Bed Exercise

If you are admitted to hospital, it is important to keep active where possible.

This booklet will give important information about what exercises to complete while in hospital and when returning home, to aid with keeping muscular strength and usual movement of the body.

How do I improve my experience with exercising?

If you do not usually exercise or are unable to complete long periods of exercise, any physical activity you can do is better than none at all.

For example:

• If you feel you need help with exercises, ask your family or friends when they come to visit.

• The most important thing to remember when doing your exercises is to start small and build up your tolerance gradually.

• During the first few months of doing more physical activity following your hospital admission, it may be helpful to be active with other people.

To reduce your risk of ill health from being inactive, it is nationally advised that adults and older adults should exercise at least 150 minutes a week and reduce the amount of time spent sitting or lying.

What are the benefits of exercising?

• Improves your muscle strength that can reduce with ageing.

• Reduces your risk of coronary heart disease, stroke, various cancers and diabetes.

• Can increases your life expectancy.

• Helps keep your independence and taking part in your usual everyday tasks.

• Improves your mental being and brain functions. This can help with managing stress and improving quality of life.

• Can reduce levels of stress and anxiety.

• Helps improve your self-confidence.

• Reduces the risk of accidental falls and fall–related injuries.

• Improves bone health and how well you can move, making daily tasks easier to complete.

Introduction to Bed Exercises:

This leaflet will demonstrate the key exercises that we promote to improve general movement, levels of functioning and overall muscular strength all while being in bed.

Each exercise will include a small explanation, together with the sets and repetitions we advise you to try when completing your exercises. A ‘repetition’ (reps) is each time you complete one whole movement, a ‘set’ is how many times each repetition/movement is completed in a row (you may set a target to achieve prior to completing your exercises). For example: when completing your first exercise ‘reaching forward in sitting’ – each time you reach forwards this is one repetition. If you were to complete 10 repetitions in a row, this would be 1 set of 10 repetitions.

Each exercise should be completed to your own ability, and you should follow the advice as noted on each exercise with regards to making each one easier or harder.

Lower Limb Strengthening Exercises:

Exercise 1: Dorsiflexion and Plantarflexion

Start by lying on your back in bed, point your feet towards your face and then point them away from your body. Your knees should always remain straight throughout exercise.

Do 2 sets of 5 repetitions on each leg.

When these start to become easier over time:

•  Increase the number of sets to 3 and increase the repetitions by 5 to 10.

•  Do the same exercise when you are sat in your chair.

If this is too hard:

•  Lower the repetitions.

• Reduce the amount you move your feet.

Why?

This exercise helps strengthen your ankle and lower leg muscles and helps to maintain good circulation in your legs whilst you are in bed. This will also aid with completion of normal day to day activities like: standing, balancing, putting on socks and getting dressed.

Exercise 2: Static Quads

Lie on your back in bed, with both legs straight and relaxed. Tense your thigh muscles and push your knee down into the bed, one leg at a time, and hold for approximately 5 seconds as able.

Do 2 sets of 5 repetitions with each leg.

When these start to become easier over time:

•          Increase the number of sets to 3 and repetitions by 5 to 10 times.

•          Build up your hold time from 5 seconds to 10 seconds per repetition.

•          Do the same exercise when you are sat in your chair

If this is too hard:

•           Reduce the amount of repetitions.

•           Reduce the amount of time doing the exercise.

Why?

This exercise helps strengthen your upper and lower leg muscles. These muscles are key for keeping your legs strong enough to mobilise, and to aid with completing normal day to day activities like: walking, getting into and out of a chair or bed, and standing still.

Exercise 3: Straight Leg Raises

Lie on your back in bed, with your legs straight. Raise your left leg off the bed as high as possible and hold for approx. 5 seconds. Return to the starting position and repeat the exercise with your right leg.

Do 2 sets of 5 repetitions with each leg.

When these start to become easier over time:

•          Increase the number of sets to 3 and the repetitions by 5 to 10.

•          Build up your hold time from 5 seconds to 10 seconds per repetition.

If this is too hard:

•          Reduce the distance you lift your leg.

•          Reduce the time you hold your leg.

Why?

This exercise helps strengthen your hip and knee muscles, and improve the flexibility in your lower limb joints. Increasing your flexibility in these joints can help with walking up the stairs and getting dressed.

Exercise 4: Hip Abduction and Hip Adduction

Lying on your back in bed, start with your legs straight and together. Move one leg out to the side, then bring the leg back in again. When completing this exercise, keep your foot pointing up towards the ceiling throughout.

Do 2 sets of 5 repetitions with each leg

When these start to become easier over time:

•           Increase the number of sets to 3 and the repetitions by 5 to 10.

•          Build up your strength by adding a small weight around your ankle if needed.

•          Try to complete this exercise when lying on your side, lifting your leg upwards.

If this is too hard:

•           Reduce the distance you move your leg out to the side.

•           Use a slide sheet or something silky underneath your leg.

Why?

This exercise helps to strengthen the muscles on the outside and inside of leg. These muscles are important when you need to move your leg sideways such as getting out of bed.

Exercise 5: Bridging

Lie on your back with your knees bent and your feet flat on the bed. Squeeze your stomach muscles in, then lift your bottom off the bed. Hold for about 5 seconds, then gently lower.

Do 2 sets of 5 repetitions.

When these start to become easier over time:

•          Increase the number of sets to 3 and the repetitions by 5 to 10.

•          Place your hands across your chest.

If this is too hard:

•           Ask someone to hold your feet.

