Fundamental positions

There are five Fundamental Positions which are usually described with their
derivatives as the starting positions from which exercises start or in which may
be given.

Starting Positions
They are five positions.
1- Lying position.
2-Sitting position.
3- Standing position.
4- Kneeling position.
5- Hanging position.

Selection of the suitable position is depending on the aim required which

may be to:

1 -Utilize support essential for relaxation.

2- Train balance.
3- Achieve adequate fixation, when movement is to be localized to a specific
joint.
4- Modify the effect of an exercise to improve ROM or strength.
5- Maintain or improve posture.

Derived positions

The position of the arms, legs or trunk may be altered in each of the fundamental
positions to modify the effects of the position or that of the exercise.

Objectives:
1- Increase or decrease the size and stability of the base of support of the body.
2- raise or lower the center of gravity (COG).
3- Ensure maximum local or general relaxation.
4- Provide a control or fixation for a particular part of the body to localize
movement to a particular part of the body to localize movements 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 intraarticular adhesions.
8- Avoid respiratory and circulatory complications as pressure ulcers and
pneumonia, DVD.
9- Increase or decrease the leverage.

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Position derived from Standing

1. Wing Standing
The hands rest on the crests of the iliac ,the fingers ,which are extended and
adducted, being anterior and the thumbs posterior. The wrists are extended,
forearms are pronated, elbows flexed and shoulders adducted. The elbow point
straight side ways.

Uses
a- Positions allow the physical therapist to grasp the patient round the shoulder
during some trunk exercise.
b- The fixed position of arm prevents their swinging during trunk exercises.

Figure (1). Wing Standing

2- Stride Standing
The legs are abducted so that the heels are two foot-lengths apart. The feet remain
at the same angle as in the fundamental position and the weight is equally
distributed between them.
Uses
Used as starting easy position for many exercises.

Figure (2). Stride Standing

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3- Walk Standing
One leg is placed directly forwards so that the heels are two-foot length apart
and are on the same line. The body weight is equally distributed between them.
Uses
a- Rotation of the pelvis towards the side of the forward leg is prevented by the
position of the back leg; the position therefore may be used to localize rotation
to the spine.
b- Tension of the hamstrings of the forward leg likewise prevents forward tilting
of the pelvis in the trunk flexion exercises.

Figure (3). Walk Standing

Position derived from Sitting

1- Crook Sitting
When sitting on the floor, the knees are bent so that the feet are together and flat
on the floor. The Knees may be together or apart.
Uses
a- In treatment of kyphosis as the movement can be localized to the upper trunk.
b- Increases the strength of back extensors.

Figure (4). Crook Sitting

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2- Long Sitting
This is similar to the previous position, but the knees are extended so that the
whole leg is supported. Used in stretching of hamstring muscles.

Figure (5). Long Sitting

3- Cross Sitting
This is also similar to crook sitting, but the ankles are crossed and the hips
strongly abducted and laterally rotated, so that the lateral aspect of the knees is
pressed to the floor. Tension on the Hamstrings is reduced but the adductors of
the hip are stretched. For this reason, the position is uncomfortable for most
adults, but suitable for children during head, arm and trunk exercise, as the pelvis
is fixed and stable.

Figure (6). Cross Sitting

4- Side Sitting
For left side sitting the left leg remains as in cross sitting and this hip supports
the main weight of the trunk, while the right leg is abducted and medially rotated
so that the lower leg is bent and to the side. The pelvis is tilted laterally to the
left, and the lumbar side flexors on the right side work to keep the trunk upright.
The position is used to increase lateral mobility of the lumbar spine or for
fixation in the side bend position when treating scoliosis

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Figure (7). Side Sitting
5-High Sitting (short sitting)
The fundamental sitting position is taken on a high plinth or table but the feet
remain unsupported. This is convenient for some foot and knee exercises.

Figure (8). High Sitting

Position derived from Lying

1. Crook lying
From Lying, the hips and knees are bent so that the feet rest on the floor or plinth.
Provided the feet are fixed by friction, very little muscles work is required apart
from that of the abductors and medial rotators of the hips to prevent the knees
from falling apart.
Uses
1- To train relaxation and posture.
2- In pelvic and back exercises.

Figure (9). Crook lying

2- Half crook lying

The same as crook lying with the hip and knee of one side are flexed and the hip
and the knee of the other side are extended.
Uses
a- In relaxation.
b- Straight leg raising exercises to extended leg.

3- Prone Lying
Lying face downwards, the body is fully supported anteriorly on the plinth or
floor. In this case the head is usually turned to one side and rested on the hands
for comfort and ease in breathing, while the heels roll apart. Placing a pillow
under the abdomen and another under the lower leg, so that the hip and knee
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joints are slightly flexed and the feet rest free from pressure may still further
reduce tension.
Uses
a- Used as corrective position for spine.
b- Used for head and shoulders exercise.

N.B. Unsuitable for heart and respiratory disease patients as breathing is so

restrict.

Figure (10). Prone lying

4- Side Lying
The body is lying on the side with the arms by the side and the legs straight.
This position is difficult to assume as the base of support is small and rounded,
some modification is made to make this position suitable for exercise.
- The under arm is bent forward or placed under the head. The upper arm is for
balanced and to prevent trunk rotation.
- The under leg is bent forward (flexed 45degrees at hip and knee) for balance
and increase base of support. The upper leg is extended.

Figure (11). Side lying

Alternatively, the shoulders may be stabilized by support from the upper arm
resting on the ground or plinth in front, the legs being free for movement. When
the under hip and knee are fully flexed the pelvis is relatively well-fixed, so that
movements of flexion and extension can be localized to the hip joint of the
uppermost leg.

Figure (12). Alternate

position for side lying