SlingExerciseTherapy (S-E-T) SET is a general collection of concepts for the application of active treatment and training with the aim of lasting improvement of musculoskeletal disorders. The therapy has active training and rehabilitation as key elements and includes two major systems of diagnosis and treatment. The former consists of muscle endurance measurements by gradually increasing the load of open and closed chain exercises, combined with routine examination of musculoskeletal disorders; the consequences include muscle relaxation, increased joint range of motion, traction, training to stabilize the muscular system, sensorimotor coordination training, open and closed chain exercises, active muscle dynamics training, fitness exercises, group training, individualized home training with long-term follow-up, and computer software to develop and modify exercise programs. computer software for developing and modifying exercise programs.
This concept has been developed in Norway for more than eight years, and the S-E-T technique is used not only in the treatment of skeletal-muscular disorders, but also in the treatment of strokes and other neurological diseases, as well as for the developmental training of children and for healthy physical exercise. It is a very common form of training in rehabilitation. This device and its use can be found in many physical therapy rooms.
I. Suspension training devices
(A) Suspension net frame
This is a very common device. This net frame is simple to install, cheap, generally equipped with suspension rope, suspension belt, pulleys, hooks, etc.. The net frame can be equipped with multiple hanging points, and it is also more convenient to move.
(B) TEMA’s suspension device
TEMA’s suspension devices are equipped with other accessories such as elastic support straps, in addition to the suspended nets, ropes, suspension straps and other accessories. Professional design and rich accessories make the use of this series of products more convenient.
Second, the purpose of suspension training
(A) Remove the motor load
Suspension of the limb, so that the patient in the horizontal direction of movement can be exempt from the role of gravity, to achieve the purpose of load shedding.
(B) provide assistance
The use of elastic suspension rope can provide external force.
(iii) Provide instability support
Suspension belt as a fulcrum is unstable, using this unstable support can carry out the corresponding sports training.
Three, the basic techniques of suspension training
(A) Suspension point
There are mainly five ways to choose the suspension point
1.Suspension point in the movement of the joint above: In this suspension mode, the movement can always be maintained in the horizontal direction of movement, no change in resistance.
2.Suspension point on the distal side of the joint: In this type of suspension, when the movement is on the line between the joint and the suspension point, the height of the limb is the lowest, and the resistance is increasing when moving to both sides, and the return is assisted by the force of gravity. The trajectory of the movement is a concave arc.
3.Suspension point in the proximal side of the movement joint: In this kind of suspension mode, the movement in the joint and the line of suspension point, the limb height is the highest, from both sides to the middle of the movement of increasing resistance, return to the force of gravity to provide assistance. The movement trajectory is convex arc.
4.Suspension point on the outside of the joint: In this type of suspension, the joint moves outward without resistance, and can move outward under the action of gravity, and moves inward with resistance and increasing. The outward motion trajectory is a gradually descending arc.
5.Suspension point in the inner side of the movement joint: In this type of suspension, the joint moves inward without resistance, and can move inward under the action of gravity, and moves outward with resistance and increasing. The outward motion trajectory is a gradually rising arc.
(B) The use of elastic band
Elastic band can be used as an extra boost, but also as a resistance to movement. Depending on the elasticity of the band selected and the degree of stretching when used, the limb can be provided with different sizes of assistance. The same can also provide different sizes of assistance.
(C) Strength step training program
The intensity step training program is a very critical part of exercise training. According to the results of the assessment, what intensity of training is provided to the patient, which is the content of the plan of different steps of intensity. In suspension training, the regulation of the step intensity is carried out mainly through the following ways.
1.Suspension point selection: the position of the suspension point can determine whether the exercise is carried out without resistance, with resistance or with assistance, and different suspension points can change the intensity of the exercise.
2, the suspension and use of elastic band: elastic suspension band can give extra help. The amount of assistance can change the intensity of the movement, or even increase the intensity by applying resistance.
3, the suspension position and suspension height of the limb: suspension belt suspension in the proximal or distal end of the limb, the leverage force is different, can be adjusted by adjusting the position of the suspended limb to adjust the intensity of movement.
4.Sports time: the length of time determines the intensity of sports.
5, the range of movement: the range of movement is closely related to the intensity. The greater the range, the greater the intensity.
6.Simultaneous other movements: When a limb movement is performed, other limbs are required to move at the same time, which can improve the difficulty and intensity of training.
7, the application of resistance: through the artificial or other ways to give the application of resistance, adjust the intensity of the size.
