Development of a tool to assess posture in bed of frail older adults, and assessment of its acceptability and validity (the HARP-B Study)


Objectives and brief methodology


High proportions of frail care home residents have co-morbidities, and spend long periods of time in bed. A tool to record their posture would support carer assessment and optimisation of bed-based posture, so increasing comfort and well-being. In the absence of a suitable postural assessment method for non-experts (non-therapists), this project’s aim is to develop an assessment tool for this group; and to assess its acceptability to staff and residents, and its validity (that it measures what we intend it to).


We will achieve our aims by:

  • Working in partnership with physiotherapists, care home staff, and other health care professionals to develop a preliminary tool to measure posture in bed;
  • Developing a short training package for non-experts (care staff or researchers) who will use the tool;
  • Consulting with care home residents, relatives and staff to establish usability and face validity of the preliminary version of the tool;
  • Refining the tool following this consultation work;
  • Piloting the refined tool in two further care homes to establish construct validity;
  • Consulting with care home residents, relatives and staff in these two homes to understand the acceptability of the refined tool.


We will use a mixed methods approach – co-production, interviews and conversations (qualitative); and analysis of completed postural assessments (quantitative).

 Partners and Collaborators

Grant applicants: Mrs Karen Hull, Professor Anne Forster, Dr Liz Graham, Dr Rebecca Hawkins

Sponsor: Bradford Teaching Hospitals NHS Foundation Trust


01/10/2022 – 01/10/2023



This work was supported by a grant from the Chartered Society of Physiotherapy Charitable Trust (PRF/20/C07)


Further information

For further information please contact Liz Graham ( Telephone: 01274 383443