Why Getting Out of Your Chair Matters: The Importance of Movement After Hospital

When you have been unwell, sitting in a comfortable chair can feel like a major achievement. After days in hospital or bed, simply getting out of bed and sitting in the living room can feel like a big step forward. Chairs are not the problem — the problem is spending most of the day sitting and rarely getting up.

For someone recovering from illness, sitting out of bed is an important part of recovery. It gets the body upright, provides an opportunity to eat and drink normally, encourages social interaction and allows the lungs, muscles and cardiovascular system to work differently from when lying in bed.

However, once someone is safely able to stand, transfer and walk, it is important to gradually increase how much they move.

Remaining in a chair for many hours with very little movement can contribute to many of the same problems as prolonged bed rest: muscle weakness, reduced fitness, poorer balance, stiffness, swelling, constipation, reduced confidence and increasing dependence on other people. NICE's current falls guidance specifically encourages people to remain active, reduce sedentary behaviour and have a structured daily routine that provides regular opportunities to stand up and walk around where appropriate.

The good news is that getting moving again does not necessarily mean going for long walks or doing strenuous exercise. Standing up regularly, walking short distances around the home and practising everyday activities can all be part of rehabilitation.

Sitting out of bed is a positive first step

It is important not to interpret this message as simply "don't sit down". For someone who has been

confined to bed, getting into a chair can be a really positive rehabilitation milestone.

Moving from lying to sitting and then sitting upright requires the body to work differently. The trunk and back muscles have to contribute to maintaining an upright position, the postural muscles have to work against gravity and the person has to maintain sitting balance rather than being fully supported by a mattress.

Sitting also gives someone the opportunity to look around, interact with other people and take part in normal daily activities. They are more likely to see what is happening around the house, have conversations, eat with family and engage with their surroundings.

It is therefore useful to think of sitting out as part of recovery — but not necessarily the end goal.

Sitting upright can help your breathing

Our position can affect how effectively we breathe. When we lie flat, the abdominal contents sit relatively close against the diaphragm, the main muscle responsible for breathing. Sitting upright changes the relationship between the chest and abdomen and generally gives the diaphragm and lungs a more favourable position for ventilation.

An upright position can make it easier to take deeper breaths and can also make coughing and clearing secretions easier. This can be particularly relevant to someone who is already vulnerable to chest problems, such as a person with COPD, bronchiectasis, neurological disease, swallowing difficulties or a recent respiratory infection.

For someone who is medically well enough to sit out of bed, spending periods upright in a chair can therefore be a useful part of maintaining respiratory function, alongside appropriate breathing exercises, sputum-clearance techniques and medical treatment where required.

Sitting out can make mealtimes safer and more normal

Getting out of bed for meals has several potential benefits.

Sitting upright provides a much better position for eating and drinking than lying in bed. Swallowing involves carefully coordinated movements between the mouth, throat and breathing system, and swallowing and breathing can become more challenging in older people or people who have become weak or unwell.

For anyone with known swallowing difficulties, the advice given by their speech and language therapist should always take priority. For someone without specific swallowing restrictions, however, sitting upright at a table for meals is generally preferable to eating lying down.

Getting up for meals also restores a normal routine: getting dressed, transferring or walking to the dining table, eating a meal and spending time with other people.

There is also an important social benefit. Meals are not simply about nutrition. They can be an opportunity to talk, interact with family and maintain a sense of normality.

Movement and your bowels

Being inactive can contribute to constipation, particularly when combined with reduced fluid intake, changes in diet, medication and illness.

Movement and regular physical activity form part of maintaining normal bowel function. Someone who spends the whole day sitting has far fewer opportunities to walk around, change position and maintain their usual daily routine.

Getting up, walking around the home and returning to normal daily activities can therefore form part of a healthy approach to bowel function, alongside appropriate hydration, nutrition and medical management.

If constipation is persistent or troublesome, it is important to discuss it with a healthcare professional rather than assuming inactivity is the only cause.

Your legs and circulation benefit from getting up

When we walk, the muscles in our legs, particularly the calf muscles, contract repeatedly. This helps act as a muscle pump, assisting the return of blood from the lower limbs.

Someone who spends most of the day sitting has far fewer of these contractions. Standing and walking therefore provide important opportunities to use the leg muscles and encourage normal circulation.

