Fundamental and derived

Positions

Dr. Taher Salah El-Din

 Objectives

1- Define The fundamental and derived Positions

2- Enumerate the Classification of fundamental and
derived Positions
3-Identify the principles of each fundamental and derived
Positions
4- Report the aims of fundamental and derived Positions.
5- Justify, and proper importance of fundamental and derived
Positions.
6- Formulate the Prerequisites For each fundamental and
derived Positions
7- Utilize the best position for diagnosis and treatment.
8-Performance of each fundamental and derived 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.
Derived Positions
 Derived positions are positions used by modification of
the arms, legs or trunk in each of fundamental position.
The aims of derived positions are:
1- To increase or decrease the base of support.
2- To rise or lower the center of gravity (COG).
3- To gain local or general relaxation.
4- To gain fixation and good control of specific area.
5- To increase or decrease the muscle work required to
maintain the position.
6- To increase or decrease the leverage.
 1- LYING (supine lying)
 This is the easiest
position as the body
can completely
supported in the
supine position and
as stable as possible.
 The body lies stretched out upon a
horizontal surface, arms to the sides and
legs straight with muscles relaxed. There is
actually no real muscle work necessary for
maintaining this position. The body is
most supported with large base and low
centre of gravity.
 This position is Used:
 For weak patients.

 For small children, because they often do not understand how to

maintain other starting positions
 it is suitable for many exercises.
 Frequantly for massage.
Positions Derived From Lying.
 1- Side Lying
 An ideal position for
relaxation for many people
is provided by adapting.
Three pillows are required,
one for the head, one for
the uppermost arm and one
to support leg which is
bent.
 Used in sling exercises.
Sling exercise
2-Prone Lying
 Uses:
 Unsuitable for heart and respiratory
diseased patients as breathing is so restrict.
 May be comfortable for young and slim
people.
 3- Half Lying
The trunk is supported in the oblique position by
inclination of the long end of the plinth, or by
the arrangements of the pillows.
 Effect:
The knees may be bent to
increase relaxation of the
abdominal wall.
 Uses:
1- It is much used forward exercises.
2- Relaxed and comfortable position
for weak and elderly people.
3- Breathing is easier than in lying, so
it is used in many chest conditions.
4- Crook Lying
 From lying, the hip and knees are bent so that the
feet rest on the floor or plinth. Very little muscle
work is required Tension is removed from the
structure anterior to the hip joint so that the pelvis
rolls backward and the lumbar spine is relaxed on
to the supporting surface.
 Uses:
1- To train relaxation and posture.
2- In pelvic and back exercises.
2- Sitting position

It is taken on a chair. In this position the body rests

chiefly on the tuberosities of the ischium bones, but
the back of the thighs should also be supported and
the feet should rest upon the floor. The hip, knee, and
ankle joints should all form right angles. The knees
should be slightly apart so that the position of the legs
is easy. The working muscles for maintaining the
position are principally the neck, back, and posterior
shoulder muscles. Your weight should be evenly
distributed on both buttocks.
 Effects And Uses
1. General steadiness in this position is
considerably greater, because : -
(a) The base is larger;
(b) The center of gravity lies nearer the base;
2. The pelvis is also firmer, because it rests on
the supporting surface.
3. The leg muscles work little.
Positions Derived From Sitting:
1- Long Sitting

 This is similar to the

previous position, but the
knees are extended so
that the whole leg is
supported.
 Effect:
 It leads to increase
tension of hamstring.
 Uses:
 Position is difficult due to
instability.
 2- Cross Sitting
 This is also similar to long 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 hamstring
muscle is reduced but the
adductors of the hip are stretched.
3- High Sitting
 The fundamental sitting position
is taken on a high plinth or table
but the feet remain unsupported.
 Uses:
 It is convenient some foot and
knee exercise.
 3- Standing Position
1- The heels are on ground with angle not exceed 45°.
2- Keep your knee straight but not locked.
3- The hips are in extension and slightly rotated laterally.
4- The pelvic is balanced on the femoral head.
5- The spine is stretched to its maximum length
6- The head is hold up straight with chin in. do not tilt your
head forward, backward, or sideways.
7- Keep your shoulder back.
8- The arms are hanged loosely to the sides, palms facing sides
of the body.
9- Your weight should be evenly distributed on both legs.
 Effects And Uses
 The chest is expanded (the shoulders being
drawn back and the spine extended).
 The internal organs have ample space, so that
they are not hampered in their functions by
undue pressure.
 The position is not steady partly, because the
base is small, because the centre of gravity lies so
high above the base (centre of gravity lies
between third and fourth sacral vertebrae).
 It is used as starting position for a number of
free-standing exercises.
Positions Derived From The Standing
Position
1- Toe standing
The heels are pressed together
and raised from the floor.
 Effect:
The base is reduced and the
center of gravity is raised.
 Uses:
1- It is used as a balance position.
2- There is a tendency for the whole
body to stretch so it is used as
treatment.
2- Stride standing
 The legs are abducted and the
heels are apart and remain in 45°.
 Effect:
 Large base lead to easy and stable
position.
 Uses:
 Used as starting easy position for
many exercises.
 3- Walk standing
One leg is placed forward to the same line of
the other leg.
Effect:
The base is much enlarged in the antro-
posterior direction stabilizing the body for
exercises in a sagittal plane. Rotation of the
pelvis towards the side of the forward leg is
prevented by the position of the back leg.
Uses:
1- Localize rotation of the spine.
2- Tension on of the forward leg prevents
forward tilting of the pelvis in trunk flexion
exercises.
 4- Half standing
The whole weight of the body is supported
on one leg, the other may be free or
supported in a variety of the positions.
Effects:
Balance is very difficult with one leg. The
free leg can rest in many positions like stool
with flexed hip and knee.
Uses in:
Increase tension of the hamstring of the
lower leg and straightening of the lumbar
spine.
4- KNEELING
 The body is supported
on the knees which
may be together or
slightly apart.
 1- The lower leg rests
on the floor with the
feet planter flexed.
 2- The feet may be in the
mid position over the edge
of the plinth.
 Effect: uncomfortable
position for most people
due to difficult balance.
 Uses: as starting position
for backward
movements.
Positions Derived From The kneeling
Position:
 1- Half Kneeling

