Fundamental & Derived Positions

Objectives

At the end of the lecture, the student will be able to:

• Enumerate the different fundamental positions.

• Mention criteria for selecting specific position.

• Describe derived positions for each fundamental one.

variety of starting or static positions.

• These positions are maintained by static contraction of the muscles which stabilize the joints or by apparatus support.

• Movement can be initiated from a wide

Fundamental & derived Positions are usually described as the starting positions from which exercises start.

Standing, Kneeling, Sitting, Supine Lying and hanging are the Fundamental Positions

Selection of the suitable position is made according to the purpose for which they are required.

They may be used to:1.Provide support essential for relaxation.

2. Train balance.

3. Achieve adequate fixation when movement is to be localized to specific joint.

4. Modify the effect of an exercise to improve ROM or strength.

5. Maintain or improve posture.

SELECTION OF THE STARTING POSITION

The following should be considered:1. The ability of the pt. to assume the position.2. The need to stabilize one segment of the body

to permit safe & efficient movement. .3. The use of gravity for assistance or resistance.4. The presence of pain or discomfort ( the

position should be pain-free to assure relaxation).

5. The use of a short lever arm versus a long lever arm.

DERIVED POSITIONS

Position of the arms, legs or trunk may be altered in the fundamental positions to modify the effects of the position or the exercises.

The purpose for modifications may be to:1. Increase or decrease the size and

stability of the BOS of the body.

2. Raise or lower the center of gravity (COG).

3. Ensure maximum local or general relaxation.

4. Provide fixation for a particular part of the body to localize movement to a specific area.

5. Increase or decrease the muscle work required to maintain the position.

6. Avoid muscle shortening and contractures.

7. Avoid joint stiffness and intra-articular adhesions.

8. Avoid respiratory and circulatory complications as pressure ulcers, pneumonia, DVT.

9. Increase or decrease the leverage.

Supine Lying Position

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LYING (SUPINE OR BACK LYING)

Characteristics:• It is the easiest of the whole positions.

• It is used in the treatment of spinal deformities.

• The body is fully supported with a wide base of support (BOS) & low center of gravity (COG).

• BOS is the supporting area beneath the body . It includes the points of contact with

the supporting surface and the area between them.

• COG is an imaginary point in a body where the total weight of that body may be thought to be concentrated.

DERIVED POSITIONS FROM LYING

1. Prone lying (face lying).

2. Side lying.

3. Crook lying.

Crooke lying

Sitting Position

Sitting Position

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SITTING

• Characteristics:It is a comfortable, natural & very stableposition. The centre of gravity is low but near to the edge of the base of support.

It can be used for non-weight bearing exercises for knees and feet.

DERIVED POSITIONS FROM SITTING

1. Long sitting.2. Half sitting.3. Forward lean sitting.4. Side sitting.

Long Sitting

Side SittingForward Lean Sitting

Kneeling Position

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KNEELING

• Characteristics:This position is unstable & difficult tomaintain as the C.O.G. falls close to the edge of the base, which is the area of the legs only.As there is tendency to hollow the back, this position can be used in flat back.

DERIVED POSITIONS FROM KNEELING

Prone kneeling (cat, quadruped, four foot position)

Kneel sitting

Standing Position

STANDING

• Characteristics:The base of support is very small & theCOG is high.

It can be considered a suitable position for patients who can maintain it correctly.

The perfect balance is achieved from this position.

DERIVED POSITIONS FROM STANDING

Stride Standing Walk standing

Hanging Position

• Description:The body is slightly lifted between the arms without any bending of the elbows.Ankles are plantar flexed.The trunk and legs are straight. The scapuae are drawn down and together.The head is held high and in neutral position.

References• http://www.moondragon.org/images/patientpositionprone1.jpg.• http://www.ilcaustralia.org/images/QLD/2189001a.jpg• http://www.yogastudies.org/wp-content/uploads/crook_lying.jpeg• http://www.ptbuddy.com/wp-content/uploads/2010/08/HW1_OPC_LS0054-

300x200.jpg• http://starfishtherapies.files.wordpress.com/2009/04/side-

sitting1.jpg?w=138&h=150• http://api.ning.com/files/FP-qWL5AxYAINua3zL8yI6XVgPRriA-DMNpx*X9p-

GXfD7LASmCgtH3qKffPUk9e/Diamantsitz2.jpg?width=180&height=433• http://4.bp.blogspot.com/-9-

KxB5KXlTU/TklZoXi6dUI/AAAAAAAAADY/9NhkU5PiSOw/s1600/securedownload-23.jpeg

• http://factoidz.com/images/user/Sedentary%20start(2).jpg• http://chestofbooks.com/health/body/massage/Massage-Original-Swedish-

Movements/images/Fig-40-Walk-Standing.png• http://www.google.com.sa/search?q=base+of+support+define&hl=ar&safe=active

&rlz=1R2ADFA_enSA471&prmd=imvns&ei=781TUK32Haic0QWpu4CIAg&start=20&sa=N&biw=1280&bih=511