This can be particularly relevant to someone who experiences swelling in their ankles and feet. However, swelling has many possible causes, so persistent or new swelling should not simply be attributed to sitting.

New one-sided swelling, particularly when accompanied by pain, warmth, redness or breathlessness, requires medical assessment.

Sitting out can help reduce prolonged pressure — but the chair matters

Pressure damage isn't only a problem for people in bed. People who sit for prolonged periods can also develop pressure ulcers, particularly if they have poor mobility, reduced sensation, poor nutrition, cognitive impairment or difficulty changing their own position.

NICE recommends considering the seating needs of people at risk of pressure ulcers who sit for prolonged periods and considering a high-specification foam or equivalent pressure-redistributing cushion where appropriate.

Getting out of the chair and standing or walking provides an opportunity to take pressure off areas that have been bearing weight. Changing position is important — but simply moving from a bed into a chair doesn't remove the risk of pressure damage.

This is why the correct chair, posture and pressure-relieving cushion can be important for someone who spends a significant amount of time sitting.

If someone is going to be sitting for long periods, particularly if they are frail, have poor sensation, previous pressure damage or difficulty repositioning themselves, it is sensible to discuss their seating and pressure-relief needs with the district nursing team or another appropriate healthcare professional.

Look after the skin

Carers and family members should be aware of changes to the skin, particularly around the bottom, sacrum, hips and other bony areas that are exposed to pressure. Look for redness or discolouration, changes in skin temperature, swelling, hardness, moisture or soreness.

One important warning sign is non-blanching erythema. In simple terms, this means an area of redness or discolouration that does not temporarily fade when pressure is applied and then released. It can be an early sign of pressure damage and should not be ignored.

Pressure damage can look different on darker skin tones, where redness may be less obvious, so carers should be alert to any new or unusual changes in colour or appearance. NICE specifically highlights this issue.

If someone develops a sore bottom, persistent redness or discolouration, broken skin or an area that looks or feels different from the surrounding skin, seek advice from the district nursing team, GP or another appropriate healthcare professional rather than simply putting another cushion underneath it.

And remember: a cushion isn't automatically a pressure-relieving cushion. The correct pressure-redistributing equipment should be selected according to the person's individual needs.

Posture and sitting balance

Sitting upright gives the body an opportunity to practise something that is surprisingly important: postural control.

When someone is lying in bed, the mattress provides a large amount of support. When sitting in a chair, the body has to maintain itself against gravity. The trunk and back muscles contribute to keeping the head and body upright, while the person has to make small adjustments to remain balanced.

This doesn't mean that sitting in a chair is a substitute for strengthening exercises. Rather, upright sitting provides another opportunity to practise postural control and tolerance of being upright.

For someone who has become very weak, even maintaining a good sitting position for longer periods can be part of their rehabilitation.

Riser-recliner chairs: incredibly useful, but use them wisely

Riser-recliner chairs can be extremely helpful for people who have difficulty getting to standing. The lifting mechanism can reduce the amount of force required to rise and can make transfers safer.

However, there can be a downside if the chair's riser function does all of the work.

If someone is physically capable of standing with some assistance but the chair is always raised almost completely to standing, they get less opportunity to use their own leg muscles. Over time, this may mean they are not challenging their muscles enough to regain strength.

Where safe and appropriate, the chair can therefore become part of a graded rehabilitation programme. Initially, the chair might be raised higher to help someone stand. As strength improves, the chair can potentially be lowered gradually so that the person contributes more of the movement themselves.

The aim isn't to make standing unnecessarily difficult. It is to provide the right amount of assistance for the person's current ability.

This is an area where physiotherapy assessment can be particularly valuable.

Reclining chairs and swollen legs

A reclining chair can be useful for someone who experiences swelling in their legs or feet. Elevating the legs for periods can be incorporated into an overall swelling-management strategy where appropriate.

However, someone with swollen legs doesn't necessarily need to remain reclined all day.

Where it is safe, try to alternate periods of elevation with periods sitting upright, standing and walking. The movement of the leg muscles during standing and walking can help circulation, while changing position prevents someone remaining in exactly the same posture for prolonged periods.

Again, unexplained or significant swelling should be medically assessed rather than simply treated by elevating the legs.

