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Table 5 Fidelity feedback on pre-pilot test of Mi-LiFE intervention in four participants—individual exercise session

From: Measuring the implementation of a group-based Lifestyle-integrated Functional Exercise (Mi-LiFE) intervention delivered in primary care for older adults aged 75 years or older: a pilot feasibility study protocol

Intervention element Fidelity feedback comments
Purpose and aims of the LiFE program explained “Explained manual and program. Overall quite well done.”
Daily routine chart used to plan how, when, and where activity will be performed and embedded “Using the daily routine chart is not just about finding a ‘place’ in the home to do the LiFE activity, but a daily task or routine in which to embed the activity.”
LiFE assessment tool used to assess ability for each activity “LAT was completed.”
Balance and strength principles taught and related to improving function and/or preventing falls “The PT taught the principles well.”
Teaching the activity “When introducing the activity try to demonstrate—this done to varying levels.”
• PT teaches the LiFE strength and/or balance principles related to the activity “It is challenging to teach participants something to embed in a daily task when you can’t demonstrate in the home. The PT got more imaginative as she went along.”
• PT demonstrates the activity and identifies situation(s) to embed activity
• Participant performs activity and confirms/identifies additional situation(s) to embed activity
• Participant technique corrected as needed “Good technique correction for tandem stand.”
• Provide positive reinforcement and encouragement
Appropriate number of activities and level of difficulty taught for participant’s ability “Only 1 strength activity done—I think certain participants could have managed at least 2.”
Recording of plans for activity performance is done on activity planner with activities linked to daily task “Planning and recording sheets—it is really important to reinforce why they need to do them. They assist in making the activities habitual.”
Familiarity with participant’s manual demonstrated by PT “Introduction to manual. Try to link activities to where they do things (e.g., cooking, in the workshop). Most other principles and key ideas covered well.”
Key points of program explained and reinforced “The PT could engage the participant in determining how, when and where the LiFE activity could be embedded.”
• Look for opportunities in daily tasks or routines
• Embed activities
• Change habits
• Challenge yourself
• Safety
Other key points mentioned “The one participant does a lot of sedentary activities. You can then try to build the LiFE activities into these.”
• Practice
• Advance slowly
• Modify environment to facilitate performance of activities
• Build in prompts/situational or environment cues to remind to do activity
Wrap-up: Participant and therapist decide on activities to perform independently and requirements until next session and how to record activities “PT often said ‘I will give you …to do’. Perhaps, it would have been better to have the participants think about and verbalize what they might like to do/what they find challenging.”
  1. PT physical therapist