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Table 2 Training protocol (adapted from [33])

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)

Motor abilities/ skills and exercises

Static/ Dynamic balance

(a) ‘Standing’

(b) ‘Weight shifting’

(c) ‘Walking’

Strength

(d) ‘Chair-rising’

Training progression

(a) ‘Standing‘(initial position: upright bipedal stance)

• With reduction of base of support: Feet shoulder-width apart ➔ side-by-side

➔ semi-tandem ➔ tandem ➔ one-legged stance

• With/ without holding at table

• With head movement

• With eyes closed

(b) ‘Weight shifting‘(initial position: upright bipedal stance)

• Weight shifting sideways: With feet on the floor ➔ with raising heel of unloaded leg

➔ with lifting foot (and holding position)

• Weight shifting forwards/backwards: Stride stance ➔ with raising posterior heel when shifting forwards

• With/ without holding at table

(c) ‘Walking’

• Small steps/ big steps/ small track width

• Sideways/ backwards

• From slow to fast movement velocity

• With/ without double or one hand contact, with/ without walking aid

(d) ‘Chair-rising’

• With booster seat if necessary (15 cm ➔ 10 cm ➔ 5 cm ➔ without booster seat)

• With/ without double hand contact, with/without using armrest

• From slow to fast movement velocity

Intensity

(a) ‘Standing‘and (b) ‘Weight shifting‘

• 10–12 repetitions of10 s, including 4–6 repetitions of moderate level of difficulty and 6 repetitions of maximum level of difficulty

(c) ‘Walking‘(distance 2–4 m)

• 10–12 repetitions, including 7–9 repetitions of moderate level of difficulty and 3 repetitions of maximum level of difficulty

(d) ‘Chair-rising’

• 5 series of 5 repetitions, including 2 series of moderate level of intensity and 3 series of higher level of intensity

Volume

• Overall: 4-month training program

• Each session (supervised): 30 min (as component of one home visit of maximally 2 h duration which further includes practicing of at least one meaningful activity and possible additional time for unstandardized interaction, e.g. conversation)

• Additional self-exercise session (unsupervised or with caregiver): 10–20 min

Frequency

• 2 supervised exercise sessions per week with a total of 35 sessions

(including 32 visits with lay instructor alone, and 3 visits with lay instructor + interventionist)

• 3–4 recommended self-exercises on days without supervised exercise sessions

• Frequency and time depending on patient’s capacity and caregiver’s support