Suspension Therapy

suspension therapy frame


Suspension therapy is a special technique of therapeutic exercise in which a part or all of the body is suspended in the air by ropes and slings attached to a fixed point above. That is given to patients to increase ROM, increase muscle power, and support body parts by using ropes and slings.

Suspension frees the body from the friction of material upon which the body components may be resting and it permits free movement without resistance. Late Mrs. Guthrie Smith invented the suspension apparatus.

Principles of Suspension Therapy

It is working under the principle  of-

  • Friction
  • Pendulum
  • Eliminating gravity movement

A) Friction-

It occurs during a particular surface moves on another. In suspension friction is less, therefore causing smooth and easy movement.

B) Pendulum-

  • Pendulum is heavy material suspended by a weightless thread. when force is applied to the pendulum it results in to and fro movement.
  • In the human body, pendular motion occurs mainly in the shoulder and hip joints, forward leg movements arm swings while walking.

Uses– To maintain the muscle property, increase the range of movement, and strengthen muscles.

C) Eliminating gravity movement-

The patient should at least have muscle power 2 for suspension therapy exercise.

Parts of Suspension Therapy

1)Fixed point- suspension frame

2) Supporting ropes

  • Single rope
  • Double rope
  • Pulley rope

3)  Sling

  • Single sling
  • Double sling
  • Three-ring sling
  • Head sling

4) Wooden cleat

5) Dog clip, S hook

1) Suspension frame-

  • It is made of stainless steel or plastic-coated steel.
  • In the top and head-end side presents the 5-centimeter metal mesh, and the remaining sides are kept open.

2) Supporting rope-

Three varieties of supporting ropes are used for the suspension to avoid slipping.

  • Single rope
  • Double rope
  • Pulley rope

a) Single rope

  • It has a ring fixed at one end by which it is hung up.
  • The other end of the rope then passes through one end of the wooden cleat through the ring of a dog clip and the other end of the cleat and then knotted.

b) Pulley rope

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

c) Double rope

  • Consists of two pulleys at upper and lower attachments.
  • So here there is a mechanical advantage of 2.

3) Slings

four varieties of slings are available-

  • Single sling
  • Double sling
  • Three-ring sling
  • Head sling

a) Single sling

  • Made of canvas bound with soft webbing and with a D ring at each end.
  • Size- 68cm length and 17cm width.
  • Used for elbow and knee
  • Some time folded in the figure of 8 manner to support the wrist and ankle.

b) Double sling

  • Bigger than a single sling
  • It will have more than two sides with the D- rings.
  • Used to support bigger parts like thorax, trunk, and thigh.
  • Size- 68cm long and 29cm width.

c) Three-ring sling

  • 75cm in length, 3-4cm in width, consisting of 3 D rings.
  • Two D rings at both the end of the sling and one in the middle kept moving.
  • Used for wrist and ankle region.

d) Head sling

  • This is a short, split sling with its two halves stitched together at an angle to create a central slit.
  • It is used for head support in the middle of the sling present a slit for the accommodation of the occipital region while in supine or lower ear accommodation while in side-lying.

4) Wooden cleat

  • It’s made of wood and is used for altering the rope.
  • It has two or three holes for the rope passage.
  • The rope itself holds the cleat by friction resistance.

5) Dog clip/ S hook

  • Used to attach the supporting rope with mesh
  • To attach the sling with a supporting rope.

Types of Suspension Therapy

  1. Axial suspension
  2. Vertical suspension
  3. Pendular suspension

1)Axial suspension

  • Joint axis is taken as the point of the suspension
  • The limb is supported by the slings above the axis of the joint.
  • If the movement is initiated the limb is moved on both sides.
  • The part moves parallel to the floor.


  1. Relaxation
  2. Maintain muscular property
  3. To Increase the blood circulation
  4. Increase the venous drainage
  5. Increase the lymphatic drainage

2) Vertical suspension

  • COG of the body part or the body is taken as a point of suspension.
  • Used to provide support to the body part of the patients.


  1. To support the body part
  2. To reduce the pressure sore.

3) Pendular suspension

  • The point of suspension should be shifted away from the joint axis.
  • Movement usually takes place against gravity.
  • Muscle will be getting resistance while moving if the axis is shifted opposite to that movement.


  1. To strengthen the muscle.
  2. To increase the muscle power
  3. Increase endurance.

Advantages of Suspension Therapy

  • It reduces the burden for the therapist.
  • Easy to lift the limb.
  • Active movement can be performed easily with minimum friction.
  • Easier to maintain the position of the limbs with slings and pulleys in the required position.

Disadvantage of Suspension Therapy

  • Quite complex and not always the first choice for beginners to resistance training.
  • Required a lot of materials like slings, ropes, and pulleys.

Indications of Suspension Therapy

  • Spinal cord injuries.
  • Hemiplegia.
  • Post-operative muscle weakness.

Contraindications of Suspension Therapy

  • Head injury
  • Fracture
  • Spinal cord injury
  • Circulatory disorder etc.

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