Clinical Hub,Patient Education,Health and Nutrition Facts For You,Miscellaneous

Supine Exercise Program (6012)

Supine Exercise Program (6012) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Miscellaneous


Supine Exercise Program

Patient Name_________________
Date ________________________
Therapist Name _______________

1. Gluteal Sets
Squeeze buttocks together.
Hold ____ seconds.
Repeat ____ times.

2. Knee Extension – Quad Sets
Lie on back, press __________
knee into mat, tightening muscle
on front of thigh. Do not hold
your breath.
Hold _____ counts.
Repeat _____ times.

3. Heel Slides – Knee and Hip Flexion
Lie on back. Slide heel up
toward buttocks. Repeat
_____ times for each leg.

4. Hip Abduction (Snow Angels)
Lie on back with Knees straight.
Move feet apart and together.
Repeat ____ times.

5. Straight Leg Raise
Lie on back with 1 knee bent. Lift
other leg. Keep knee straight.
Repeat _____ times each leg.

6. Lower Trunk Rotation
Lie on back with knees bent.
Roll knees from side to side.
Repeat _____ times.

7. Bridging
Lie on back with knees bent.
Lift bottom up.
Repeat _____ times.

8. Ankle Circles
Move feet around in a circle.
Repeat _____ times.

9. Heel Cord Stretch
Use cane, belt or assistant’s
arm to stretch toes upward.
Do slowly by counting
to ________ .
Repeat _____ times.

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 1/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#6012