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Table 1 OF-Care key elements of the intervention

From: Multifactorial intervention for hip and pelvic fracture patients with mild to moderate cognitive impairment: study protocol of a dual-centre randomised controlled trial (OF-CARE)

Key element Rationale and brief description
 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
 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
 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)