Suspension therapy involves hanging body parts using slings and ropes attached to fixed points above the body. This allows patients to move weak body parts in an active-assisted manner without therapist assistance. Suspension therapy uses various slings and ropes connected to fixed overhead points to support and move different joints. It provides benefits such as promoting relaxation, reducing resistance to movement, and allowing patients to work independently after instruction.

1. CHAPTER- 5
SUSPENSION
THERAPY

2. CHAPTER: 5 SUSPENSION THERAPY
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SUSPENSION THERAPY
INTRODUCTION
Suspension therapy is a part of Therapeutic exercise. When patient want to move his/her
weak body part in ‘active-assisted’ way, without help of Therapist only then ‘Suspension
procedure’ helps them. Suspension therapy is very helpful for spinal cord injured patient.
The term ‘Suspension’ means hanging the body part by rope & sling.
Definition:
Suspension means a part of the body are suspended (Hanged) in ‘slings’ & elevated by the
‘ropes’, which is fixed to a ‘point’ above the body.
Basically suspension frees the body from the friction of the material upon which body
component may be resting. (TEFT)
Making the body suspended, need two things. They are ‘A fixed point’ & ‘A Suspension unit’
 A fixed point: The fixed point depends on the type of suspension therapy & the
body part.
 A Suspension unit: A suspension contains two things.
They are:
1. Sling
2. Adjustable rope
The fixed point
In the suspension bed three metal
meshes are used at the above, side &
head of the plinth. Fore example: 1m
or 2m wide × 2m long at above the
plinth. Perhaps 2m ×2m on the wall
at the side of the plinth, & at the head
of the plinth 1 m or 2m × 2m long &
2m high metal meshes are used for ‘a
fixed point’
(Hollis,M & Cook,P.F ,p 96)

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The Clip:
Clip may be small part but it has a vital role in suspension. Clip is used to attach the rope &
sling to the fixed point. There are two type of clip are used in suspension therapy. These are:
1. Dog clip
2. Karabiner clip
Picture of clip
Figure: The first one is ‘Dog clip’ & second one is ‘Karabiner clip’
The Suspension unit
The Sling:
There are different types of sling are used in Suspension Therapy. Each sling has its own
purpose. The slings are given below:
1. Single sling: It is a long sling with ‘D’ ring at each end. Single sling is 68cm long &
17cm wide. Single sling is used in different ways.
2. Double sling: This type of sling is used to support pelvis, thorax or thigh. The double
sling is 68cm long & 29cm wide.
3. Three ring sling: This type of sling is used to support the wrist & hand or ankle &
foot. Three ring slings are 71cm long & 3-4cm wide. It has three ‘D’ rings. Two ‘D’ rings
are attached at each end & one ‘D’ ring is free in the middle.
4. 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 & upper parts of the skull, or in the side lying position leaves the ear free.
Skilful tilting of the sling when it is applied in side lying will arrange it so that the front
ring lies at the level of the forehead & not over the eyes & nose, with the other half lying
below the occiput.

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Figure: A: Single sling, B: Double sling, C: Three ring sling, D: Head sling
Use of single sling
Use of three ring sling

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Use of double sling
Use of head sling

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The Suspension Rope/ Supporting rope:
The Suspension rope should be of 3-ply hemp so that they will not slip. The suspension rope
can be arranged in there ways.
1. Single rope: One ring is fixed at the one end of the rope, by which it is hung up. The
other end of the rope passes through one end of the wooden cleat & through a ring of
‘Dog clip’ & through the other end of wooden cleat.
2. Pulley rope: A ‘Dog clip’ attached to one end of the rope, then passes over the wheel of
a pulley. The rope then pass through the one end of ‘wooden cleat’, then passes through
the second ‘Dog clip’ & finally the other end of rope attached at the other end of
‘wooden cleat’. The two ‘dog clips’ are attached to the ring of sling. The pulley rope is
used for three dimensional movements of limb (Abduction or adduction with flexion or
extension, combined, oblique or rotator movement).
3. Double rope: In the double rope, one end fixed in a ring by which the rope is hung up
then goes through one end of wooden cleat then through the wheel of one pulley then
through another end of wooden cleat then through wheel of another pulley & finally
goes downwards & attached with wooden cleat. This type of rope is used to suspend
heavy part of body such as Pelvis, thorax.
[Single Rope] [Pulley Rope] [Double Rope]

