| Author year . | Supervised/ unsupervised . | Type . | Duration . | Frequency . | Intensity . | Psychological . | Environment/ assistive technology . | Knowledge . | Outdoor . |
|---|---|---|---|---|---|---|---|---|---|
| Arija 2017 [20] | supervised | socio-cultural activities and walking itineraries (average 5 km circuits) accompanied and monitored by healthcare professionals | 9 months | 2 walking sessions per week, socio-cultural activities once per month | 120 min/week walking (396 METs min/week) | no | no | walking itineraries | outdoor sociocultural activities, walks encouraged in and around the city |
| Arkkukangas 2019 [60], Tuvemo Johnson 2021 [16]* | supervised | a: Otago exercise programme and walking programme b: Otago exercise programme, walking programme, and motivational interviewing | 12 weeks | a and b: exercise three times per week b: motivational interviewing five sessions | a and b: exercise 30 min | b: motivational interviewing | ankle weight | exercise manual with pictures and description of each exercise | walks encouraged in between exercise days |
| Bae 2019 [41] | supervised | four to five participants and two staff per group. Stretching, physical cognitive and social activities tailored to preference and available community resources near their residence. | 24 weeks | twice weekly | 90 min | social activities; group based | accelerometer | no | outdoor activity of choice e.g. walking, visiting temple, shopping |
| Boongird 2017 [40] | unsupervised following 1 h demonstration; telephone progress monitoring | modified Otago program and a walking plan | 12 weeks | exercise six times weekly; twice weekly walking | 20 min exercises; 30 min walking | weekly planners | video disc recorder | fall prevention education, exercise manual | walks encouraged 2 x 30 min weekly |
| Clemson 2004 [57] | supervised | 12 participants in each group. Lower limb balance and strengthening, community mobility and discrete skills. One session included a community mastery experience during which community mobility and discrete skills e.g. negotiating grass or curb ramps were practiced. | 7 weeks | once weekly | 120 min | group based. Reflections and sharing accomplishments, action planning, weekly homework | no | coping with visual loss and regular screening, medication management, environmental and behavioural home safety, community safety | community mobility session |
| Croteau 2007 [45] | supervised and unsupervised | intervention consisting of pedometer usage, counselling, and self-monitoring | 24 weeks (12 week intervention, 12 week maintenance) | monthly group sessions, daily walking | Individually tailored - step count 5% greater than participants baseline | counselling, goal setting, identifying strategies to increase step count | pedometer | step calendar, list of sample strategies to increase physical activity | list of walking strategies included outdoor mobility (e.g. talking dog for walks, walking with a friend) |
| Crotty2002 [48] | supervised | gait, balance, functional tasks, general physical activity | individually tailored | individually tailored | individually tailored | goal setting | home risk assessment, modifications, mobility aids | no | author confirmed outdoor mobility training included |
| de Roos 2018 [56] | supervised and unsupervised | incremental treadmill walking, cycling and extremity resistance exercise, education sessions, instructions to walk | 10 weeks | two times per week | 10 min incremental treadmill walking, cycling and resistance exercise Self-paced walking programme | no | no | instructions on exercise compliance and the importance staying active | ≥30 min walking 1 day per week |
| Echeverria 2020 [44] | Supervised (hospital group session) and unsupervised (individual home program) | SGB: 6 weeks at hospital +18 weeks at home LGB: 12 weeks at hospital +12 weeks at home Group = strength, power, balance, walking Individual = Otago Program e.g. balance, strength, walks | 24 weeks | Hospital: 2 x 1 h per week Home: walk 15–60 min daily | Strength training: weeks 1–3 40–50% 1RM, weeks 4 onwards 60–70% 1RM | No | No | No | home component included 7 days of walking recommendations aimed at perform outdoor walking without assistance. |
| Hauer2002 [38] | supervised | gait, balance and functional training, strength/resistance, general physical activity. | 3 months | 145 min 3 days/week | 70–0% max workload | no | no | no | author confirmed outdoor mobility training included |
| Hughes 2004 [59] Hughes 2006 [62]* | supervised | Fit and strong intervention: flexibility exercises, resistance training, walking, group discussion and education | 8 weeks | 90 min sessions, three times per week | Individually tailored | goal setting and systematic feedback on progress made, identify strategies for self-efficacy adherence | no | Performance records shared with participants. Exercise log, The Arthritis helpbook, and health education. | outdoor walking |
| Iliffe 2014 [39] | supervised and unsupervised | a: Otago exercise and walking programme b: community centre postural stability instructor led exercise programme, Otago home exercise, and walking programme | 24 weeks | a: three times per week; and at least twice weekly walking b: one group exercise class, twice weekly home exercise; and at least twice weekly walking | a: 30 min home exercise; walking 30 min at moderate pace b: 1 h group exercise, 30 min home exercise, walking 30 min moderate pace | coping strategies to reduce risk of complications from a long lie after a fall. | a: ankle cuff weights | a and b: instruction booklet | walks encouraged 2 x 30 min weekly |
| Karlsson 2016 [47] | supervised | comprehensive geriatric assessment, gait, balance and functional training, strength/resistance, general physical activity, monitoring -pain, wound care, medication, nutrition. Intervention specified walking ability indoors and outdoors. | 10 weeks | initially daily home visits | na | no | home risk assessment, modifications, assistive devices | no | walking indoors and outdoors with physiotherapist |
