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Use Of Fundamental & Derived Position.


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The position, which is adopted, by the patients or an individual to perform the exercise or the movement to gain relaxation and stabilize body.

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  • I am stuck on this question of final exam paper please advise as soon as possible, also - With all zones, aspects positions, etc., related to the Supine PEBP, give precise instructions for moving from the Supine Relaxation Position to sitting up with legs and arms outstretched in front of you. ASAP please if anyone is out there
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  • Please help answer this question I am stuck on, with all zones, aspects, positions etc. related to the standing PEBP (primary extended body position), give precise instructions for moving from a kneeling up, toes down - ready position, to the prone relaxation position
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Use Of Fundamental & Derived Position.

  1. 1. Topic: Use Of Fundamental & Derived Position.
  2. 2. Presented By: BS (PHYSIOTHERAPY) Jinnah Postgraduate Medical Center, Karachi.
  3. 3. Fundamental Position • Sherrington stated that “Every movement begins in posture and ends in posture". it is applicable to the dayto-day activities too.
  4. 4. Starting Position The position, which is adopted, by the patients or an individual to perform the exercise or the movement to gain relaxation and stabilize body is called as STARTING POSITION.
  5. 5. Derived Positions Derived positions are positions used by modification of the arms, legs or trunk in each of fundamental position.
  6. 6. Derived Positions Objectives: 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.
  7. 7. 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.
  8. 8. Starting Positions 5- Lying position. 4- Hanging position. 2-Sitting position. 1- Standing position. 3- Kneeling position.
  9. 9. 1. Standing Position
  10. 10. Standing Position • The whole body is supported or aligned by the smaller base. So that this Position is most difficult to adopt for linger period. There will be a lot of coordinated muscle activity to maintain this posture.
  11. 11. Standing Position Effects And Uses: 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.
  13. 13. By Altering the Arm Wing standing Bend standing Reach standing Stretch standing
  14. 14. By Altering the Arm Yard standing Cross arm standing Heave standing
  15. 15. 1- Wing Standing Effects and uses: • Used to perform trunk bending exercises • Used to perform neck exercises • Beside the effects common to all back exercises, this movement specially helps in expiration as well as inspiration.
  16. 16. 2- Bend standing Effects and uses: • Used to perform trunk bending exercises • Used to perform shoulder rotation exercises • This position is corrective for position of upper back • Full flexion of elbow reduces leverage for abductor muscles
  17. 17. 3- Reach standing Effects and uses: • Used to perform sit up exercises by grasping bar with hand • To assist balance during walking sideways • To perform wrist exercises
  18. 18. 4- Yard standing Effects and uses: • To perform trunk rotation and bending exercises • To perform wrist, elbow and finger exercises • To perform arm swinging movements
  20. 20. Lateral Deltoid Raise Stand in an upright position with a dumbbell in each hand, palms facing in towards your sides. Slowly raise the arms out by your sides, maintaining a small bend in the elbows. Bring your arms up until they are parallel with the ground. Pause at the top and repeat as desired.
  21. 21. Bicep and Shoulder Stretch Action Roll your chest out and raise your arms up towards the ceiling. Hold and then relax. Repeat twice, holding each stretch approximately 12 to 15 seconds.
  22. 22. DERIVED POSITION FROM STANDING • By Altering Lower Limb
  23. 23. 1- High Standing Position. •Standing on the stool or in any raised platform •Movements as mentioned in the Standing. High Standing
  24. 24. 1- High Standing Position. Uses in Physical Therapy: • To perform upper and lower limb Exercise • To perform hanging, swinging the arm and leg. Example: • To take some object from the height. • Fitting the fan in the ceiling.
  25. 25. 2- 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.
  26. 26. 2- Walk standing • Uses in Physical Therapy: • 1- Localize the hamstrings rotation of the spine. • 2- Tension on of the forward leg prevents forward tilting of the pelvis in trunk flexion exercises.
  27. 27. 3- Stride standing • The legs are abducted and the heels are apart and remain in 45°. • Effect and Uses: • Large base lead to easy and stable position. • The effective base is much enlarges laterally, making this as easy and stable position from which to perform exercises, especially those in a frontal plane.
