When working with a traditional hand quilting frame, the backing was secured around on 4 long boards. This large square was placed on corner stands/ saw horses or ropes from the ceiling. The batt was smoothed over the backing and the top was smoothed on top. The quilt was hand quilted and the boards were usually rolled as they proceeded to the center of the quilt.
The other method was to hand quilt in a lap frame. The quilt sandwich was usually laid out on the floor and hand basted with thread. Machine quilting has been around since the invention of the sewing machine but was usually just straight stitched in lines. I imagine it was just as hard to tackle the basting job as it is today but with few of our modern aids.