STARTING
STARTING POSITIONS POSITIONS
30thOct, 2013 514222
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MUJALIN PRASANNARONG, Ph.D.
MUJALIN PRASANNARONG, Ph.D.
Department of Physical Therapy, Chiang Mai University
Objectives Objectives
• นักศึกษาเข้าใจหลักเกณฑ์ของท่าเริ่มต้นของการออก กําลังกาย
• นักศึกษาสามารถแยกประเภทของท่าเริ่มต้นของการ
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• นักศึกษาสามารถแยกประเภทของท่าเริ่มต้นของการ ออกกําลังกายได้
• นักศึกษาสามารถเขียน ปฎิบัติ และอธิบายท่าเริ่มต้น ของการออกกําลังกายได้
“Posture follows movement like a shadow: every movement begins in posture and ends in posture”
Sherrington Sherrington Starting positions are the postures from
which movement is initiated. They may be either active or passive in character.
Type of s
Type of starting tarting positions positions
•• Fundamental positions Fundamental positions
–
– Five basic starting positions: lying, Five basic starting positions: lying, sitting, kneeling, standing, and sitting, kneeling, standing, and sitting, kneeling, standing, and sitting, kneeling, standing, and hanging.
hanging.
•• Derived positions Derived positions
–
– Derived from starting positions.Derived from starting positions.
–
– Altering the position of the arms, legs Altering the position of the arms, legs or trunk.
or trunk.
To maintain starting positions To maintain starting positions
•• Equilibrium and stability using Equilibrium and stability using
–
– bbalance of force acting upon the bodyalance of force acting upon the body –
– mmuscular isometric contractionuscular isometric contraction
•• Postural reflexes control the Postural reflexes control the
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•• Postural reflexes control the Postural reflexes control the
strength and distribution of muscle strength and distribution of muscle contractions.
contractions.
•• During the learning process of new During the learning process of new postures, voluntary effort may be postures, voluntary effort may be required.
required.
Fundamental positions Fundamental positions
--
--Lying (Ly.) Lying (Ly.)-- --
• The easiest of the fundamental positions.
• The body can be completely supported.
• The body is supine with the arms by the sides, with fingers relaxed.
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sides, with fingers relaxed.
• The palms of the hands face the outer sides of the thighs.
• Legs straight.
• Feet are together, with the toes pointing upwards.
Fundamental positions Fundamental positions
--
--Sitt Sitting ing ((Sitt Sitt.) .)-- --
• The position is taken on the chair or stool, the height and width of which allow the thighs to be fully supported.
• The hips and knees flexed to a right angle.
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• The hips and knees flexed to a right angle.
• The knees are apart sufficiently to allow the femora to be parallel.
• The feet rest on the floor.
• The heels vertically below the knees.
Fundamental positions Fundamental positions
--
--Kneel Kneeling ing (Kn.) (Kn.)-- --
• The body is supported on the knees (may be together or slightly apart).
• The lower leg rests on the floor with the feet plantaflexed.
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feet plantaflexed.
• The rest of the body is held as in standing
Fundamental positions Fundamental positions
--
--Stand Standing ing (St.) (St.)-- --
• The heels are together and on the same line. Toes slightly apart. The angle
between the feet does not exceed 45°.
• The knees are together and straight.
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• The knees are together and straight.
• The hips are extended and laterally rotated slightly.
• The pelvis is balanced on the femoral heads.
Fundamental positions Fundamental positions
--
--Stand Standing ing (St.) (St.)-- --
• The spine is stretched to its maximum length.
• The vertex is thrust upwards, the ears are level and the eyes look straight forwards.
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level and the eyes look straight forwards.
• The shoulders are down and back.
• The arms hang loosely to the sides, palms facing inwards towards the body.
Fundamental positions Fundamental positions
--
--Hang Hanging ing (Hg.) (Hg.)-- --
• The body is suspended by grasping over a horizontal bar.
• The forearms being pronated.
• The arms straight and at least the
• The arms straight and at least the shoulder width apart.
• The head is held high
• The scapulae are drawn down and together.
• The trunk and legs hang straight, with the heels together and the ankles
plantaflexed.
Derived
Derived positions positions
--
--Lying Lying-- --
• Crook lying (Ck. Ly.) • Crook lying using a pillow
• Side lying (S. Ly.) • Prone lying (Pr. Ly.)
Derived
Derived positions positions
--
--Lying Lying-- --
• Quarter turn (¼ Tn.)
The body is turned through 45° from either lying, side lying or prone lying.
• Half lying (½ Ly.)
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• Half lying (½ Ly.)
The body is bend at the hips and the trunk is raised from lying to any angle up to 90°.
• Side half lying (S. ½ Ly.)
The trunk and head are turned to one side so that the patient rests on one buttock and leg and that side of the trunk.
Derived
Derived positions positions
--
--Sitt Sitting ing-- --
• Forward lean sitting (Fwd. Ln. Sitt.)
