Wing

Yard

Heave

Reach-grasp

Neck-rest

Stretch

Sitting.

They arise in the same way as the corresponding derived positions from standing, and have the same effects and uses.

B. By altering the Position of the Legs.

1. 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. To maintain this position the abdominal muscles and flexors of the hip joint must work, generally also the extensors of the knee.

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.

2. Half-sitting. - Is taken by placing one leg over the boom, so that the thigh is supported just behind the knee joint. The leg hangs straight down by its own weight. The height of the boom is such that the thigh is horizontal. It can also be taken over a high plinth, table, or something similar, when the patient, standing at the side of the apparatus, places one leg on it in such a way that the leg hangs over the side.

It is used really only for one movement, viz., Knee-bending and - stretching.

The special use of the position consists in the fact that the movement is complicated and made more difficult partly because the muscles of the supporting leg must work to maintain the position, partly because the origin and insertion of Rectus Femoris of the leg which performs the movement approach one another, so that the strength of the muscle is diminished and the stretching made more difficult.

3. Stride-sitting. - Arises from the Fundamental position by placing the feet two foot-lengths away from each other. Right angle between thigh and leg.

Effects and Uses - Base is enlarged, so that the position is very steady, or can be made so (by work of the leg muscles). It is much used both for trunk and arm exercises.

4. Ride-sitting. - Is taken by the patient sitting astride a plinth, chair, form, or other suitable apparatus. The feet are often fixed by some support.

This position fixes the legs and pelvis most firmly of all, and this effect can be increased by fixing a broad strap over the legs.

When the position is taken on a high plinth it is called High-ride-sitting (Fig. 50).

It is used partly for strong trunk exercises to give the working muscles a firm origin on the pelvis, partly in order to limit a movement as far as possible to the trunk muscles, e.g., Trunk -rotations, Plane-twisting, Arch-twisting, etc.

C. By altering the Position of the Trunk.

1. Arch

2. Stoop

3. Turn

4. Lax-stoop

- Sitting.

They have, of course, the same effect and use as the corresponding positions derived from standing.

Fig. 50.

5. Fall-sitting. - Arises by backward falling of the trunk at the hip joint. For this the feet or knees must be fixed by apparatus or living support. The degree of falling can be modified according to the patient's strength.

The working muscles are : -

(a) Flexors of ankle (statically to fix feet).

(b) Extensors of knee (statically).

(c) Flexors of hip (first eccentrically, then statically).

(d) Abdominal muscles (statically).

(e) Muscles at front of neck (statically).

In a word, all the muscles in front of the body. Effects and Uses. - (a) Repleting to pelvic organs (according to Brandt, because Ilio-psoas works).

(b) Because the abdominal muscles are exercised and developed it counteracts lordosis and aids peristalsis (by associated action of the abdominal muscles with those of the intestines).

(c) Impedes respiration. Should be avoided, therefore, for patients who are weak or suffer from heart or lung diseases.

6. Spring-sitting (Fig. 51). - This position resembles Fall-out b standing, but is unlike this in that the anterior thigh rests on some suitable apparatus, stool, high plinth or something similar. The arms (both or one) in Wing, Neck-firm, or Stretch position.

Effects And Uses

The same as Fall-out-standing position. Left-spring-sitting position (left foot forward) corrects, consequently, a lumbar scoliosis with convexity to the left.

Right-stretch Right-spring-sitting position corrects an S (double) curve with upper convexity to left, the lower to the right.

D. By Combination we get, among others : -

Wing-high-ride-sitting. Stretch-stoop-stride-sitting, etc.

Their effects may be understood from those of the simple positions.

Fig. 51.