Exhibit 10.3


                              INVACARE CORPORATION






                                 FIRST AMENDMENT
                         Dated as of September 29, 2005



                                       to



                             NOTE PURCHASE AGREEMENT
                           Dated as of October 1, 2003







         Re: $50,000,000 3.97% Series A Senior Notes due October 1, 2007
           $30,000,000 4.74% Series B Senior Notes due October 1, 2009
                                       and
           $20,000,000 5.05% Series C Senior Notes Due October 1, 2010





================================================================================

                   FIRST AMENDMENT TO NOTE PURCHASE AGREEMENT

     THIS FIRST  AMENDMENT  dated as of  September  29, 2005 (the or this "First
Amendment") to the Note Purchase  Agreement dated as of October 1, 2003 is among
INVACARE  CORPORATION,  an Ohio  corporation  (the  "Company"),  and each of the
institutions  which is a signatory to this First  Amendment  (collectively,  the
"Noteholders").


                                    RECITALS:

     A. The Company and each of the  Noteholders  have  previously  entered into
that certain Note Purchase  Agreement dated as of October 1, 2003 (the "Existing
Note Purchase Agreement," and, as amended hereby, the "Note Purchase Agreement")
pursuant to which the Company issued the (i)  $50,000,000  3.97% Series A Senior
Notes due October 1, 2007 (the "Series A Notes"),  (ii) $30,000,000 4.74% Series
B Senior Notes due October 1, 2009 (the "Series B Notes"), and (iii) $20,000,000
5.05%  Series C Senior  Notes due  October  1, 2010 (the  "Series C Notes";  and
together  with the  Series A Notes  and the  Series  B Notes  collectively,  the
"Notes"). The Noteholders are the holders of the outstanding principal amount of
the Notes identified on the signature pages hereto.

     B. The  Company  has also  previously  entered  into  that  certain  Credit
Agreement dated as of January 14, 2005 (the "Bank Credit  Agreement")  among the
Company and certain Borrowing Subsidiaries (as defined therein), the banks named
therein (the "Banks"),  JPMorgan Chase Bank,  N.A., as agent,  Keybank  National
Association as  Syndication  Agent,  J.P.  Morgan  Securities,  Inc. and Keybank
National Association as Co-Lead Arrangers, pursuant to which the Banks agreed to
make term loans and extend a credit  facility to the  Company and the  Borrowing
Subsidiaries.

     C. In  furtherance of the foregoing,  the Company and the  Noteholders  now
desire to amend the Existing Note Purchase  Agreement in the respects,  but only
in the respects, hereinafter set forth.

     D.  Capitalized  terms  used  herein  shall  have the  respective  meanings
ascribed  thereto in the Note  Agreement  unless  herein  defined or the context
shall otherwise require.

     E. All requirements of law have been fully complied with and all other acts
and things  necessary  to make this First  Amendment a valid,  legal and binding
instrument  according to its terms for the purposes  herein  expressed have been
done or performed.

     NOW, THEREFORE,  upon the full and complete  satisfaction of the conditions
precedent  to the  effectiveness  of this  First  Amendment  set forth in ss.3.1
hereof, and in consideration of good and valuable  consideration the receipt and
sufficiency of which is hereby acknowledged,  the Company and the Noteholders do
hereby agree as follows:
<page>
SECTION 1. AMENDMENTS.

     Section  1.1.  Amendment  to  Section  10 of  the  Existing  Note  Purchase
Agreement.  Section 10 of the Existing Note Purchase  Agreement  shall be and is
hereby amended to insert a new Section 10.7 to read in its entirety as follows:

               "Section 10.7. Minimum Credit Agreement  Commitment.  The Company
          shall at all times  maintain at least  $350,000,000  in aggregate loan
          commitments under its Credit Agreement."

     Section  1.2.  Amendment  to Section  11.3 of the  Existing  Note  Purchase
Agreement.  Section 11.3 of the Existing Note Purchase Agreement shall be and is
hereby amended in its entirety to read as follows:

               "Section 11.3.  Maximum Amount of Consolidated  Debt. The Company
          will  not at any  time  permit  the  ratio  of  Consolidated  Debt  to
          Consolidated Operating Cash Flow to exceed 3.50 to 1.00 (or such lower
          ratio at all times during which the Credit Agreement  requires a lower
          ratio) for the immediately  preceding four fiscal quarter period taken
          as a single accounting period ending on the date of calculation."

