I do hand quilting almost all together---stitch in the ditch for charity quilts, etc. I always use a hoop---some times a 16" and sometimes a 14" and sometimes both depending on the area I am quilting. I recently bought a border hoop---quite a luxury for me, but I really enjoy that. I would never be comfortable without a hoop to hold things in position. I sit in a recliner chair, and recline to the first position, prop my feet to raise my knees to help hold the hoop and away I go. But the greatest thing is about quilting, Every One Can Do Their Own Thing Their Own Way---be it quilting, the pattern, the fabric---all those things....it is still quilting and still soul-satisfying.