 One knee supports most of the

weight and other leg is bent to
a right angle at hip, knee and
ankle so that the foot is
supported on the ground in a
forward direction.
2- Kneel Sitting
 The knees and hips are
flexed so that patient
sits on his heels.
 Uses:
 Sometimes used for
small children, but
most people find it
very uncomfortable.
3- Prone Kneeling
The trunk is horizontal, supported under the
shoulders by the arms, and at the pelvis by the
thighs, which must be held vertical. The head is held
in line with the trunk.
 Effect and Uses:
The position is stable, comfortable and suitable for
many trunk and head exercises. The pelvis is free for
antro-posterior and lateral movement, but fixed
rotation. The body may be inclined forwards and
downwards.
 5- HANGING
 The body is suspended by grasping over
horizontal bar.
 The arms straight & at least shoulder width
apart and forearm being pronated. The legs
and trunk hang straight with the heels together and
the ankle planter flexed.
Uses:
 it is suitable for athletic persons with high muscle
strength.
 Produces a passive stretching of the spine and its
ligaments, especially in the lower part, and is
therefore used in treating spinal curvatures.
 Raises the ribs by stretching the shoulder muscles,
and is therefore used in the treatment of flat chest.
Derived Positions From Hanging:
 Half Hanging
The body is supported in the oblique position
by the arms which grasp a horizontal bar, while
the rest of the body is inclined and straight.
 Effect and Uses:
The position requires very strong muscle work
for the back muscle, especially the scapulae
retractors, which work against gravity and the
weight of the body.
DESCRIPTIONS OF MOVEMENTS
 Flexion (Flex.)
– An angular movement. A forward movement in
which joints are bent. Usually the approximation of
two ventral surfaces. Takes place about a transverse
axis and in the median or sagittal plane.

 Extension (Ext.)
– An angular movement. A backward movement in
which joints are straightened. The opposite of
flexion with the same axis and plane.
DESCRIPTIONS OF MOVEMENTS
 Abduction (Abd.)
– An angular movement. Movement away from the mid-line of the body,
occurs round an anteroposterior, i.e. sagittal axis and in the coronal or
frontal plane. The exceptions are the shoulder joint and the
carpometacarpal joint of the thumb.
 Adduction (Add.)
– An angular movement, the opposite of the above. Movements towards the
midline of the body.
 Circumduction O
– A combination of the four angular movements so that each position is
adopted in turn and in sequence. The moving bone/s circumscribe a
conical space.
DESCRIPTIONS OF MOVEMENTS
 Rotation (Rot.)
– A turning movement, about a vertical axis and in a
horizontal plane, of limbs, head or trunk in which case
the direction in which the anterior surface is turning is
first indicated.
 Medial Rotation (M. Rot.)
– Occurs around a vertical axis. The anterior aspect of the
limb turns towards the mid-line.
 Lateral Rotation (L. Rot.)
– The opposite of the above, though the axis is the same.
DESCRIPTIONS OF MOVEMENTS
 Side Flexion (S. Flex.)
– An angular movement. Movements of the head or
trunk away from the mid-line in a lateral direction.
 Inversion (Inv.)
– Applies to the foot and is a movement of adduction
and inward rotation of the forefoot of which the sole
faces inwards.
 Eversion (Ev.)
– Applies to the foot and is the opposite of the above.
DESCRIPTIONS OF MOVEMENTS

 Supination (Sup.)
– Applies to the forearm. The palm of the hand
is turned forwards so that the thumb is lying
laterally.
 Pronation (Pron.)
– The opposite of the above.
Equilibrium and Stability
 Line of Gravity
 Centre of Gravity
 Base of Support
Equilibrium and Stability
 Line of Gravity
– Is the imaginary vertical
line that extended from the
COG to the ground. It has
a inverse relationship with
the stability. The longer
the LOG of a position, the
lesser the stability of that
position.
Equilibrium and Stability
 Centre of Gravity
– The point through which the LOG would pass
with the body orientated in any direction is
called the centre of gravity
– This lies at approximately the level of the
second sacral vertebra.
Equilibrium and Stability

 Base of Support
– The base of support (BOS) refers to the
supporting area beneath a body.
– It includes both the parts of the body in direct
contact with the surface and the area enclosed
by the contact points.
THANK YOU