Name: _________________________________
Time:
_______ Day:______________________
Date:
_______________
Therapist name: __________________
|
1 |
Sit up on side of
bed |
|
2 |
Straighten right
knee 10 times |
|
3 |
Straighten left
knee 10 times |
|
4 |
Spread knees apart
20 times |
|
5 |
Lift right leg up
off bed 10 times |
|
6 |
Lift left leg up
off bed 10 times |
|
7 |
Stand up to walker
until bell rings |
|
8 |
Pedal foot bike
until bell rings |
|
9 |
Straighten right
knee with weight 10 times |
|
10 |
Straighten left
knee with weight 10 times |
|
11 |
Lay back down in
bed |
Bedside
PT routine