Anti-Gravity Positions: Prone Extension and Supine Flexion

Prone Extension

Between 6 and 12 months of age a typically developing baby is so strong that when placed on the belly, she can lift her head, upper back, arms and legs off the floor at the same time. Holding this position is not easy when the force of gravity is pulling down on all those little body parts. Therapists call this "antigravity" position prone-extension. Sometimes this position is called "Super Man" position..... and rightly so since holding it demands a strong core, especially when flying!.

Supine Flexion

Another anti-gravity position called supine flexion also demonstrates good muscle tone and strength to flex limbs against the forces pulling them downward. Babies reach for their toes and often enjoy sucking on them; thus strengthening the core muscles.

An older child shown below demonstrates good postural control to flex his head, flex knees pulled up to his chest and wrap his arms around his legs- all while balancing on an unstable surface. The ability for 5 and 6 year old children to hold these anti-gravity position is one indication of adequate vestibular sensory processing.

Airplane Position 

When a child gets into prone extension and supine flexion anti-gravity positions, she is demonstrating good muscle tone and vestibular function.  Between ten and eleven months of age, babies become so strong that they can extend the head, back, hips, and legs while the parents hold them under the belly and suspend them in the air- commonly referred to as the airplane position.

Promote Prone-Extension!

  • Place baby where she can look up and reach while exploring the environment.

  • Position child prone over a horse while giving mom a high five....

  • Position child on a ball. Encourage flying like "Super Man".

  • My client shown below is on top of a small scooter and attempting to bat at the ball. He has low tone and poor postural control. This activity is strengthening the muscles that will help him to be a "Super Man" .

  • Try the above with a partner!

  • Position prone on a swing while engaged in activities such as stacking rings. Be sure to place rings both right and left of midline so that the client switches hands used for weight bearing and reaching.

Clinical Significance of Prone Extension 

According to a Pub Med, study :

"This study was designed to determine whether developmental changes occur in the duration and quality of maintaining a prone extension position. Three groups of 26 to 30 normal children ages 4, 6, and 8 years were tested on the prone extension position. Results indicated a significant difference in both duration of maintenance and quality between the performance of the four-year-olds and the other two age groups. No significant differences were found between the six- and eight-year-olds. Smooth assumption of the position and distance of thighs off the mat were found to be the most important factors in discriminating a good prone extension position from an inadequate one. The variability of performance by the four-year-olds indicates that the ability to assume and maintain a prone extension position is not a valid measurement tool for discriminating between normal children and those "at risk" for learning disabilities at this age level. The inability of children six years or older to maintain a "good" prone extension position for 30 seconds suggests a vestibular processing inefficiency."

Making It Fun!

Promote Supine Flexion

Reaching for objects while supine on the ground, a ball, horse or other apparatus  strengthens the core muscles. The child shown in the video below makes it fun by rocking with arms crossed, around his flexed knees... "curled into a bug".

According to a study by PubMed,

"the ability to perform isometric trunk flexion improves with age. Height was another significant variable contributing to test results (p less than .0001). Children were able to perform sit-ups consistently at age 6 years only; the male subjects performed an average of 20 more sit-ups than the female subjects (p less than .04). I discuss in this article the possible contribution of neuromuscular maturation and physical growth to the development of normal trunk flexion. The results may be useful to clinicians to assess abnormal trunk flexion accurately in children aged 3 to 7 years."

The following video demonstrates use of a scooter board while reaching for objects in the supine position. This is a great activity to strengthen the Core and promote vestibular sensory processing.

References and Resources

A. Jean Ayres, Sensory Integration and the Child (Los Angeles: Western Psychological Services, 1979)

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