the close quilting is also a tradition. The women worked without a hoop and measured the lines of echo quilting by their finger.
as for how I appliqued such a ginormous piece (about 108x108), I would fold it up, then pull out the section I was working on and maneuver my left hand underneath however I could. Obviously, the borders were relatively simple. But the piece is heavy so I'd need my lap and couch to support it.