Rehabilitation Science Department

Therapeutic Exercises
Course name: Physical therapy procedure II
Course code & number: 322 RHS
Lecture Name: herapeutic e!ercises
Lectures Name: Dr" #shra$ Ramadan Ha$e%
Date:
&b'ecti(e o$ Lecture:
#$ter studyin) this lecture* the student must be able+
o de$ine the basic $undamental positions
o de$ine the deri(ed positions
o de$ine the e$$ects and uses
Content o$ lecture
basic $undamental positions
Lyin) position and its uses
Deri(ed position $rom lyin)
Sittin) position and its uses
Deri(ed position $rom sittin)
Standin) position and its uses
Deri(ed position $rom standin)
,neelin) position and its uses
Deri(ed position $rom -neelin)
Han)in) position and its uses
Deri(ed position $rom han)in)
.undamental and deri(ed 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 .
Startin) Positions :
1- Lying position.
2 - itting position .
! - tanding position .
" - #neeling position .
$ - %anging position .
Deri(ed positions
&erived positions are positions used by modification of the arms' legs or trun( 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 *+,- .*
! - To gain local or general relaxation .
" - To gain fixation and good control of specific area .
$ - To increase or decrease the muscle wor( re.uired to maintain the position .
/ - To increase or decrease the leverage .
1 - Lyin)
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 hori0ontal surface' arms to the sides and legs
straight with muscles relaxed. There is actually no real muscle wor( necessary for
maintaining this position. The body is most supported with large base and low centre
of gravity .
his position is /sed :
- For wea( patients.
- For small children' because they often do not understand how to maintain other
starting positions .
it is suitable for many exercises -.
- Fre.uantly for massage .
- Positions Deri(ed .rom Lyin) "
1 - ide Lying )
1n ideal position for relaxation for many people is provided by adapting. Three
pillows are re.uired' one for the head' one for the uppermost arm and one to
support leg which is bent -.
- 2sed in sling exercises .
2 - Prone Lying )
/ses :
2nsuitable for heart and respiratory diseased patients as breathing is so restrict -.
- 2sed as corrective position for spine .
3ay be comfortable for young and slim people -.
3 0 Hal$ Lyin) :
The trun( is supported in the obli.ue position by inclination of the long end of the
plinth' or by the arrangements of the pillows .
1$$ect :
The (nees may be bent to increase relaxation of the abdominal wall .
/ses :
1 - 4t is much used forward exercises .
2 - 5elaxed and comfortable position for wea( and elderly people .
! - 6reathing is easier than in lying' so it is used in many chest conditions .
2 0 Croo- Lyin) :
- From lying' the hip and (nees are bent so that the feet rest on the floor or plinth.
7ery little muscle wor( is re.uired Tension is removed from the structure anterior
to the hip 8oint so that the pelvis rolls bac(ward and the lumbar spine is relaxed on
to the supporting surface .
/ses :
1 - To train relaxation and posture .
2 - 4n pelvic and bac( exercises .
20 Sittin) position
4t is ta(en on a chair. 4n this position the body rests chiefly on the tuberosities of
the ischium' but the bac( of the thighs should also be supported and the feet should
rest upon the floor. The hip' (nee' and an(le 8oints should all form right angles. The
(nees should be slightly apart so that the position of the legs is easy. The wor(ing
muscles for maintaining the position are principally the nec(' bac(' and posterior
shoulder muscles. 9our weight should be evenly distributed on both buttoc(s .
1$$ects #nd /ses :
1 . -eneral steadiness in this position is considerably greater' because - )
: a: The base is larger ;
: b: The centre of gravity lies nearer the base ;
2 . The pelvis is also firmer' because it rests on the supporting surface .
! . The leg muscles wor( little .
Positions Deri(ed .rom Sittin) :
1 - Long itting )
This is similar to the previous position' but the (nees are extended so that the
whole leg is supported .
1$$ect :
4t leads to increase tension of hamstring .
/ses :
Position is difficult due to instability .
2 - +ross itting )
This is also similar to croo( sitting' but the an(les are crossed and the hips
strongly abducted and laterally rotated' so that the lateral aspect of the (nees is
pressed to the floor. Tension on the hamstring muscle is reduced but the adductors
of the hip are stretched .
