Interventions
flexion movements, disability, hip abduction
Once the clinical manager deemed the patient to be in a stable condition and capable of participating in the study, the evaluation and intervention programme commenced. The same investigator, who was blinded to the participants' training group, conducted the assessments at admission and hospital discharge. The control group received standard hospital care with a focus on walking exercises to restore functionality when required. While the usual care group did not receive a formal exercise prescription, they underwent the same assessments as the intervention group, which occurred at the study's outset and after 3–4 days at hospital discharge.The multicomponent exercise intervention was performed in an equipped room with training equipment located in the ACE geriatric unit. The training sessions took place at two times of the day, morning and afternoon, with the morning session being supervised by a researcher specializing in physical conditioning trained in safe patient handling techniques. The specialist provided verbal instructions and encouragement throughout the training session and documented adherence to the intervention programme in a daily register. The multicomponent exercise sessions lasted approximately 20 min, during three consecutive days of hospitalization (including weekends) and were considered completed when 90% or more of the planned exercises were successfully performed.The prescribed exercises were based and adapted from the multicomponent physical exercise programme Vivifrail to prevent functional disability and risk of falls. The morning sessions included individualized supervised progressive resistance, balance, and gait retraining exercises. The resistance exercises were tailored to the individual's functional capacity using variable resistance training machines (Matrix; Johnson Health Tech and Exercycle S.L., BH Group) aiming at 2 to 3 sets of 8 to 10 repetitions with a load equivalent to 40% to 60% of the 1‐repetition maximum (1RM). Participants performed three exercises involving mainly lower‐limb muscles (squats rising from a chair, leg press, and bilateral knee extension) and one involving the upper‐body musculature (seated bench press). The researcher supervised the patients so that they performed the movements correctly and requested that the execution of the concentric phase of the exercises be at the maximum intentional speed possible, in order to optimize muscle power gains, while the eccentric phase was performed at a slower and controlled speed. In this study, besides absolute load (kg) and equivalent % of 1RM, we recorded the peak power and mean propulsive power in the leg press exercise with the aim of subsequently analysing the load and power progression between consecutive sessions.In addition to resistance exercises, the intervention group also performed balance and gait exercises that gradually progressed in level of difficulty and proceeded as follows: semi‐tandem foot standing, stepping practice, line walking, walking with small obstacles, proprioceptive exercises on unstable surfaces using foam pads sequence, altering the base of support, and weight transfer from one leg to the other.The second daily training session was unsupervised; notwithstanding, patients and their relatives were familiarized with the correct training procedures and executions before beginning the intervention. The exercises were performed with light loads (i.e., 0.5 to 1 kg anklets) and consisted of knee extension and flexion movements, hip abduction, handgrip with ball and daily walking in the corridor of the acute care unit with a duration based on the clinical physical exercise guide Vivifrail (vivifrail.com/resources/).