Why sitting less and moving more matters

Our bodies adapt to the amount of activity we ask of them. If we spend most of the day sitting, we are giving our muscles very little reason to maintain their strength. We also give our balance system, cardiovascular system and walking pattern fewer opportunities to practise.

Research in older adults has found associations between sedentary behaviour, breaking up sedentary time and physical function. The evidence doesn't mean that every short period of standing will prevent decline, but it supports the broader principle that regular movement and reducing prolonged sedentary time are important parts of maintaining physical function.

NICE's current falls guidance goes further, recommending that people should be encouraged to remain active and have opportunities to regularly stand up and walk around where appropriate.

The practical message is simple: don't worry about whether every movement counts as "exercise" — create more opportunities to move.

Standing up from the chair is exercise

For someone who has become weak, simply standing from a chair can be a significant physical challenge.

Standing requires the thighs, hips and trunk to generate enough force to move the body's weight upwards. It also requires balance and coordination.

This is why repeated sit-to-stand practice is often included in rehabilitation programmes. It is directly relevant to everyday life: getting out of a dining chair, standing from the toilet, getting out of the car and getting out of bed all require similar physical abilities.

If someone has been assessed as safe to practise sit-to-stands, this can be an excellent functional strengthening exercise.

Walking is one of the best things you can practise

Walking is both exercise and a skill.

After illness, someone who previously walked independently may temporarily require a walking aid. This is completely normal. The important thing is to ensure the aid provides the right amount of support while allowing safe practice of walking.

A Zimmer frame or standard walking frame provides a large base of support and can be particularly useful for someone who is weak or unsteady. However, it needs to be lifted and moved, so the person needs sufficient upper-limb strength and coordination.

A wheeled Zimmer frame can make moving the frame easier because the person doesn't have to lift it completely.

A four-wheeled walker or rollator allows a smoother, more continuous style of walking and can be particularly useful for someone who needs support but has reasonable mobility. However, because it rolls easily, it can sometimes move faster than a nervous user expects. Someone who is anxious about falling may therefore need assessment and practice before using one independently.

A gutter or pulpit frame can provide more support through the forearms and may be useful for people who have difficulty taking weight through their hands or require substantial upper-limb support.

Crutches can be useful where appropriate, particularly where weight-bearing through one or both legs needs to be reduced, but they require good balance, coordination and upper-body strength.

A stick generally provides less support and is often more appropriate later in rehabilitation when someone has regained much of their strength and balance.

Where possible, rehabilitation may progress from a more supportive walking aid to a less supportive aid and eventually to walking without an aid. However, not everyone will reach that point, and the goal should always be the highest level of safe independence realistic for that person.

Transfer equipment can be a stepping stone

Some people returning home from hospital are initially unable to stand or walk independently. Equipment such as standing transfer aids and patient turners can be invaluable in this situation.

A Sara Stedy-style standing transfer aid, for example, can allow someone with some ability to weight-bear through their legs to stand with support and transfer over a short distance without needing to walk independently.

These devices can provide an important bridge between being unable to transfer and becoming independently mobile. They can also reduce the physical demands placed on family members and carers.

However, the person's ability should be reviewed regularly. If they are getting stronger, it may be possible to progress from a standing aid to supported standing, stepping and then walking with an appropriate frame.

Equipment should enable rehabilitation, not accidentally prevent it.

Why physiotherapy is important when progressing mobility

One of the hardest questions after hospital is: "How much should I be doing?"

Too little activity can allow deconditioning to continue. Too much, too quickly can lead to excessive fatigue, loss of confidence, unsafe transfers or falls.

Physiotherapy can help find the appropriate middle ground. A physiotherapist can assess strength, balance, transfers, walking, cardiovascular tolerance, confidence and the person's ability to follow instructions. They can then help determine what level of assistance is appropriate.

This might mean progressing from a Sara Stedy to supported standing, from supported standing to a Zimmer frame, from a Zimmer frame to a wheeled frame, from a wheeled frame to a four-wheeled walker, and eventually perhaps to a stick or no walking aid.

The important part is the progression being safe, controlled and appropriate to the individual.

Current NICE falls guidance recommends that falls-prevention exercise programmes should be progressive and tailored to the individual's needs, abilities and goals, with regular reviews of progress. Programmes should address relevant components such as balance, coordination, strength and power.

