The discussion included time to be spent on each component in the exercise program, safety aspects, group size, verbal and hands-on instructions, and how the exercises could be individualized and progressed. The length of each selleck chemicals session and the intensity and duration of the exercise program were defined in congruence with previous research and clinical experience among the physiotherapists. Practical issues were also considered, such as the possibility and likelihood of an outpatient investing time and effort into participating in the exercise program, and the feasibility of delivering the program to actual patients. A preliminary

program was constructed, and the physiotherapists had further opportunity to practice the exercises themselves. A second meeting was held where the physiotherapists were able to reflect and comment

once more before the final version of the program was confirmed. Once consensus was reached, a manual was printed with a description of the exercises in text and illustrations including progression of the exercises. The manual was accessible at each site during the intervention period, and the primary investigators were available for discussion and advice throughout the study period. The balance Akt inhibitor exercise program was delivered by physiotherapists involved in the intervention development. The exercise program was given twice weekly for 7 weeks in groups of 4 to 7 people. Each session lasted 60 minutes

and started with 20 minutes of selected core stability exercises inspired by those described by Freeman et al.33 The physiotherapists initially explained and demonstrated the core muscles and the core stability exercise technique. After training core stability, the participants were encouraged to maintain their focus on core stability when performing the remaining tasks, which covered dual tasking and different sensory conditions (for more details, see appendix 1; the program is available on request to [email protected]). Examples of sensory strategies were using an uneven, soft, or moving surface and/or withdrawing visual Obatoclax Mesylate (GX15-070) input. Each session allowed for approximately 5 minutes of stretching, relaxing, or both, at the end. All participants were provided with a printout of the program after the study period. Data on self-reported falls (indoors and outdoors) were collected prospectively during three 7-week periods. A fall was defined as “an unexpected contact of any part of the body with the ground or lower level due to loss of balance,”34(p1619) and a faller was defined as a person reporting 1 or more falls during a 7-week period. The physiotherapists instructed the participants how to fill in the fall diaries. The diaries consisted of 6 sheets (2 for each 7-week period) where number of falls (0, no falls) was to be recorded for each day during the study period.