! - %igh itting )
The fundamental sitting position is ta(en on a high plinth or table but the feet
remain unsupported .
/ses :
4t is convenient some foot and (nee exercise .
3 0 Standin) Position )
1 - The heels are on ground with angle not exceed "$< .
2 - #eep your (nee straight but not loc(ed .
! - The hips are in extension and slightly rotated laterally .
" - The pelvic is balanced on the femoral head .
$ - The spine is stretched to its maximum length
/ - The head is hold up straight with chin in. do not tilt your head forward' bac(ward'
or sideways .
= - #eep your shoulder bac( .
> - The arms are hanged loosely to the sides' palms facing sides of the body .
? - 9our weight should be evenly distributed on both legs .
1$$ects #nd /ses
- The chest is expanded *the shoulders being drawn bac( and the spine extended .*
- The internal organs have ample space' so that they are not hampered in their
functions by undue pressure .
- The position is not steady partly' because the base is small' because the centre of
gravity lies so high above the base *centre of gravity lies between third and fourth
sacral vertebrae .*
4t is used as starting position for a number of free-standing exercises - .
Positions Deri(ed .rom he Standin) :
3 0 oe standin) :
The heels are pressed together and raised from the floor .
1$$ect :
The base is reduced and the center of gravity is raised .
/ses :
1 - 4t is used as a balance position .
2 - There is a tendency for the whole body to stretch so it is used as
treatment .

2 0 Stride standin) :
The legs are abducted and the heels are apart and remain in "$< .
1$$ect :
Large base lead to easy and stable position .
/ses :
2sed as starting easy position for many exercises .
:
3 0 4al- standin)
,ne leg is placed forward to the same line of the other leg .
1$$ect :
The base is much enlarged in the antro-posterior direction stabili0ing the body
for exercises in a sagittal plane. 5otation of the pelvis towards the side of the
forward leg is prevented by the position of the bac( leg .
/ses :
1 - Locali0e the hamstrings rotation of the spine .
2 - Tension on of the forward leg prevents forward tilting of the pelvis in trun( flexion
exercises .
2 0 Hal$ standin) :
The whole weight of the body is supported on one leg' the other may be free or
supported in a variety of the positions .
1$$ects :
6alance is very difficult with one leg. The free leg can rest in many positions li(e
stool with flexed hip and (nee *step st.:. This position reflexes the tension of the
abdominal operations .
/ses in :
4ncrease tension of the hamstring of the lower leg and straightening of the lumbar
spine .
2 0 ,N11LIN5
The body is supported on the (nees which may be together or slightly apart .
1 - The lower leg rests on the floor with the feet planter flexed .
2 - The feet may be in the mid position over the edge of the plinth .
1$$ect) uncomfortable position for most people due to difficult balance .
/ses) as starting position for bac(ward movements .
Positions Deri(ed .rom he -neelin) )
3 0 Hal$ ,neelin)
,ne (nee supports most of the weight and other leg is bent to a right angle at
hip' (nee and an(le so that the foot is supported on the ground in a forward
direction .
2 - #neel itting
The (nees and hips are flexed so that patient sits on his heels .
/ses :
ometimes used for small children' but most people find it very uncomfortable .
3 0 Prone ,neelin)
The trun( is hori0ontal' 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
trun( .
1$$ect and /ses :
The position is stable' comfortable and suitable for many trun( and head
exercises. The pelvis is free for antro-posterior and lateral movement' but fixed
rotation. The body may be inclined forwards and downwards .
6 0 H#N5IN5
The body is suspended by grasping over hori0ontal bar .
The arms straight @ at least shoulder width apart and forearm being pronated. The
legs and trun( hang straight with the heels together and the an(le planter flexed .
/ses :
it is suitable for athletic persons with high muscle strength .
Produces a passive stretching of the spine and its ligaments' especially in the
lower part' and is therefore used in treating spinal curvatures .
5aises the ribs by stretching the shoulder muscles' and is therefore used in the
treatment of flat chest .
Deri(ed Positions .rom Han)in)
Han)in) 0 Hal$
The body is supported in the obli.ue position by the arms which grasp a hori0ontal
bar' while the rest of the body is inclined and straight .
1$$ect and /ses :
The position re.uires very strong muscle wor( for the bac( muscle' especially the
scapulae retractors' which wor( against gravity and the weight of the body .