Simple exercises you can do from your chair

If you aren't yet safe to stand independently, there are still plenty of ways to keep moving.

Ankle pumps: Move your feet up and down slowly to maintain ankle movement and encourage circulation.

Knee extensions: Straighten one knee at a time, hold briefly and slowly lower it.

Seated marching: Lift one knee and then the other, as though marching while sitting.

Heel raises: Keep your toes on the floor and lift your heels up and down.

Toe raises: Keep your heels down and lift your toes towards you.

Seated arm movements: Reach forwards, upwards and out to the side within a comfortable range.

Sit-to-stand: If you have been assessed as safe to stand, practise standing up from the chair and sitting back down in a controlled manner.

These exercises should be appropriate for the individual. Someone who has recently returned from hospital, is significantly weak, dizzy, breathless or at high risk of falling should seek professional advice before starting a new exercise programme.

Don't forget your breathing exercises

Sitting upright is also a good opportunity to practise breathing. Try sitting comfortably and taking slow, controlled breaths, allowing your ribs and abdomen to expand naturally. Avoid forcing huge breaths if they make you uncomfortable or dizzy.

If you have been taught specific breathing exercises, huffing, coughing techniques or an active cycle of breathing technique by a respiratory physiotherapist, continue these as advised.

For people who have difficulty clearing sputum, upright positioning, movement and appropriate respiratory exercises can all be important parts of respiratory management.

Don't make every movement into "exercise"

One of the best ways to increase activity is to make movement part of normal life.

Walking to the kitchen to make a cup of tea is movement. Standing to brush your teeth is movement. Walking to the bathroom is movement. Getting dressed is movement. Walking into the garden is movement. Standing while talking to someone is movement.

These activities also have a purpose.

Instead of thinking, "I need to exercise for 30 minutes", it may be more achievable for someone recovering from illness to think, "I'm going to get up regularly throughout the day."

The amount and frequency should be appropriate to the person's health and ability, but breaking up long periods of sitting is a useful principle.

The psychological benefits of getting moving

There is a significant psychological element to recovery.

Someone who spends most of the day sitting in the same chair, particularly if that chair is in their bedroom, can become increasingly isolated from the rest of the household.

Moving into the living room, sitting at the dining table, having a cup of tea with someone or going into the garden can create a sense of normality.

It also provides reasons to move.

Rather than asking someone to exercise simply because they "should", walking to the kitchen to make a drink or moving to the dining room for lunch gives the movement a purpose.

Getting mobile isn't just about getting stronger. It's about getting back into life.

Movement can help prevent the cycle of deconditioning

The biggest concern after hospital isn't necessarily that someone sits in a chair. It is what can happen if that sitting becomes the person's entire day.

They sit because they are weak.

Because they sit, they become weaker.

Because they are weaker, standing becomes harder.

Because standing is harder, they become nervous about falling.

Because they are nervous, they move even less.

Eventually, a short period of illness can become a much longer-term loss of independence.

Breaking that cycle early is one of the most important goals of rehabilitation. NICE's rehabilitation guidance emphasises early rehabilitation and progression from sitting, to standing, to supported steps and functional activities such as walking to the toilet and managing stairs.

How Physio At Home can help

At Physio At Home, we regularly see people who have returned home from hospital and are spending much more time sitting than they did before becoming unwell. Sometimes they are simply unsure how to get moving again. Others have become significantly weaker and need help progressing from transfer equipment to standing, from standing to walking, or from a more supportive walking aid towards greater independence.

Because we work in the person's own home, we can assess the real-life challenges they are facing. Can they safely get out of their chair? Can they walk to the bathroom? Can they stand from their riser-recliner without it doing all the work? Is their walking aid appropriate? Are they sitting safely? Is their pressure-relieving cushion appropriate? Can they get into the kitchen or garden?

We can assess strength, balance, transfers, walking, confidence and functional ability and develop a graded rehabilitation programme around the person's own home and goals.

Where transfer equipment or walking aids are being used, we can help determine whether they remain appropriate and whether the person is ready to progress. Sometimes the next step is simply reducing the amount of assistance from a riser chair. Sometimes it is moving from a standing aid to a frame. Sometimes it is building enough confidence to walk further around the home.