(D) open chain movement and closed chain movement
OpenKineticChain: no weight-bearing or only partial weight-bearing at the distal end; distal free. Open chain exercise mainly trains separate muscles or muscle groups, namely the active and antagonistic muscles.
ClosedKineticChain: distal weight-bearing; distal closure. Closed chain exercise is the simultaneous contraction of the active, fixed, synergistic and antagonistic muscles, mainly in functional training, to improve joint stability and stability of movement.
(v) Weak link
It is a muscle that is too weak and appears to be unable to perform its proper function properly. The function of the muscle as well as the sensorimotor function can be reflected in the open-chain and closed-chain movement patterns. Therefore, the presence of weak links can be determined by performing open-chain and closed-chain motor tests.
The formation of weak links is mainly due to weakness and atrophy of muscles and diminished sensorimotor function.
1, stability: some studies have shown that in the motor system, there are some muscles with some special stabilizing functions to stabilize the joints, these muscles are mainly small muscles distributed around the joints, some people call them “localmuscles” (local muscles) or ” coremuscles” (core muscles). These local muscles are an important source of joint stability and an important guarantee of efficient limb movement. In contrast to the concept of local muscles, the concept of “globalmuscles” (peripheral muscles) has been proposed as the primary function of these muscles for the production of limb movement. Before any limb activity occurs, a “pre-feedback” mechanism causes these local muscles to be excited in advance, providing a stable support and foundation for the upcoming muscle movement. Weak local muscles leading to reduced stability may be the cause of chronic low back pain.
2, sensory-motor function: sensory-motor function is an important feedback regulation mechanism in movement. Any injury to muscles, tendons, etc., disuse, etc., can lead to a decrease in motor sensation, thus making the coordination, stability, efficiency, etc., of movement reduced, and ultimately impairing motor function. With the assistance of S-E-T, the body can allow the muscles to move within a safe range in the early stages of injury and disease, and in the later stages, with the instability support provided by S-E-T, motor closed-chain mode movement can well improve the patient’s impaired sensorimotor function.
3. Limb movements: Limb movements are produced under the action of the so-called peripheral muscles. In paralyzed patients, not only local muscle weakness occurs, but also the reduced function of peripheral muscles is very obvious. Under the suspension of S-E-T, in addition to providing good support for limb movement to compensate for the function of local muscles, it also allows the affected limb to be trained without negative or even external assistance, which can reduce the work intensity of therapists and improve the training effect.
The use of suspension training in clinical practice
Suspension training is a form of exercise therapy, and there are many convenient places for exercise training in suspension. Almost all the open and closed chain movements of the limbs can be done under suspension, and there are multiple levels of load intensity to choose from.
(i) Use for paralyzed patients
This is by far the most widely used area of suspension training in rehabilitation. Due to the neuromuscular damage, the function of paralyzed patients is impaired, not only the function of peripheral muscles is reduced, but also the function of core muscles is reduced, and their function in open and closed chain movements is weakened. In this case, the combination of the nerve promotion technique and the training in the form of suspension can get twice the result with half the effort.
Suspension techniques can also be used to evoke reflexes in patients with central palsy, especially in pediatric cerebral palsy. S-E-T provides suspension accessories that allow cerebral palsy patients to perform reflex elicitation, OT training, etc. on unstable support surfaces, as well as assisted standing and balance training with the aid of suspension devices. It allows the therapist to have more space to assist and induce the patient to train when treating the patient.
(ii) Use for patients with pain
It is now theorized that chronic musculoskeletal disorders will result in reduced local muscle stability, reduced sensorimotor function, muscle atrophy, decreased muscle strength, reduced cardiovascular function, and lead to chronic pain. Some studies have shown that the use of suspension techniques for stability training can be effective in treating low back pain.
There are now evidence-based medical studies showing the definitive efficacy of exercise training for the treatment of non-specific pain. These exercises include relaxation training, active motor training, and S-E-T therapy, which provides a rich variety of training modalities for open and closed chain training to rebuild local muscle stability, strength, and sensorimotor function for the treatment of chronic pain.
In addition, joint release techniques in suspension are also a use of suspension. Joint release in suspension allows the patient to fully relax and facilitates the therapist in performing the manipulation, improving safety and efficacy.
(iii) Use of fracture patients
After the necessary repositioning and fixation, patients with fractures need early movement to maintain and improve function, which is very important for fracture patients and can even determine the success or failure of surgery. With the early use of suspension techniques, patients can be very safely trained with passive or active exercises.