     Section 1.3.  Amendments to Existing Defined Terms.  The following  defined
terms set forth in Schedule B to the Existing Note Purchase  Agreements shall be
and are hereby amended as follows:

          The definition of  Consolidated  Total Assets shall be amended to read
     in its entirety as follows:

          ""Consolidated  Total Assets" means,  at any time, the total assets of
     the Company and its Subsidiaries determined on a consolidated basis at such
     time in accordance  with GAAP,  less, to the extent  otherwise  included in
     shareholders'  equity, all assets that have been pledged in connection with
     or otherwise relate to the Receivables  Securitization Program in an amount
     equal to the amount of the related Debt."

          The last paragraph of the definition of Debt is hereby amended to read
     in its entirety as follows:

          For the purposes of the  avoidance of doubt,  "Debt" shall not include
     (i) any benefit  liability or funding  obligation  of the Company or any of
     its Subsidiaries in respect of any Plan or (ii) amounts  outstanding  under
     any  Permitted  Receivables  Securitization  Program,  whether  or not such
     amounts are shown as a liability on the balance sheet of the Company or any
     of its Subsidiaries.  For purposes of determining  "Debt," no amount listed
     above shall be included more than once in such determination.

                                       2
<page>
     The definition of "Priority  Debt" shall be amended to read in its entirety
     as follows:

          "Priority Debt" means the sum, without duplication, of (i) Debt of the
     Company secured by Liens not otherwise permitted by clauses (a) through (k)
     of  Section  11.7,  and  (ii) all Debt of all  Subsidiaries  not  otherwise
     permitted by clauses (a) through (d) of Section  11.5;  provided,  however,
     notwithstanding  the foregoing,  "Priority  Debt" shall include all Debt of
     Subsidiaries outstanding under the Credit Agreement.

SECTION 2. REPRESENTATIONS AND WARRANTIES OF THE COMPANY.

     Section  2.1. To induce the  Noteholders  to execute and deliver this First
Amendment  (which  representations  shall  survive the execution and delivery of
this First  Amendment),  the Company  represents and warrants to the Noteholders
that:

          (a) this  First  Amendment  has been  duly  authorized,  executed  and
     delivered by it and this First Amendment  constitutes the legal,  valid and
     binding  obligation,  contract  and  agreement  of the Company  enforceable
     against it in  accordance  with its  terms,  except as  enforcement  may be
     limited by bankruptcy,  insolvency,  reorganization,  moratorium or similar
     laws or  equitable  principles  relating to or limiting  creditors'  rights
     generally;

          (b) the Existing Note Agreement,  as amended by this First  Amendment,
     constitute  the  legal,  valid  and  binding  obligations,   contracts  and
     agreements of the Company  enforceable  against it in accordance with their
     respective  terms,  except as  enforcement  may be limited  by  bankruptcy,
     insolvency,  reorganization,   moratorium  or  similar  laws  or  equitable
     principles relating to or limiting creditors' rights generally;

          (c) the  execution,  delivery and  performance  by the Company of this
     First  Amendment (i) has been duly  authorized  by all requisite  corporate
     action  and, if  required,  shareholder  action,  (ii) does not require the
     consent or approval of any  governmental or regulatory body or agency,  and
     (iii) will not (A)  violate  (1) any  provision  of law,  statute,  rule or
     regulation or its certificate of incorporation or bylaws,  (2) any order of
     any  court  or any  rule,  regulation  or  order  of any  other  agency  or
     government binding upon it, or (3) any provision of any material indenture,
     agreement  or other  instrument  to  which  it is a party  or by which  its
     properties  or  assets  are or may be bound or (B)  result  in a breach  or
     constitute  (alone  or with due  notice or lapse of time or both) a default
     under any indenture,  agreement or other  instrument  referred to in clause
     (iii)(A)(3) of this ss. 2.1(c);

          (d) as of the date  hereof  and  after  giving  effect  to this  First
     Amendment, no Default or Event of Default has occurred which is continuing;
     and

          (e) all the representations  and warranties  contained in Section 5 of
     the Existing Note Agreements are true and correct in all material  respects
     with the same force and  effect as if made by the  Company on and as of the
     date hereof.

                                       3
<page>
SECTION 3. CONDITIONS TO EFFECTIVENESS OF THIS FIRST AMENDMENT.