We also recognise that people don't always receive all the rehabilitation they need immediately after hospital. With community services under considerable pressure, some people may be waiting for NHS physiotherapy or rehabilitation to begin. Physio At Home is happy to provide private physiotherapy support during this period, helping people get started rather than allowing further deconditioning to develop while they wait.

Early intervention can be particularly valuable because the longer someone remains inactive, the more difficult it can become to regain their previous level of function.

Our aim isn't simply to help someone stand up once. It is to help them build the strength, balance, confidence and functional ability they need to become as independent as possible in their own home.

A simple goal: sit less, move more

For someone recovering from illness, sitting in a chair can be a huge improvement compared with remaining in bed. But once someone is safely able to stand and move, spending the entire day in their chair can still contribute to deconditioning.

Try to build movement into the day. Get dressed. Sit out for breakfast. Walk to the bathroom if safe. Stand from your chair regularly. Walk to the kitchen. Sit at the dining table for lunch. Do some seated exercises. Practise standing if appropriate. Take a short walk around the house.

Spend some time in the garden. Gradually increase what you can do.

For someone with significant weakness, even a few extra stands or a short walk to the kitchen can be meaningful.

The chair is there to help you rest — not to become your permanent home.

The bottom line

Getting someone out of bed and into a chair is an important step in recovery, but getting into the chair should not necessarily be the end goal.

Sitting upright can support better positioning for eating and swallowing, provide opportunities for deeper breathing, encourage social interaction, improve postural control and allow someone to participate in normal daily routines. Standing and walking then provide further benefits for muscle strength, balance, circulation, cardiovascular fitness, bowel function and independence.

For people at risk of pressure damage, changing position and getting out of the chair can help reduce prolonged pressure, but prolonged sitting still carries a pressure risk. A suitable pressure-redistributing cushion and appropriate seating should be considered where necessary. NICE specifically recommends considering seating needs and pressure-redistributing cushions for people at risk who sit for prolonged periods.

Walking aids, riser-recliner chairs and transfer equipment can all be extremely valuable. They should not be seen as a failure or something to avoid. They are tools that can allow someone to move safely while they rebuild their ability.

The important thing is to keep reviewing what the person can do and, when safe, gradually reduce the level of assistance.

After hospital, recovery isn't just about getting over the original illness. It is also about rebuilding the strength, balance, fitness, confidence and independence that may have been lost while someone was unwell and inactive.

Getting out of the chair is often the first step. Getting moving is how recovery continues.

Important safety advice

This article is general information and is not a substitute for an individual assessment. If you have recently returned home from hospital, have significant weakness, dizziness, chest pain, unexplained breathlessness, a high risk of falling or have been given specific mobility restrictions, seek appropriate professional advice before increasing your activity.

Never attempt to stand or walk independently if you have been advised that you require assistance. Walking aids and transfer equipment should be appropriately selected, adjusted and demonstrated for the individual.

If someone develops a new sore area, persistent redness or discolouration, broken skin or an area that appears different over a bony prominence, seek advice from the district nursing team, GP or appropriate healthcare professional.

Where it is medically safe to do so, however, regular movement is one of the most important tools we have for preventing deconditioning and working towards maintaining independence.

Research and further reading

NICE – Falls: assessment and prevention in older people and people aged 50 and over at higher risk. The current NICE guidance recommends progressive, tailored strength and balance exercise and specifically encourages people to be less sedentary, with regular opportunities to stand up and walk around where appropriate.NICE – Falls: assessment and prevention

NICE – Pressure ulcers: prevention and management. Guidance covering pressure-ulcer prevention, skin assessment, repositioning and appropriate seating and pressure-redistributing cushions for people who sit for prolonged periods.NICE – Pressure ulcers: prevention and management

NICE – Rehabilitation after critical illness in adults. NICE describes rehabilitation as progressing through goals such as sitting, standing, marching, taking supported steps and eventually functional activities such as walking to the toilet and managing stairs.NICE – Rehabilitation after critical illness

Research on sedentary behaviour and physical function in older adults. Research has examined the relationship between sedentary time, breaking up prolonged sitting and physical function in older adults.PubMed – Sedentary time and physical function in older adults

NICE – Pressure redistribution and seating. NICE specifically recommends considering seating needs and a high-specification foam or equivalent pressure-redistributing cushion for people at risk who sit for prolonged periods.NICE – Pressure redistribution devices