The trunk is inclined forwards and the head is supported on pillows on a table at the front.
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• Half sitting (½ Sitt.) • Crook sitting (Ck. Sitt.)
Derived
Derived positions positions
--
--Sitt Sitting ing-- --
• Long sitting (Long Sitt.) • Cross sitting (X sitt.)
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Derived
Derived positions positions
--
--Kneel Kneeling ing-- --
• Kneel sitting (Kn. Sitt.)
From kneeling to sitting back on the heels. A stable position and much used for retraining balance and by children at play.
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children at play.
• Half kneeling (½ Kn.)
From kneeling, one leg is taken forward to bent at right angles at the hip, knee and ankle.
A stage in raising from kneeling to standing or transferring from floor to stool.
Derived
Derived positions positions
--
--Stand Standing ing-- --
• High standing (High St.)
Standing on a platform or stool of any height.
• Half standing (½ St.)
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• Half standing (½ St.)
Standing on one leg, i.e. one hip is hitched up or one leg is bent at the hip and knee.
• Close standing (Cl. St.)
Standing with the feet are together and parallel.
Derived
Derived positions positions
--
--Stand Standing ing-- --
• High standing (High St.)
Standing with the body raised onto the toes.
• Step standing (Step St.)
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• Step standing (Step St.)
Derived
Derived positions positions
--
--Hang Hanging ing-- --
• Arch hanging (Arch Hg.)
The straight position for forward and backward swinging of the trunk.
• Half hanging (½ St.)
Hanging by one arm. The position achieved during lateral travel on the beam.
Derived
Derived positions positions
--
--moving the arms (A.) moving the arms (A.)-- --
• Half (½)
• Stretch (Str.)
• Yard (Yd.)
• Reach (Rch.)
• Low grasp (Low Gr.)
• Forehead support (F. head Supp.)
• Arm lean (A. Ln.)
• Reach (Rch.)
• Head rest (H. Rst.)
• Bend (Bd.)
• Wing (Wg)
• Heave (Hve.)
• Grasp (Gr.)
• Arm lean (A. Ln.)
• Forward propping (Fwd. Prop.)
• Backward propping (Bwd. Prop.)
Derived
Derived positions positions
--
--moving the legs (Lg.) moving the legs (Lg.)-- --
• Stride (Std.)
• Walk (Wk.)
• Oblique stride (Obl. Std.)
• Step
• Crook (Ck.)
• Cross leg (X Lg.)
• Cross ankle (X Ankle)
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(Obl. Std.)
• Lunge (Lge.)
• Cross ankle (X Ankle)
Derived
Derived positions positions
--
--moving the trunk (Tr.) moving the trunk (Tr.)-- --
• Stoop (Stp.)
• Relaxed or slack stoop (Lax. Stp.)
• Arch
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• Arch
• Turn (Tn.)
Derived
Derived positions positions
--
--in water in water-- --
• Support lying (Sup. Ly.) • Half support lying (½ Sup. Ly.)
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Derived
Derived positions positions
--
--in water in water-- --
• Inclined standing (Incl. St.)
• Half grasp inclined away standing (½ Gr. Incl. aw. St.)
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Describe of movements Describe of movements
• Flexion (Flex.)
• Extension (Ext.)
• Abduction (Abd.)
• Lateral rotation (L. Rot.)
• Side flexion (S. Flex.)
• Invertion (Inv.)
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• Adduction (Add.)
• Circumduction (o)
• Rotation (Rot.)
• Medial rotation (M.
Rot.)
• Evertion (Ev.)
• Supination (Sup.)
• Pronation (Pron.)
Describe of activities Describe of activities
• Starting position
i.e. Std. Sitt., ½ Gr. Incl. tow. S. St., Fl. Sup. Ly.
• The apparatus i.e. (Stool), (Form)
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i.e. (Stool), (Form)
• Direction
i.e. M. Rot., Inv., Abd., Sup.
• The repetition number and count i.e. R., L., 4x, (1-4) slow
Examples of activities Examples of activities
• High Sitt; K. Ext. alt. R. and L. (10x)
• Std. Sitt. (Stool); T. Tn. alt. R. and L. (4x)
• Std. Sitt. (Stool); T. Tn. alt. R. and L. (1-4) slowly (5-8) quickly
quickly
• Std. St. T. Tn. alt. R. and L. with Reb. (1-4) and T. drop fwd. (5) T. Str. Up. (6-8)
References References
• Colson, J. HC., Collison, F. W. (1983). Progressive exercise therapy in rehabilitation and physical education, 4thed., London: Wright PSG.
• Gardiner, M. D. (1981). The principles of exercise
• Gardiner, M. D. (1981). The principles of exercise therapy, 4thed., London: Bell & Hyman.
• Hollis, M., Fletcher-Crook, P. (1999). Practical exercise therapy, 4thed., Oxford: Blackwell Science.