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Biking…in bed? How I get seniors moving

Kyle Freedman, P.T.

This is part two of a post about the negative effects of immobility and one physiotherapist’s invention and solution. Read part one here.

In the previous post, I shared how my community physiotherapy practice amongst retirement facilities in Surrey enlightened me to a gap in senior health care. When seniors lose their mobility or become a high falls risk, they are often confined to a bed or wheelchair for much of the day and have few exercise options other than working with a physiotherapist. 

At the family’s request of a double-amputee woman (let’s call her Mary), I agreed to build something that would allow her to exercise regularly and safely without supervision. 

 

The start of it all

I purchased a basic front-mounted arm ergometer online and, with some high school shop skills, attached a wooden base that would fit over Mary's lap. 

She loved it, and her family was ecstatic. Mary lost weight, was able to roll and reposition in bed, became strong enough to self-propel in her wheelchair, and was able to aid the staff with transfers. 

What was more, the nurses at CareLife Fleetwood thought it was a great idea. One nurse even encouraged me to start a company, so that is what I did.

 

Product Development

When I began the process of starting a medical device company and manufacturing overseas, I had no idea how much work was involved. We’ve shared the long and dramatic version of our story on our website—the short version is that it took:

  • 2.5 years
  • Six prototypes
  • 1000+ hours of work
  • Expert advice from engineers, entrepreneurs, and medical colleagues 

Throughout the prototyping process, we received feedback from the hospitals and facilities we met with. Their perspectives were invaluable, and led to our inclusion of a graded resistance knob, removable timer, and increased leg height to accommodate bariatric patients.

The specs on BedBike

1. If you’re familiar with existing arm ergometry products, you’ll know that most are bulky and require the patient to physically move to the device in order to use it. 

We thought that paradigm ought to be flipped and we made the bike portable, so that it could easily be brought to the patient. 

Our bike enables residents to get cardiovascular exercise while safely seated in bed, without risk of falling, and without requiring supervision. 

2. Unlike other arm ergometers, ours is portable, lightweight at 11 pounds, and collapses for easy storage. One model fits most; its adjustable height and width can accommodate patients of different sizes. It is simple to set up and take down: most family members, nurses, or care aides can facilitate an exercise session, enabling seniors to have more daily exercise. 

3. The pedals are ergonomic, keeping the user’s shoulders in neutral—an improvement from the common horizontal arm ergometer handles, which can cause shoulder impingement and irritation to the web space between thumb and forefinger. 

4. With medical grade anodizing, our recovery bike can easily be disinfected with most common wipes.

 

Our ideal patient/our typical patient

The primary application for our portable arm ergometer is for complex care facilities. The product is intended for residents to experience daily cardiovascular exercise. This activity helps them regain strength and function, and aids in preventing pneumonia, the single most common cause of death due to infectious disease among Canadian and American senior populations (ref below).

BedBike provides seniors with cardiovascular exercise without needing supervision, mental stimulation, and the power to impact their own rehabilitation.

We believe that BedBike has the potential for many other uses beyond senior care facilities, including many sub-acute hospital wards, assisted living facilities, some higher acuity wards such as the ICU, and for seniors preparing for joint replacement and rehabilitation afterwards. It could also be used with younger individuals having suffered spinal cord injury, amputees, and with a grip assist aid it would serve well in the rehabilitation of some stroke survivors.

 

Not a replacement: an extra tool

One concern we often encounter is that the focus in hospital physiotherapy is to get patients up and walking as soon as possible, rather than exercise in bed. By no means do we intend to replace traditional rehab with arm ergometry. 

However, studies have shown that arm ergometry combined with traditional rehab exercises was a much more effective form of cardiorespiratory exercise compared with a traditional physiotherapy program alone (see our previous post for research refs.). It is our hope that our recovery bike can allow hospitals and facilities to augment their patients’ exercise programs, both cost-effectively and sustainably. 

Our recovery bike provides an opportunity to get more physical exercise and, in some cases with hip and knee replacement patients, more strenuous exercise for those unable to walk quickly enough to raise their heart rates and breathing rates to significant levels. For these reasons, we think that BedBike has the potential to impact senior health across North America.

What I’ve learned so far

While this journey has been tremendously rewarding, it has also been time intensive. I treat patients for 30-40 hours a week while applying for grants, continue with product development, marketing, arranging trials, and seeking out distribution channels. 

However, so far I’ve learned that:

  • If you have noticed a problem and are thinking about inventing a solution, don’t be daunted by the effort needed to get it off the ground! 
  • As professionals who encounter physical limitations on a daily basis, who better than people like us to invent solutions for our patients? 
  • We are uniquely positioned to make a difference. 

 

Seriously, if you have an idea, try this

If you already have an idea, great!

If I may offer some advice, the first thing you need to figure out is what your available resources are. 

Consider factors like:

  • Are you willing to invest the time? 
  • The financial commitment? 
  • If you don’t have all the know-how, can you find experts who do? 

There were things that we simply couldn’t do on our own, like steel tube bending for the first prototype, or 3D mechanical drawings in SolidWorks®, or gaining insight into the manufacturing and medical distribution industries.

Don’t be shy about reaching out to mentors and business contacts who have the talent and expertise you lack. Most people really do want to help.

I spent time designing during evenings and weekends. I tested the market by showing various prototypes to facilities. I got as much advice as I could before finally registering my business and paying for professional services. 

In the beginning, all I could bring to the table was my physiotherapy background. 

Now, dozens of seniors are moving with BedBike, a product that, three years ago, was just an idea. 

Step by step, you can move forward. 

 

So what do you think? Let’s talk 

We are always looking for feedback on how our portable arm ergometer can be improved, and also to get the conversation going about promoting mobility. Please feel free to answer one or all of these and I’ll join in the conversation as best I can:

  1. How do you encourage patients to move when it might be a challenge?
  2. Have you ever considered a portable arm ergometer for your patients?
  3. Do you have other products or strategies you recommend for encouraging patients to move, even while in bed?
  4. Have you ever tried to create a product? What challenges have you faced getting it to market?

 

Reference:

1. Hoyert, DL, et al. “Deaths preliminary data for 2003.” Natl Vital Stat Rep. 53(15), 2003, p1–48.

 

About Kyle Freedman

Kyle is the founder and CEO of PhysioHealth Technologies Ltd. He continues to practice at a multi-disciplinary clinic with a focus on orthopaedics and also treats geriatrics patients at their residential care facilities. One of his passions, besides his family and racquet sports, is to help provide access to affordable and portable equipment that allows for self-rehabilitation.

Follow BedBike’s progress on Facebook or learn more at www.physiohealthtech.com