Strength-suspension-hip ABD/ADD (L1)

AIM:

To increase hip abduction/adduction strength using suspension (for paralysed/ very weak muscles)

Impairment:

Loss of strength

Rationale:

Suspension is used to strengthen paralysed/very weak muscles (by eliminating the effect of gravity in the plane of movement and eliminating friction between the limb and the support surface).

Equipment:

  • Adjustable height plinth
  • Pillow
  • Suspension cage
  • Suspension ropes, hooks, slings and plumb line
  • Counter
  • Targets

Key Points:

  • Initial alignment: Patient positioned in supine
  • The plumb line is used to locate the centre of the hip joint (not shown in video)
  • The slings are placed to support the knee and ankle
  • A suspension rope is attached to each sling and fixed on the suspension cage above the centre of the hip joint (axial fixation)
  • Position a target either side of leg to act as a cue for range of movement
  • Ensure movement is in mid-range
  • Ensure limb is well-supported and free to move
  • Ensure patient is given a counter to record repetitions

Common Errors:

  • Therapist uses a fixation point that is not directly above the centre of the joint resulting in pendular movement
  • Therapist positions sling under thigh resulting in knee hyperextension
  • Therapist positions sling under calf resulting in ankle plantarflexion
  • The limb is not clear of the support surface resulting in increased friction

Progression and Variety:

  • Increase amplitude and/or speed of movement
  • Add resistance in mid range (using theraband or springs)