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Bedside Exercise For Mobility-Limited Nursing Home Residents: A Case Study

Deneen Elizabeth K. PT GCS; Banerjee, Sikhar MD; Heermans, Amanda G. PT, GCS; Dean, Robert C. ScD
Journal of Geriatric Physical Therapy: 2002
Article: PDF Only


Background and Purpose:

Illness or injury in elderly patients may lead to physical inactivity and result in functional decline. Application of specific resistive exercises for elderly patients during, or following, a course of illness may reduce the rate of physical decline. The purposes of this case study of mobility limited subjects were to: (1) demonstrate that frequent, daily, resistive exercise of medium intensity performed in bed, using a special exercise device, is feasible and safe;and (2) describe subjects'responses to the exercise regimen with respect to their lower extremity strength, balance, and functional mobility.


Three nondemented nursing home residents (71, 78, and 82 years old), who required assistance for ambulation, participated in the study.

Materials and Methods:

The In-Bed Exercise (IBEXTM) device, which attaches to the frame of hospital beds, was used to provide resistance to lower limb extension. Lower limb strength was measured with the IBEXTM device using the one repetition maximum (1RM) method. Mobility and balance were measured with the Physical Disability Index (PDI). The intervention consisted of 3 short duration exercise sessions per day, 5 days per week, for 6 weeks, beginning at 50% of 1RM and progressing to a maximum of 80% of 1RM.


All subjects completed the study. Strength outcome varied between subjects. The PDI scores increased during the exercise intervention in all subjects. Most of the functional improvement occurred in bed mobility while the least improvement occurred in balance.

Discussion and Conclusion:

Exercising with IBEXTMseveral times per day offers a possible method of reducing the risk of functional decline in the frail elderly following illness or injury. Further studies are needed to establish the efficacy of using the device.

This study was completed in partial fulfillment of the requirements of Ms. Deneen's Master of Science degree in clinical investigation. This Pilot Study was sponsored by Synergy Innovations, Lebanon, NH, with partial funding from the National Science Foundation grant # DMI-9860355.

Please send correspondence to: Elizabeth K. Deneen, Red Barn Physical Therapy Associates LLC, PO Box 886, Norwich, VT 05055, Ph: 802/280-1878, Fax: 802/280-1871 (

Copyright © 2002 the Section on Geriatrics of the American Physical Therapy Association