Evidence of how the quilting was done in the Middle Ages is about as hard to come by as the quilts themselves. So the question we are left with is: What might they have used?
The only evidence I actually have is a woodcut and since I have no reference for where this woodcut comes from, I can't even say for sure that it is evidence. The woman in the illustration appears to be wearing later than medieval period clothing. The woman is using no frame at all, no hoop, no wooden square, nothing to hold the fabric tight while it's sewn. It was simply lap quilted, no frame necessary. And it's entirely possible that no frames were used for quilting during the Middle Ages. They likely wouldn't have been practical for garments and larger bed coverings could easily have been quilted without a frame to hold the fabric taut. If you would like to learn this technique of quilting, I highly recommend Georgia Bonesteel's book on Lap Quilting. It's a classic.
If they did use a frame of some sort, I would imagine that a square frame like what the embroiders used with the quilt edges lashed to the wooden frame would probably not be too far off. I have frames like this of varying sizes with sides from 2 feet to 8 feet in length that I use today and such frames have been in use by my family's quilter's for generations. I use standard 1 by 4's from the hardware store and staple old denim or some other sturdy fabric or muslin to the edge which my quilt is then stretched and pinned to. I hold the whole thing together at the corners with "C" clamps. I balance it on the backs of chairs or tables. As the quilt is sewn, the sides are rolled inward, so the inner areas may be more easily reached. I have done some research into how long this type of frame has been in use and I've not been able to date how far back it goes. This type of frame is commonly seen today where quilting is done by a group and it seems to have been this way for a very, very long time. The majority of books on quilting history, deal primarily with American quilting and this type of frame has apparently always been in use in America which would take it back to at least the colonial period. If we assume that it was brought here from Europe and there's no reason why it wouldn't have been in widespread use in Europe. They had "C" clamps and other means of holding the boards together. However, any archeologist finding such devices in digs is probably not likely to attribute them to use in a quilting frame. It's a very practical system. Clamps don't take up much room and they are used for a variety of other purposes. Any straight boards of the right length could have been used. We know that they had frames akin to this in use during the Middle Ages for other crafts. It would not be beyond the realm of possibility to think they used exactly this sort of frame to do their quilting. It just so happens that we're still using the same basic frame today.
I can date this simple frame back to the beginning of the colonial period and for knowledge of this frame to have been widely transported to the Americas, it must have been widely in use in Europe at the time. It's not that big a jump to place said frame in use in at the very least during the late Middle Ages.
Instructions for building your own frame can be found under the basics - how to section.
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