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 |