  28. 28. 4- Toe standing • Standing on the toes and toes raise the body. • This is also one of the unstable position because the COG increases and the BOS is decresing in this position.
  29. 29. 4- Toe standing • Uses: • Strengthening the planter flexors ant Toe extensors. • Strengthening the dorsiflexors. Example: Raising the body by the toes to see invisible things in the crowd
  30. 30. 5- Close Standing • Uses: • The size of the base is reduced and balance is more difficult, it is therefore a progression on the standing position. • To perform hip, Trunk bending and rotational exercises. • Arm swinging Exercises • Starting position for sit-up exercises. • To perform the upper and lower extremity exercise
  32. 32. WALKING • Walking Exercise: Walking is a very effective exercise for people of all age groups. Walking for at least twenty minutes is essential to relax our body muscles and provide our mind good recreation from our stressful daily routines.
  33. 33. Standing Shin Stretch Instructions Preparation • Stand and touch wall or stationary object for balance. Grasp forefoot behind.Execution • Pull forefoot to lower back. Hold stretch. Repeat with opposite side. • Muscles • Target • Tibialis Anterior Other • Quadriceps
  34. 34. Triceps Extension • Action EXHALE: Push weight onto right foot as you extend left leg behind you. Simultaneously extend from the elbows, as if reaching your pinkies toward the ceiling behind you. INHALE: Lower left leg back to the ground as you bend the elbows, returning weight to the starting position.
  35. 35. Alternating Step-ups Keep your back straight and step on the riser with your right foot. With a steady and controlled motion slowly pull yourself up onto the bench using only your right foot. Step off the bench with your left foot first and then the right foot until you are again standing in front of the riser.
  36. 36. DERIVED POSITION FROM STANDING • By Altering Trunk
  37. 37. 2-BY ALTERING THE TRUNK h) Relaxed Stoop Standing i) Stoop standing j) Fallout standing
  38. 38. Relaxed Stoop Standing Hip and trunk are flexed totally and Upperlimb kept hanging. • Uses: Trunk bending and stretching movement can be performed Sretching the hip and trunk muscle
  39. 39. Stoop Standing • Trunk inclined forward and upper limb placed parallel to the Body line to the this Position. • Uses: Pendular movements of the shoulder. Trunk bending and Streching Exercise.
  40. 40. FALL OUT STANDING • One leg kept forward with Knee Bending, the other leg remains straight and trunk inclined forward. • Uses: • Stretcing the Hip flexors • Strengthening exercise to the forward leg can be performed
  41. 41. 2. Sitting Position
  42. 42. 2- SITTING POSITION It is taken on a chair. In this position the body rests chiefly on the tuberosities of the ischium, 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.
  43. 43. Positions Derived From Sitting.
  44. 44. (i) Long Sitting •The patient sits with legs fully extended and supported for the whole of their length •The trunk and thighs at a right angle.
  45. 45. Long Sitting • Effects And Uses • (a) Stretches muscles at the back of the thigh, if they are too short. • (b) The pelvic tilt is diminished by stretching the above muscles. This causes again a straightening-out of the lumbar spine and stretching of ligaments and muscles at the back. Therefore used in treatment of lordosis. • (c) The abdomen becomes compressed, so that pressure there is increased, and as the abdominal muscles, as already explained, must also work to maintain the position, respiration is impeded. Therefore this position must be avoided for patients with heart or lung complaints.
  46. 46. ii- CROOK SITTING • Knee and Hip are flexed in, and feet are kept forward while sitting in the floor Movement: • Hip flexed, • Knee flexed, and • Ankle in neutral position.
  47. 47. CROOK SITTING • Uses: • To perform mat activities. • To perform breath exercises. • To perform neck and ankle exercise. Example: Relax wall sitting while watching T.V
  48. 48. iii STRIDE SITTING • Uses: • To perform leg swinging exercises. • To perform neck and trunk exercises • To perform upper limb exercises. Example: Bike riding posture Horse riding posture
  49. 49. iv. Cross Sitting Uses in Exercise Therapy: Breathing exercise and reduce the respiratory distress. Hip adductor stretching. Trunk and Neck exercise. Example Some floor level activities like eating, cutting vegetables.