     Section 3.1. This First Amendment  shall not become  effective  until,  and
shall become  effective  when,  each and every one of the  following  conditions
shall have been satisfied (the "First Amendment Effective Date"):

          (a) executed  counterparts of this First  Amendment,  duly executed by
     the Company and the holders of more than 50% of the  outstanding  principal
     of the Notes, shall have been delivered to the Noteholders;

          (b) the  Noteholders  shall have received a copy of the resolutions of
     the Board of Directors or its  equivalent  of the Company  authorizing  the
     execution, delivery and performance by the Company of this First Amendment,
     certified by its Secretary or an Assistant Secretary;

          (c) the representations and warranties of the Company set forth in ss.
     2 hereof are true and correct on and with respect to the date hereof;

          (d) the  Noteholders  shall have  received  the  favorable  opinion of
     Calfee,  Halter & Griswold  LLP,  counsel for the Company,  dated the First
     Amendment  Effective  Date,  which  opinion  shall be in form and substance
     satisfactory  to the  Noteholders and Chapman and Cutler LLP, their special
     counsel;

          (e)  All  proceedings   taken  in  connection  with  the  transactions
     contemplated by this First  Amendment,  and all documents  necessary to the
     consummation  thereof,  shall  be  reasonably   satisfactory  in  form  and
     substance  to the  Noteholders  and Chapman and Cutler LLP,  their  special
     counsel,  and the  Noteholders  shall  have  received a copy  (executed  or
     certified as may be  appropriate)  of all legal  documents  or  proceedings
     taken in connection with the consummation of said transactions; and

          (f) As of the  effective  date of this First  Amendment  (after giving
     effect to the  amendments  contemplated  hereby),  no  Default  or Event of
     Default shall have occurred and be continuing.

SECTION 4. PAYMENT OF NOTEHOLDERS' COUNSEL FEES AND EXPENSES.

     The Company agrees to pay upon demand,  the reasonable fees and expenses of
Chapman and Cutler  LLP,  counsel to the  Noteholders,  in  connection  with the
negotiation,  preparation,  approval,  execution  and  delivery  of  this  First
Amendment.

SECTION 5. MISCELLANEOUS.

     Section 5.1. This First Amendment shall be construed in connection with and
as part of the Existing  Note  Agreement,  and except as modified and  expressly
amended by this First Amendment,  all terms,  conditions and covenants contained
in the Existing Note  Agreement  are hereby  ratified and shall be and remain in
full force and effect.

                                       4
<page>
     Section  5.2.  Any  and  all  notices,  requests,  certificates  and  other
instruments  executed and  delivered  after the  execution  and delivery of this
First  Amendment  may  refer  to the  Note  Agreement  without  making  specific
reference to this First Amendment but  nevertheless  all such  references  shall
include this First Amendment unless the context otherwise requires.

     Section 5.3. The descriptive  headings of the various  Sections or parts of
this First Amendment are for  convenience  only and shall not affect the meaning
or construction of any of the provisions hereof.

     Section 5.4.  This First  Amendment  shall be governed by and  construed in
accordance  with  the  law of the  State  of New  York  excluding  choice-of-law
principles of the law of such State that would require the  application  of laws
of a jurisdiction other than such State.


                                       5




     Section  5.5.  The  execution  hereof by you shall  constitute  a  contract
between  us for the uses and  purposes  hereinabove  set  forth,  and this First
Amendment  may  be  executed  in  any  number  of  counterparts,  each  executed
counterpart constituting an original, but all together only one agreement.

                               INVACARE CORPORATION


                          By:   /s/ Ronn L. Claussen
                                ________________________________________________
                          Name:   Ronn L. Claussen
                          Title:  Vice President and Treasurer


                                       6



The foregoing is hereby agreed to as of the date thereof:

                          METROPOLITAN LIFE INSURANCE COMPANY



                          By    /s/ Judith A. Gulotta
                                ________________________________________________
                          Name:   Judith A. Gulotta
                          Title:  Director

                          $__________ Series ___


                                       7





                          TEACHERS INSURANCE AND ANNUITY ASSOCIATION OF AMERICA



                          By    /s/ Elizabeth Schulz
                                ________________________________________________
                          Name:   Elizabeth Schulz
                          Title:  Director-Private Placements

                          $11,000,000 Series C


                          TIAA-CREF LIFE INSURANCE COMPANY

                          By:   Teachers Insurance and Annuity Association of
                                America, as Investment Manager



                          By    /s/ Elizabeth Schulz
                                ________________________________________________
                          Name:   Elizabeth Schulz
                          Title:  Director-Private Placements

                          $9,000,000 Series A



                                       8





                          MEDICAL PROTECTIVE COMPANY



                          By ___________________________________________________
                          Name:
                          Title:

                          $__________ Series ___

                                       9




                          GENERAL ELECTRIC CAPITAL ASSURANCE COMPANY



                          By    /s/ Morian C. Mooers
                                ________________________________________________
                          Name:   Morian C. Mooers
                          Title:  Investment Officer

