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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