  50. 50. iv. SIDE SITTING • Uses: • Progression from prone to sitting in mat activity • To perform Trunk Exercise. Example: • All Floor level activities lioke cutting vegetables and garland making
  51. 51. 6- FOOT SITTING (Squatting) • Sitting on Feet Movement: Hip and knees are flexed and weight is transmitted through the feet.
  52. 52. FOOT SITTING (Squatting) • Uses: • Starting position for sit-up exercises. • Starting position for Running race. Example: • The position adopted while washing clothes and cleaning vessels
  53. 53. Leg extension The leg extension is a simple, classic exercise targeting the quadriceps muscles. This exercise is great for anyone who needs to strengthen the muscles surrounding the knee to provide more stability and support. You can do this exercise on a leg extension machine, but this seated version can be done anytime, anywhere. Add ankle weights or a resistance band for more intensity. You can also sit on an exercise ball to make the move more difficult.
  54. 54. Lat pull downs with a resistance band The pull-down exercises can be effectively used for hypertrophy or strength training adaptations. Although pull-ups may induce hypertrophy or strength, they also provide an additional challenge and adaptation in ‘kinetic chain functionality’; or the ability to transfer force through multiple joints.
  55. 55. Kneeling Position • The is like the fundamental position of Standing but the weight is transmitted through the knee joint, due to right angle alignment of the knee to the body. • The lower leg rests on the floor with the feet planter flexed. • It is very much difficult position to maintain for longer period.
  56. 56. Uses in exercise Therapy • Many of the upper limb and trunk exercises can be performed. • To perform the mat activities. • To perform coordination and balancing exercises.
  57. 57. Derived positions of kneeling Derived Positions from Kneeling positions are: • • • • Half kneeling Kneel sitting Prone kneeling Inclined prone kneeling
  58. 58. Half kneeling Uses in physical therapy: • To perform trunk bending and stretching exercises • To perform neck exercises • To perform stretching and strengthening exercises for the knee and hip muscles
  59. 59. Kneel sitting Uses in physical therapy: • To perform trunk bending and stretching exercises • To perform neck exercises • To perform stretching and strengthening exercises for the knee and hip muscles
  60. 60. Prone kneeling • • • • • Effects and uses: To perform mat activities To perform coordination exercises Cat and camel exercises This position is stable and comfortable for many trunk and head exercises as the spine is relieved of the weight of the head and it tends to straighten
  61. 61. Inclined prone kneeling • Uses in exercise therapy: • To perform breathing exercises and postural draining technique • Example: • Muslim namaz position
  62. 62. The kneeling roll out • The kneeling roll out is a great abdominal it works all of the muscles in the core as you have to stabilize in order to stay straight. • Muscles used Primary- Rectus abdominus, internal/ external oblique, erector spinae Secondary- serratus anterior, lattsimus dorsi,
  63. 63. Kneeling Calf Stretch • Instructions • Preparation • Kneel on lower leg. Place foot of opposite leg flat on floor.Execution • Lean forward so knee travels beyond toes. Hold stretch . Repeat with opposite leg. Muscles Target: • Soleus Other • Erector Spinae
  64. 64. Gluteus Maximus Stretching Instructions Preparation From rack with barbell upper chest height, position bar on back of shoulders and grasp barbell to sides. Dismount bar from rack. Execution Step back with one leg while bending supporting leg. Plant forefoot far back on floor. Lower body by flexing knee and hip of supporting leg until knee of rear leg is almost in contact with floor. Return to original standing position by extending hip and knee of forward supporting leg and return rear leg next to supporting leg. Repeat movement with opposite legs alternating between sides.
  65. 65. Hanging Position 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.
  66. 66. Derived Position From HANGING
  67. 67. a)-Half Hanging 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. • Normally it is used in gymnastic Activities.