                          $2,000,000 Series A
                          $3,000,000 Series B


                          GE LIFE AND ANNUITY ASSURANCE COMPANY



                          By    /s/ Morian C. Mooers
                                ________________________________________________
                          Name:   Morian C. Mooers
                          Title:  Investment Officer

                          $3,000,000 Series B


                          EMPLOYERS REINSURANCE CORPORATION

                          By:  GE Asset Management Incorporated,
                               its Investment Manager

                          By:  Genworth Financial Asset Management,
                               LLC, its Investment Advisor


                          By    /s/ Morian C. Mooers
                                ________________________________________________
                          Name:   Morian C. Mooers
                          Title:  Assistant Vice President

                          $4,000,000 Series A


                                       10





                          MIDLAND NATIONAL LIFE INSURANCE COMPANY



                          By ___________________________________________________
                          Name:
                          Title:

                          $__________ Series ___


                          NORTH AMERICAN COMPANY FOR LIFE AND HEALTH INSURANCE



                          By ___________________________________________________
                          Name:
                          Title:

                          $__________ Series ___


                          NORTH AMERICAN COMPANY FOR LIFE AND HEALTH INSURANCE
                          OF NEW YORK



                          By ___________________________________________________
                          Name:
                          Title:

                          $__________ Series ___


                                       11




                          MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY

                          By:   Babson Capital Management LLC, as Investment
                                Adviser


                          By    /s/ Kathleen Lynch
                                ________________________________________________
                          Name:   Kathleen Lynch
                          Title:  Managing Director

                          $5,400,000 Series A


                          C.M. LIFE INSURANCE COMPANY

                          By:   Babson Capital Management LLC, as Investment
                                Sub-Adviser


                          By    /s/ Kathleen Lynch
                                ________________________________________________
                          Name:   Kathleen Lynch
                          Title:  Managing Director

                          $1,600,000 Series A


                                       12




                          PHOENIX LIFE INSURANCE COMPANY


                          By    /s/ John H. Beers
                                ________________________________________________
                          Name:   John H. Beers
                          Title:  Vice President

                          $2,500,000 Series B


                          PHL VARIABLE INSURANCE COMPANY



                          By    /s/ John H. Beers
                                ________________________________________________
                          Name:   John H. Beers
                          Title:  Vice President

                          $2,500,000 Series B



                                       13





                          PRINCIPAL LIFE INSURANCE COMPANY

                          By:   Principal Global Investors, LLC
                                a Delaware limited liability company,
                                its authorized signatory


                          By ___________________________________________________
                          Name:
                          Title:


                          By ___________________________________________________
                          Name:
                          Title:

                          $__________ Series ___


                                       14



                          AMERICAN UNITED LIFE INSURANCE COMPANY


                          By    /s/ Michael Bullock
                                ________________________________________________
                          Name:   Michael Bullock
                          Title:  V.P. Private Placements

                          $2,200,000 Series 5.05%


                          THE LAFAYETTE LIFE INSURANCE COMPANY

                          By:  American United Life Insurance Company, Its Agent


                          By    /s/ Michael Bullock
                                ________________________________________________
                          Name:   Michael Bullock
                          Title:  V.P. Private Placements

                          $800,000 Series 5.05%


                          PIONEER MUTUAL LIFE INSURANCE COMPANY

                          By:  American United Life Insurance Company, Its Agent


                          By    /s/ Michael Bullock
                                ________________________________________________
                          Name:   Michael Bullock
                          Title:  V.P. Private Placements

                          $500,000 Series 5.05%

                                       15




                          THE STATE LIFE INSURANCE COMPANY

                          By:  American United Life Insurance Company, Its Agent


                          By    /s/ Michael Bullock
                                ________________________________________________
                          Name:   Michael Bullock
                          Title:  V.P. Private Placements


                         $500,000 Series 5.05%

                                       16




                         AMERICAN FAMILY LIFE INSURANCE COMPANY



                          By    /s/ Phillip Hannifan
                                ________________________________________________
                          Name:   Phillip Hannifan
                          Title:  Investment Director


                          $2,250,000 Series B



                                       17




                          AMERITAS LIFE INSURANCE CORP.

                          By:   Ameritas Investment Advisors, Inc., as Agent



                          By    /s/ Andrew S. White
                                ________________________________________________
                          Name:  Andrew S. White
                          Title: Vice President-Fixed Income Securities

                          $1,000,000 Series B


                          ACACIA NATIONAL LIFE INSURANCE COMPANY

                          By:   Ameritas Investment Advisors, Inc. as Agent



                          By    /s/ Andrew S. White
                                ________________________________________________
                          Name:  Andrew S. White
                          Title: Vice President-Fixed Income Securities

                          $750,000 Series B

                                       18