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Table 2 Pre-defined protocol for the overground FALLS program

From: Walking adaptability therapy after stroke: study protocol for a randomized controlled trial

Setting

Groups of 4–6 participants for 90 min, participants will alternately train and rest.

Frequency

Twice weekly overground training program, which incorporates walking adaptability exercises.

Therapy

The first therapy session of the week will be devoted to an obstacle course that simulates potential challenging situations of daily life. The obstacle course facilitates practicing balance, gait, and coordination, and mimics activities of daily life with high fall risk, such as walking over obstacles, uneven terrain, slalom walking and tandem walking. The obstacle course will also be negotiated while imposing cognitive and motor dual-tasks, as well as under visual constraints.

The second therapy session of the week will include walking exercises and practice of fall techniques. The walking exercises simulate walking in a crowded environment. Adjustments in walking speed and direction are required during these exercises and collisions with other people challenge balance. The practice of fall techniques is based on martial arts techniques and will include falling forwards, backwards, and laterally. The level of difficulty will be gradually enhanced by increasing fall height (from sitting on a safety mat to stance height).

Therapist

The therapy sessions will be provided by two or three therapists, depending on the size of the group. At least one of therapists is trained in the background, methods, and techniques of the FALLS program. All therapists involved in the FALLS program are trained and experienced with regard to the program protocol and instructed to follow the specific guidelines of the intervention for the purpose of this trial. The therapists regularly meet the research assistant to ensure adherence to the protocol. (Additional file 2).