•           Don’t try and lift too high.

•           Try putting your hands on the bed by your side.

Why?

This exercise helps to strengthen your back, hip and buttock muscles. These are the muscles used when completing normal day-to-day activities like: moving around the bed, standing up from the chair and getting dressed. Completing these exercises also helps to relieve the pressure on your bottom when you are lying in bed.

Upper Limb Strengthening Exercises

Exercise 1: Frontal raises

Lie on your back with your arms down beside your body. Lift one arm so that it is straight in the air, making sure you keep your elbow straight and hold for about 5 seconds. Gently lower it back to the bed beside your body. Make sure each repetition is slow and controlled.

Do 2 sets of 5 repetitions with each leg.

When these start to become easier over time:

•           Increase the number of sets to 3 and the repetitions by 5 to 10.

•           If appropriate, hold a small hand weight.

If this is too hard:

•           Grip both hands together and complete the exercise.

• Keep your elbows slightly bent.

Why?

This exercise helps to strengthen your shoulder muscles and improves function and movement within the shoulder joint. This helps with normal day-to-day activities like: washing, dressing and lifting items.

Exercise 2: Lateral Raises

Lie on your back with your arms down beside your body. Lift one arm straight out to the side of your body, making sure you keep your elbow straight and hold for about 5 seconds. Gently lower it back to the bed beside your body. Make sure each repetition is slow and controlled.

Do 2 sets of 5 repetitions with each leg.

When these start to become easier over time:

•          Increase the number of sets to 3 and the repetitions by 5 to 10.

•           If needed, hold a small hand weight.

If this is too hard:

•           Keep your elbows slightly bent.

•           Tuck your hand under your armpit.

Why?

This exercise helps to strengthen your shoulder muscles and improves function and movement within the shoulder joint. This helps with normal day-to-day activities like: washing, dressing and lifting items. 

Exercise 3: External Rotation of the Shoulder

While in bed (sitting up or lying down), tuck your elbow into your ribs and place your elbow at a 90-degree angle. Rotate your arm away from the body approximately 45 to 90 degrees, depending on your normal shoulder movement, and return to normal position. Make sure each repetition is slow and controlled. 

Do 2 sets of 5 repetitions with each shoulder.

When these start to become easier over time:

•          Increase the number of sets to 3 and the repetitions by 5 to 10.

•          Lie flat in bed as this will involve completing the exercise against gravity.

If this is too hard:

Position arm on table at a 90 degree angle to reduce the effort of your elbow muscles.

Why?

This exercise helps to strengthen your shoulder muscles and improves your function and movement in your shoulder joint. This helps with normal day-to-day activities like: washing, dressing and lifting items.

Exercise 4: Elbow Flexion

While in bed (sitting up or lying down), tuck your elbow into your ribs with arms down by your side. Bend your elbow, bringing your hand towards your shoulder and return to normal position. Make sure each repetition is slow and controlled.

Do 2 sets of 5 repetitions with each elbow.

When these start to become easier over time:

•          Increase the number of sets to 3 and the repetitions by 5 to 10.

•           Holding a small weight in your hand i.e. tin, bottle.

If this is too hard:

•          Use your opposite arm to assist with exercise to reduce the effects of gravity.

Why?

This exercise helps to strengthen arm and shoulder muscles. This will help you with normal day-to-day activities like: lifting objects, putting cutlery and plates away and carrying your shopping.

Exercise 5: Making a Fist

This can be done either lying in bed or sat in bed. Your arm can be in any position you find easy. Close palm of your hand to make a fist, once closed squeeze fist as hard as possible for 3 seconds. Make sure each repetition is slow and controlled.

Do 2 sets of 5 repetitions with each hand.

When these start to become easier over time:

•           Increase the number of sets to 3 and the repetitions by 5 to 10.

•          Use therapy putty (or stress ball) to increase resistance on each repetition

If this is too hard:

•           Reduce the amount of time you squeeze your fist.

Why?

This exercise helps to strengthen your forearms and overall grip strength making it easier to complete normal day-to-day activities like: lifting your shopping, gripping and twisting cans, and picking up your cup of tea.

PIL1507 – Bed Exercises – Progress Tracker (251kB pdf)

What do I do if I have a fall?

Although increasing physical activity levels can reduce the risk of accidental falls and falls-related injuries, falls can still happen. If you have had a fall, lost your confidence or became unsteady on your feet, it is even more important that you stay active and complete your exercises daily (NHS inform, 2023).

If you do have a fall, the following information can help with remaining safe:

• Do not panic.

• Use a telephone, pendant alarm, or try to shout for help.

• Do not move if you feel any sort of pain or know that you have injured yourself.

• And you are not injured, you may want to try to get onto your hands and knees near the closest chair first before getting up.

• If you have tried to get up but are unable to, you need to keep warm! Try to keep your arms and legs moving regularly and cover yourself with anything close by. 

• You should always tell your doctor and health care professionals; even if you were successful with getting yourself up following the fall and do not feel injured.

References & Further Reading

• NHS Inform (2023) Keeping active to help prevent falls. Available at: https://www.nhsinform.scot/healthy-living/preventing-falls/keeping-well/keeping-active-to-help-prevent-falls  (Accessed on: 18 May 2023)

• Alberta (2019) How to get up from the floor by yourself. Available at: https://myhealth.alberta.ca/Alberta/Pages/get-up-by-yourself-fall-prevention.aspx  (Accessed on: 19 May 2023)

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]