Application of suspension systems with rigid elastic elements in the physical rehabilitation of patients with amputation defects of the lower extremities

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BACKGROUND: Exercise on suspension systems (gravitational neuromuscular activation) is a highly effective means of physical rehabilitation for patients with various pathologies. Modernization of these products through the use of rigid elastic slings or equipping standard simulators with elastic elements expands the capabilities of this type of equipment, allows you to master new types of exercises, positively affecting the strength, tone and endurance of muscle groups.

AIMS: to study the impact of the inclusion of suspension systems with rigid elastic elements (slings) in physical rehabilitation programs for patients with amputation stumps at the hip level.

MATERIAL AND METHODS: Twelve patients were tested before and after repeated prosthetics in the conditions of the FB MSE Clinic, which, due to the use of suspension systems, including elastic elements, not only increased strength, endurance and coordination relationships of muscles, but also changed the structure of their walking. The active part of the course of physical rehabilitation with the inclusion of suspension systems with elastic elements was less than two weeks. Setting the patient the task of increasing the speed of movement on the prosthesis in the long term, in the near future we focused exclusively on the correctness of the step structure and subjective sensations.

RESULTS: The technical improvement of suspension systems due to elastic elements increases the convenience of their use, the speed of mastering by patients and the degree of efficiency, determining a high percentage of achieving the planned result. Inclusion in the course of training on the simulator with the use of elastic slings allows the patient to master and confidently perform various complexly coordinated movements, including squats, to participate in new types of game activities, which contributes to an increase in his adaptation and socialization in society. Subjectively, patients note greater strength of muscle groups that have undergone additional stress on these systems, improved coordination of movements and endurance when walking on a prosthesis as a whole, as well as a sense of "correctness" of walking, which is confirmed by clinical examination methods and the results of biomechanical tests (increased pace and speed of walking with a decrease in the duration of the step cycle).

CONCLUSIONS: Suspension systems are most useful for the prevention and elimination of atrophy of the muscles that support the movement of the pelvic girdle, in comparison with conventional dynamic training and walking on a prosthesis. Modifications of suspension systems by including elastic elements in them allow functional training not only using static, but also dynamic exercises, expanding their application possibilities in medical and complex rehabilitation, adaptive physical culture and adaptive sports.

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About the authors

Denis D. Bolotov

Federal Bureau of Medico-Social Examination; Russian Medical Academy of Continuing Professional Education

Author for correspondence.
ORCID iD: 0000-0003-1320-0960
SPIN-code: 8846-6802

MD, Cand. Sci. (Med.), Associated Professor

Russian Federation, Moscow; Moscow

Sergey M. Starikov

Medical Institute of Continuing Education of the Moscow State University of Food Production

ORCID iD: 0000-0003-4915-6164

MD, Cand. Sci. (Med.), Associated Professor

Russian Federation, Moscow

Yana N. Zakharova

Federal Bureau of Medico-Social Examination

ORCID iD: 0000-0003-3345-0828
Russian Federation, Moscow


  1. Valerius KP, Koster BK, Frank A. Muscles. Anatomy. Movements. Testing. Translated from English. Ed. by M.B. Tsikunov. Moscow: Practical Medicine; 2015. 432 p. (In Russ).
  2. Myers TV. Anatomical trains. Churchill Levingstone Publishing House; 2018. 272 р. (In Russ).
  3. Yanda V. Functional diagnosis of muscles. Moscow: Eksmo; 2010. 352 p. (In Russ).
  4. Kirkesola G. Neurac: a new treatment method for chronic musculoskeletal pain. Fysiotherapeuten. 2009;76(12):16–25.
  5. Liu H, Yao K, Zhang J, et al. Sling exercise therapy for chronic low-back pain (Protocol). The Cochrane Library. 2013;9:CD010689. doi: 10.1002/14651858.CD010689
  6. Eom MY, Chung SH, Ko TS. Effects of bridging exercise on different support surfaces on the transverse abdominis. J Physical Therapy Science. 2013;25(10):1343–1346. doi: 10.1589/jpts.25.1343
  7. Huang JS, Pietrosimone BP, Ingersoll CD, et al. Sling exercise and traditional warmup have similar effects on the velocity and accuracy of throwing. J Strength Conditioning Res. 2011;25(6):1673–1679. doi: 10.1519/JSC.0b013e3181da7845
  8. Kim JH, Kim YE, Bae SH, Kim KY. The effect of the neurac sling exercise on postural balance adjustment and muscular response patterns in chronic low back pain patients. J Physical Therapy Sci. 2013;25(8):1015–1019. doi: 10.1589/jpts.25.1015
  9. Kuszewski M, Gnat R, Saulicz М. Stability training of the lumbopelvohip complex influence stiffness of the hamstrings: a preliminary study. Scand J Med Sci Sports. 2009;19(2):2606. doi: 10.1111/j.1600-0838.2008.00793.x
  10. Kline JB, Krauss JR, Maher SF, Qu X. Core strength training using a combination of home exercises and a dynamic sling system for the management of low back pain in preprofessional ballet dancers. J Dance Med Sci. 2013;17(1):2433. doi: 10.12678/1089-313x.17.1.24
  11. Saeterbakken AH, van Den Tillaar R, Seiler S. Effect of core stability training on throwing velocity in female handball players. J Strength Conditioning Res. 2011;25(3):712–718. doi: 10.1519/JSC.0b013e3181cc227e
  12. Pedersen JI, Magnussen R, Kuffel E, Seiler S. Sling exercise training improves balance, kicking velocity and torso stabilization strength in elite soccer players. Med Sci Sports Exercise. 2006;38(5):243. doi: 10.1249/00005768-200605001-01072
  13. Liga Priedena. Sling therapy for the treatment of pain. Hospital Newspaper. An informative publication of liepajas regional slimnica LLC. 2013;(42):2. (In Russ).
  14. Istomin AG, Lutsenko EV. Modification of sports suspension systems for use in the rehabilitation process. Injury. 2016;17(2):6–10. (In Russ).
  15. Solodyanin EE, Burmistrov AL, Bondareva EA, Mozol VV. Neuromuscular activation using pendant systems inpatient rehabilitation. Medical News. 2014;(11):53–55. (In Russ).
  16. Vitenson AS. Patterns of normal and pathological walking of a person. Moscow: Zerkalo-M; 1998. 271 p. (In Russ).
  17. Vitenson AS, Ivanov AM, Gritsenko GP, Petrushanskaya KA. Rehabilitation of disabled people with a thigh stump through programmed electrical stimulation of muscles when walking. Moscow: Zerkalo-M; 2001. 176 p. (In Russ).

Supplementary files

Supplementary Files
1. Fig. 1. Practicing squats with the use of elastic slings by a patient with post-traumatic amputation of the left lower limb at the level of the middle third of the thigh with a uniaxial hydraulic knee module that allows you to control the phases of transfer and support.

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2. Fig. 2. The possibility of performing a movement that is qualitatively new for this patient — squats — under the complicated conditions of using the Bosu balancing platform. Side view.

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