  68. 68. b) Prone Falling Effect and uses: Many muscles work strongly and the necessary coordination is difficult, the position is therefore only suitable for those whose arm are strong in relation to their body length and weight. The body may be taken through a quarter turn so that the weight is supported on the lateral border of one foot, and on one hand.
  69. 69. Hanging knee exercises If you wish to strengthen your abdominal muscles, go for the hanging knee raise exercise. The hanging knee raise is an exercise which is aimed at strengthening the lower abdomen muscles. Although you can literally hang from anything to perform this exercise, the most popular method is to hang down from a pull up bar. All you require to do is to hang from a horizontally placed bar, keeping your arms parallel to the body length. This exercise is highly recommended if you want a flat belly
  70. 70. Flexed arm hanging The flexed-arm hang is an exercise that tests the strength and endurance of the muscles in the upper body. The main muscles used for the flexed-arm hang are the biceps, forearm and finger flexors and several back muscles. The flexed-arm hang is used by body builders and in military training.
  71. 71. Prone falling Muscle work: • The Extensor of the elbow and all the muscle of the shoulder regionwork strongly to support the weight of the body, while the serratusanterior hold the scapulae firmly against the chest wall. • The Neck Extensors, controlled by the pre-vertebral muscles, maintainthe position of the head against the pull of the gravity. • The Flexors of the lumbar spine prevent sagging of the trunk. • The Extensors of the knees keep them straight. • When the foot is fixed in the dorsiflexion the long flexor of the toeswork with excellent leverage to grip the floor.
  72. 72. LYING Lying on the floor or on the bad, in supine position with arm by side of the body and legs are keep straight. It is the most stable kind than the other fundamental starting position due to lower placement of the COG and the broader base. This position can be adopted for prolonged period than any other starting position. USES: It is very much useful position to perform many of the upper limb, lower limb, trunk, neck exercises like strengthening, stretching, aerobic and anaerobic and breathing exercise.
  74. 74. DRIVED PODITIIN-LYING a. b. c. d. Prone Lying. Half Lying. Crook Lying. Side Lying.
  75. 75. PRONE LYING: Anterior portion of whole the body turned towards the couch or floor. This position is inconvenient for maintaining for longer period. All the body parts are relaxed and the head also get relaxed, if it turned and kept a part. This position is very much difficult for the respiratory distress and elderly patients.
  76. 76. USES IN EXERCISE THEARAPY • Spinal extensor and neck extensor exercise can be performed . • This position can be used for back massage. • Some of the upper and lower extremity exercises can be performed. EXAMPLE Toppled position of getting blessing from the elders.
  77. 77. CROOK LYING Modifications are made in lower limb in the supine lying position. The hip and knee are flexed, and the feet kept forward USES IN EXERCISE THERAPY •Abdominal muscle strengthening exercises can be performed. •Pelvic bridging exercises can be performed.
  78. 78. SIDE LYING Lying on the side of the body. It is most inconvenient to maintain for longer period. The upper extremity which is placed under the body will be more painful and positioning the lower limb also very much difficult. Upper extremity, which is below the body, is flexed and kept under the head, and the lower limb which is up to be placed forward to reduce the inconvenient.
  79. 79. USES IN EXERCISE THERAPY • Many of the upper limb, lower limb exercises can be performed. • Breathing exercises and postural drainage can be done. EXAMPLE Daily unknown activity while sleeping.
  80. 80. Hamstring Stretch While Lying on the Back • Most patients with low back pain or leg pain will benefit from hamstring stretching exercises done while lying on the back. These hamstring stretching positions are the least stressful. • Lie on the back, supporting the thigh behind the knee with the hand or with a towel, slowly straighten the knee until a stretch is felt in the back of the thigh, trying to get the bottom of the foot to face the ceiling, one leg at a time . Hold the position initially for 10 seconds, and gradually work up to 20-30 seconds.
  81. 81. Hook lying • Hook lying is often recommended as a great way to relax back muscles. Just lie on your back, knees bent and feet flat on the floor • Effect on Spinal Motion • With your knees bent, your spine tends to flex. In the hook-lying position, the flex will likely be pretty minimal. Just the same, if you have disc problems, this position may bring on your symptoms.