Preview the template below. Print directly from your browser, or download the printable PDF for the formatted single-page version.
Inspired Comforts Toolkit
Tracking daily PT exercises and range of motion shows progress and helps your physical therapist adjust. Fill in after each session, home or in clinic.
About my procedure
Joint replaced + date
Surgeon
PT clinic / home program
Daily exercise log
| Date | Exercises completed | Walker / cane / none | Walking distance | Pain (0-10) | Notes |
|---|---|---|---|---|---|
Range of motion (weekly)
| Week | Flexion (°) | Extension (°) | Notes |
|---|---|---|---|
By the Inspired Comforts editorial team · inspiredcomforts.com
For inspiration only. Customize for your situation. Always consult your medical team. Inspired Comforts is not a medical provider.
Visited 1 times, 1 visit(s) today