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TYPE OF SUSPENSION THERAPY
Basically two types of suspension procedures are used in suspension
therapy. They are:
1. Vertical fixation:
The rope is fixed vertically over the center of gravity (COG) of
the moving segment (Body part). The part can then move like a
pendulum, describing an arc. Usually the movement is small
range, so this type of suspension is primarily used for support.
(Therapeutic exercise foundation & technique)
2. Axial fixation:
Here the point of attachment of all ropes, supporting the body
pat is above the axis of the joint to be moved. The part will move
on a flat plane parallel to the floor. This type of fixation always
used for maximum movement of the joint.
(Therapeutic exercise foundation & technique)

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Suspension procedure for upper extremity
Shoulder abduction & adduction:
 Position: Supine lying
 Type of Suspension: Axial Fixation
 Sling:
1. One single sling
2. One three ring sling
 Rope:
1. One single rope
 Procedure:
1. Fixed point is selected at the above of the axis of
shoulder abduction & adduction
2. Single sling is used for supporting the elbow joint
3. Three ring sling is used for supporting the wrist joint
4. A single rope start from fixed point & attached to the both single sling & three ring
sling
Elbow flexion & extension:
 Position: Sitting
 Type of Suspension: Both Vertical & Axial Fixation
 Sling:
1. One single sling
2. One three ring sling
 Rope:
1. Two single rope
 Procedure:
1. One Fixed point is selected at the above of the axis of
Elbow flexion & extension
2. Another fixed point is just above the mid point of arm
3. Single sling is used for supporting the arm
4. Three ring sling is used for supporting the wrist joint
5. One single rope is used to hang the arm & attached to the single sling
6. Another single rope is used to hang the wrist & attached to the three ring sling.

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Suspension procedure for lower extremity
Hip abduction & adduction:
 Position: Supine lying
 Type of Suspension: Axial Fixation
 Sling:
1. One single sling
2. One three ring sling
 Rope:
1. One single rope
 Procedure:
1. Fixed point is selected at the above of the axis of
Hip abduction & adduction
2. Single sling is used for supporting the knee joint
3. Three ring sling is used for supporting the ankle joint
4. A single rope start from fixed point & attached to the both single sling & three ring
sling
Hip flexion & extension:
 Position: Side lying
 Type of Suspension: Axial Fixation
 Sling:
1. One single sling
2. One three ring sling
 Rope:
1. One single rope
 Procedure:
1. Fixed point is selected at the above of the axis of Hip flexion & extension
2. Single sling is used for supporting the knee joint
3. Three ring sling is used for supporting the ankle joint
4. A single rope start from fixed point & attached to the both single sling & three ring
sling

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Knee flexion extension:
 Position: Side lying
 Type of Suspension: Axial Fixation
 Sling:
1. One three ring sling
 Rope:
1. One single rope
 Procedure:
1. Fixed point is selected at the above of the axis of knee flexion & extension
2. Three ring sling is used for supporting the ankle joint
3. A single rope start from fixed point & attached to the three ring sling
BENEFITS OF SUSPENSION THERAPY
 Patient can actively use the particular muscle for particular movement
 For secure support relaxation can promoted
 As the part is suspended so little work is required for stabilizing muscles
 Reduce the friction resistance during the movement
 Patient can work independently after the instruction of the therapist.
(Therapeutic exercise foundation & technique)

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Study question:
1. Define suspension therapy. Write down the component of suspension therapy.
2. What is suspension unit?
3. Write down the measurement of fixed pint.
4. Write down the type of clip used in suspension therapy with picture
5. How many types of slings are used in suspension therapy? Describe them with
picture
6. Draw & level the use of single sling & three ring sling
7. What is suspension rope? Who many type of them? Draw & level of them
8. How many type of suspension therapy? Write down their benefits
9. Describe the types of suspension therapy with picture
10. Write down the procedure of suspension therapy in shoulder abduction &
adduction
11. Write down the procedure of suspension therapy in elbow flexion & extension
12. Write down the procedure of suspension therapy in hip abduction & adduction
13. Write down the procedure of suspension therapy in hip flexion & extension
14. Write down the procedure of suspension therapy in knee flexion & extension