We all want patients to stay healthy, mobile and out of hospital for longer. We’ve rolled out a successful programme that does just that – increasing exercise on inpatient units with easily-set-up exercise machines that patients can operate themselves.
Many inpatients spend a lot of time inactive on the wards with limited physiotherapy resource. So two physiotherapists began thinking about what else they could offer their patients.
We introduced exercise machines on community inpatient wards that are easy to set up and accessible for patients with varying levels of mobility. Using simple, chair-based exercises, patients can engage in progressive resistance training, helping to reduce the deconditioning often experienced during hospital stays—delivered in a cost-effective and efficient manner.
Here’s the process we took to begin the programme.
At the time each machine cost £107 – so £642 from HCRG’s Difference Grant could provide six machines. We received initial approval from the head of our business unit.
Our CEO and a panel of judges had to decide which project would get funding – we presented research and evidence of how much elderly people are sedentary in hospitals.
After securing the funding and machines, we formed patient eligibility criteria and trained therapy teams on using the machines, measuring outcomes and collecting data.
We began the project at Paulton Hospital in August 2023, and a month later at St Martin’s Hospital. The machines were easily set up and used initially by the therapy team, and later by nursing colleagues.
One of the patients pictured here is 101 years old.
The aim was to increase a patient’s functional independence to get them to a safe level where they could return home. The project outcomes included questionnaire feedback from patients and colleagues, collecting usage statistics and repeating physiotherapy outcomes on discharge.
96% positive feedback from patients
Patients agree that having the machines in hospital is beneficial, and if they were admitted to hospital in the future, they would use the machines again.
After using the exercise machines as part of his rehabilitation programme, Mr B made excellent progress with his mobility and was able to walk up and down the ward with a wheeled Zimmer frame and supervision of one person. At this stage, Mr B was able to return home to his wife, with the support of the community therapy team.
Over 100 patients used the machines in three months
They completed more than 6,000 minutes of exercise. Later in the project we had a record month – 4,310 minutes of exercise by 41 patients.
After the initial project concluded, physiotherapists Ami and Debbie won the Community Hospital Association Award in October 2024. They have since continued to use the machines with patients, training nursing colleagues to set up the exercise machines, and sharing the results widely to inspire other services.
They have completed outreach and education:
Rated 8 out of 10 by patients
Based on the average from 79 patients when asked how much they enjoyed using the seated exercise machine during their time on the rehabilitation unit.
71% of patients experience an increase in mobility
In 5-minute tests completed on admission and discharge.
Mr R’s recovery following a hip operation involving an intramedullary nail is a striking example. After his operation he was transferred to Paulton Hospital. Mr R was unable to walk and required the assistance of two people and a stand aid just to transfer from bed to chair. He was significantly deconditioned, with reduced exercise tolerance, fatigue, and severely limited mobility.
However, through regular use of the exercise machine, Mr R regained his mobility. By the time of discharge, he could walk 15 metres without stopping, using a pulpit frame, representing a remarkable improvement in a short period. His progress was so encouraging that his family purchased the same exercise machine for his 90th birthday, allowing him to continue exercising and maintaining his independence at home.
Although a bit apprehensive about returning home, Mr R wished to go back to his own property with care support and his wife. He was really pleased with the machine his family surprised him with and felt it would really help him towards his goal of walking unaided again.
He still had ongoing rehabilitation needs, but these could be met by the Community Reablement Team within his own environment, as he no longer had a requirement to stay in a Community Hospital bed.
The project highlights the real and rapid benefits of investing in simple, scalable interventions that support patient mobility and prevent deconditioning.
