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

2. Topic: Use Of
Fundamental &
Derived
Position.

3. Presented By:
BS (PHYSIOTHERAPY)
Jinnah Postgraduate Medical Center,
Karachi.

4. Fundamental Position
• Sherrington stated
that
“Every movement
begins in posture and
ends in posture". it is
applicable to the dayto-day activities too.

5. 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.

6. Derived Positions
Derived positions
are positions used
by modification of
the arms, legs or
trunk in each of
fundamental
position.

7. 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.

8. 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.

9. Starting Positions
5- Lying position.
4- Hanging position.
2-Sitting position.
1- Standing position.
3- Kneeling position.

10. 1. Standing Position

11. 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.

12. 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. DERIVED POSITION FROM
STANDING
By Altering Arms

14. By Altering the Arm
Wing
standing
Bend standing
Reach standing
Stretch
standing

15. By Altering the Arm
Yard
standing
Cross arm
standing
Heave
standing

16. 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.

17. 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

18. 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

19. 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. SOME EXERCISES

21. 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.

22. 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.

23. DERIVED POSITION FROM
STANDING
• By Altering Lower Limb

24. 1- High Standing Position.
•Standing on the stool
or in any raised
platform
•Movements as
mentioned in the
Standing.
High Standing

25. 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.

26. 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.

27. 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.

28. 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.

29. 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.

30. 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

31. 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. SOME EXERCISES
ALTERING LOWER LIMB

33. 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.

34. 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

35. 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.

36. 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.

37. DERIVED POSITION FROM
STANDING
• By Altering Trunk

38. 2-BY ALTERING THE TRUNK
h) Relaxed Stoop
Standing
i) Stoop standing
j) Fallout standing

39. 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

40. 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.

41. 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

42. 2. Sitting Position

43. 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.

44. Positions Derived From Sitting.

45. (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.

46. 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.

47. 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.

48. 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

49. 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

50. 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.

51. 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

52. 6- FOOT SITTING (Squatting)
• Sitting on Feet
Movement:
Hip and knees are
flexed and weight
is transmitted
through the feet.

53. 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

54. 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.

55. 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.

56. 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.

57. 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.

58. Derived positions of kneeling
Derived Positions from Kneeling positions are:
•
•
•
•
Half kneeling
Kneel sitting
Prone kneeling
Inclined prone kneeling

59. 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

60. 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

61. 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

62. Inclined prone kneeling
• Uses in exercise therapy:
• To perform breathing
exercises and postural
draining technique
• Example:
• Muslim namaz position

63. 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,

64. 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

65. 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.

66. 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.

67. Derived Position From HANGING

68. 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.

69. 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.

70. 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

71. 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.

72. 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.

73. 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. LYING POSITION

75. DRIVED PODITIIN-LYING
a.
b.
c.
d.
Prone Lying.
Half Lying.
Crook Lying.
Side Lying.

76. 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.

77. 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.

78. 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.

79. 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.

80. 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.

81. 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.

82. 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.