I am pleased to inform you that the list serve has once again provided me
the information I requested.my original question was:
I am in need of information about the silesian belt. I recently advocated
for this suspension system stating that it assisted in initiation of swing and
stabilized in adduction during stance. IU was challenged on my statement and
am in the position of defending my remark. I can find absolutely no articles
discussing the bio mechanics of this form of suspension and am having
difficulty proving my position and. Can anyone help me with this issue? Did I learn
the wrong thing all those years ago
I will first indicate that I was faxed two article both of which indicate
that the the silesian belt can or may 1) control rotation or lateral
displacement 2)assist adductors in swing phase 3)assist abductors in stance phase 4)
aid hip flexors at toe off.
Unfortunately this info. is not available through standard web search
engines. Here is a list of other responses.
1:
Per the NYU “Lower Extremity Prosthetics” manual, page 158, relative to
suspension of an above-the-knee prosthesis, and I quote,
“The primary function of the Silesian bandage is control of socket rotation,
though it is also useful as an aid to socket suspension, lateral stability,
and control of abduction and adduction.”
I do not recall ever seeing anything about helping to initiate swing. Hope
this helps.
Warren R Mays, CPO
2:
I don’t recall any implications that a silesian belt assisted initiation of
swing. I was taught that it was used primarily to control rotation and
secondarily assisted suspension of the prosthesis. NUPOC 1968.
Bill Schumann, CPO
3:
The NYU Lower limb prosthetics manual supports your assertion
with regards to “lateral stability”; however, not with your assertion
with regard to initiating flexion. P217 6. Suspension (1975 REVISION)
Ron Brooks CPO
Shriner’s Hospitals for Children
4:
do not see how it aids in initiating swing but it definitely does aid in
maintaining the limb in adduction. Fitted properly, it is a very good
suspension mode. Usually used for short or weak residiums. I personally like the
Fillauer kit that has everything needed to fit one w/velcro closures. But you
must fit the belt w/Yates clamps then sew the velcro.
5:
Forest,
I would agree that a silesian belt (which got its name from Silesia, Russia)
will help to stabilize the hip and control adduction of a prosthesis, but
would not imagine that it helps to iniate any flexion of the hip joint as the
limb enters swing phase. Because the adductor muscles usually overpower the
abductors of the amputated limb, a silesian belt, in my opinion, is a valuable
tool in providing a secondary form of suspension as well as controlling
adduction of the femur.
Steven Fries, LPO
6:
think this is one of those “obvious” bits of P&O knowledge that may have
never been really researched. The Silesian belt does not in my understanding
produce or stabilize “adduction” during stance. It reduces and stabilizes
against the lateral drifting of the proximal transfemoral socket during stance.
In other words, it reduces lateral gapping, which is a sign of the proximal
socket having lateral thrust. This lateral gapping / thrust results in a
reduced ability of the amputated femur to stabilize and support the torso and
remaining limb in swing, about the axis of the amp. side hip joint.
The Silesian belt, by reducing the lateral drift of the proximal socket,
improves trunk stability and reduces the need for the amputee to lurch his trunk
to the amputated side during amp. side stance. Of course, having the trunk,
hip and amp. femur in a more biomechanincal alignement (ie. femur adducted
about 7 deg.) also improves the ability of this hip joint to generate the
neccessary moments to initiate swing. The action of the hip flexors (iliopsoas,
rectus fem. , etc. muscles) is more in line with the direction of hip flexion
than when the femur is abducted and most likely externally rotated.
Hope this helps,
Markus Saufferer, B,Sc.Kinesiology, C.P.(c)
7:
Forest,
The following is a description of the Silesian bandage or belt from the 1975
NYU prosthetic supplement to the Lower Extremity Manual.
” The Silesian bandage is a light webbing band which encircles the pelvis
and is attached to the socket in such a way that there is very little
restriction of trunk motion. One end is attached to the lateral proximal
aspect of the socket in the region of the trochanter. The other end is
attached the anterior wall of the socket on the vertical midline at ischial
level.
Suspension by Silesian Bandage alone can sometimes be accomplished if the
quadrilateral socket is closely fitted to the individual ……. this helps
control rotation the prosthesis and help with lateral stability.” It does
not help with initiating swing other than being part of the suspension.
If your looking for good info try RECAL or Northwestern University library
services.
Hope this helps,
Carey Glass CPO FAAOP
