on the side of the frame allow lateral fixed points and can be used to keep the small apparatus near at hand
    - - • Storage of slings and ropes can otherwise be on a wall frame of suitable hooks or on amobile trolley
        • Hooks that have a large & small curve are used.
      - c. Supporting ropes
        
        • Ropes should be of 3 ply hemp- so that they can be of three arrangements
        
        a. A single rope
        
        b. A double rope
        
        c. A 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 ropes then passes through the cleat and a 2nd dog clip as described above.
        .
        • The arrangement is used for reciprocal pulley
        .
        • 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 & medial or lateral rotation (combined, oblique, rotatory movements)
        
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        mesh-S hook- one end of wooden cleat- 1st pulley (which is att to a sling)-other end of wooden cleat- 2nd pulley (which is near the mesh)- passed thru middle of the wooden cleat-knotted
        
        the rope is shortened by pushing the cleat down
        
        2 pulleys- mechanically advantageous
        
        uses- to support heavy parts of the body-pelvis, thorax, thighs
        
        • A single rope has a ring at one end, by which it is hung up
        .
        • The other end if the rope passes through one end of the cleat and is then knotted with a half-hitch knot
        .
        • The cleat is for altering the length of the rope and should be held horizontally for movement and pulled oblique when supported
        ,
        • The rope then ‘holds’ on the cleat by frictional resistance
        ,
        • The dog clip should be on a pivot to allow adjustments in position with minimum discomfort when the slings are attached
        ,
        • The total length of rope required is 1.5 M
        
        mesh-wooden cleat-sling-wooden cleat- knotted
        
        d. Slings
        
        a. Single slings
        
        to support the distal portion of a limb, or to support the hand or foot
        
        • Single slings are made of canvas bound with soft webbing & with a D ring at each end.
        .
        • They used often to support the limbs, or folded in two as a figure of eight to support the hand or forearm.
        .
        • They measure 68 cm long n 17cm wide
        
        b.Double sling
        
        broad slings to support the pelvis or thorax. or thighs together
        
        Double slings are broad slings measuring 68 cm long by 29 cm wide with D rings at each end,
        
        and are used to support the pelvis or thorax or the thighs together, especially when the knees are to be kept straight.
        
        c.Three ring slings
        
        These are webbing slings 71cm long by 3-4 cm wide
        
        have 3 D rings
        
        center ring for attachment to a dig clip & the end D rings to make 2 loops.
        
        These slings are used to support the wrist and hand or ankle & foot.
        
        d. head sling
        
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        e. Clips
        
        • karabiner hooks of 70 mm or 100 mm provide a convenient alternative means of clipping 2 pieces of equipment together.
        
        • Dog clip
        
        f.wooden cleat
        
        horizontal orientation
        
        for changing the length of the rope
        
        oblique orientation
        
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        g. knots
        
        2 techniques to fasten a knot