Key element | Rationale and brief description |
---|---|
Structure | |
 Interventions starting in the patient’s home early after discharge from inpatient rehabilitation | • Exercise continuity after rehabilitation period (transitional care) • Long-term care counselling addressing new support needs and other adaptation issues at home for both, care recipient and caregiver. |
 Professional exercise instructor (physiotherapist, sports scientist) | • Appropriate exercise selection and progression to improve strength and balance. • Physical activity promotion and goal setting • Addressing fall and safety risks in the patient’s home and during training • Demonstration of additional self-exercises to patient and family member • Training and supervision of lay instructor |
 Lay-instructor | • Ensuring exercise continuity through regular home visits • Spending some additional time with enjoyable activities together with the fracture patient (positive reinforcement for the whole program) |
 Social worker | • Assessment of care needs • Organisation of support if necessary (case management) • Addressing caregiver issues |
 Linking of intervention to long-term care counselling | • Standardized communication and shared analysis of patient’s needs and activity goals between social worker and exercise instructor |
Contents | |
 Individual goal setting | • Application of an iconographical card sorting task to facilitate goal setting in this target group • Enhancing intrinsic motivation and training adherence |
 Exercise program | • Individually tailored, progressive, supervised exercise regime, 2 times per week (details see Table 2) • Additional self-exercises to promote activity on the days without supervised training, 1–4 times per week • (Supervised) physical activities, gradual progression by splitting instrumental activities in single components first |
 Long-term  care counselling | • Structured assessment of needs and wishes of patients with focus on care issues and social participation • Structured problem-solving with the main caregiver (if existing) |