| Kerr 2018 [17] Crist 2021 [61]* | supervised and unsupervised | group walks led by staff and peer leaders from 6 weeks to 6 months, led by peer-leaders alone from 6 to 12 months. Goal setting for step count to achieve during group walks and independently. | 12 months | all participants encouraged to achieve a 3,000 step increase from baseline in first 12 weeks and maintain this for remainder of study. | four counselling phone calls in first 8 weeks to identify barriers and set goals. Goals achieved celebrated in group sessions. Progress charts of steps taken every two weeks for first 6 months. Weekly step logs. | pedometers | step counts for common locations around their area, and walking maps for their local community. Nine group education sessions led by research staff and peer-leaders for information e.g. local activity classes, safe walking tips, barriers and benefits of PA, goal setting, social support, disease specific recommendations. | encouraged to walk around community | |
| Kerse 2010 [43] | supervised and unsupervised | Otago exercise programme, progressive resistance training, progressive balance training, and walking programme | 6 months | three times per week; six visits in first 2 months, seventh at month, eighth at month 6 | walking 30 min; 60 min visits | calendars to record physical activity; functional goal setting; encouraged to identify a social companion for exercise | no | no | regular walking 3 x weekly and functional goal setting e.g. prune the roses |
| Lee 2007 [19] | supervised | Community-based walking intervention underpinned by self-efficacy theory delivered by a public health nurse | 6 months | individually tailored (median = 6) | NA | discuss ideas for overcoming perceived barriers, verbal encouragement; recognise interpretations of physiological and emotional responses to walking, identify performance accomplishments | pedometer | advise about regular walking and a walking log, shared practical information about pleasant walking routes and others experiences of success | community-based walking |
| Logan 2004 [54] | supervised | assessment of barriers to outdoor mobility, mobility goal setting and tailored interventions to achieve goals | up to 3 months | seven times | tailored | advice, encouragement, mobility goal setting, overcoming fear/apprehension by e.g. supervised mobility | walking aids, adaptations as needed | leaflets describing local mobility services, information on e.g. resuming driving, alternatives to cars and buses | intervention based on mobility goals e.g. getting public transport |
| Logan 2014 [18] | supervised | additional rehabilitation, exercise, practical activities, psychological interventions to improve confidence and targeted information; a treatment manual | 4 months | according to participants preference, maximum 12 visits | Individually tailored | goal planning, checklist of benefits and barriers of going outside, motivational and confidence-building strategies | Walking aids, referrals for additional equipment as needed | example of skills needed for outdoor mobility, case vignettes of treatment plans, personalised pack of local travel information | intervention based on mobility goals (e.g. long walk of >100 m), included a protocol for a first outing walking and practicing outdoor mobility |
| Magaziner 2019 [49] | supervised | gait, balance and functional training, strength/resistance, endurance | 4 months | 60 min every other day | Strength:3x8 repetitions at eight repetition max Endurance: 50% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor ambulation (if able) on flat surface or up and down steps |
| Mangione 2005 [50] | supervised | group 1: strength/resistance, group 2: endurance | 3 months | 30–40 min x2/week month 1 and 2, then x1/week month 3 | Strength: eight repetition max Endurance: 65-75% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor and indoor walking included in endurance training |
| Orwig2011 [53] | supervised x3/week month 1 and 2, x2/week month 3 and 4, x1/1-2 weeks for remainder | strength/resistance, endurance, flexibility, cognitive behavioural interventions | 12 months | strength x2/week 30 min aerobic x3/week | Strength: 3 × 10 repetitions x 11 exercises TheraBand at individual level | motivational phone calls | no | no | author confirmed aerobic activity incorporated outdoor walking |
| Pfeiffer2020 [21] | supervised (eight sessions) and unsupervised | cognitive behavioural interventions, gait, balance, and functional training, strength/resistance | 3 months | 30–60min ≥2/week | NA | no | home risk assessment, modifications | written exercise programme with photos and instructions or recorded instructions with music player, exercise diary | intervention targeting mobility-based goals example specifies travelling by bus using a wheeled walker |
| Pol2019 [51] | supervised and unsupervised | cognitive behavioural interventions, gait, balance and functional training | 3 months | 60 min/week coaching, on discharge: four phone calls over 10 weeks | NA | no | home risk assessment, modifications | information and education sessions on importance of physical activity | specified monitoring of outdoor physical activity; appendix describes case addressing poor outdoor mobility in goal setting |
| Resnick 2007 [52] | supervised | strength/resistance, endurance, flexibility | 12 months | Strength: x2/week Aerobic: 30 min x3/week | NA | goal setting, group 2 + 3: verbal encouragement, removal of unpleasant sensations, cueing | no | group 2 + 3 booklet on exercise benefits after hip fracture | author confirmed aerobic activity incorporated outdoor walking |
| Vander Walde 2021 [58] | unsupervised | walking programme | tailored | from 3 days to 5 days/week | from 15 min to 30 min | walking diary | no | exercise workbook; information of exercise to improve fatigue during radiotherapy | encouraged 150 min walking per week |
| Varas 2018 [55] | supervised and unsupervised | exercise training and plan to increase physical activity level | 8 weeks | walking 5 days a week | walking for 30–60 min (incremental cycles of 15–20 min) at individualised predetermined speeds | weekly phone calls for encouragement, objective setting, analyse reasons of noncompliance | pedometer | activity diary to note gait and steps per day | walking programme |
| Voukelatos 2015 [42] Merom 2015 [63] * | unsupervised | walking programme: stage 1 -12 weeks focused on frequency and duration, stage 2 -12 weeks focused on intensity, and stage 3 -24 weeks of maintenance | 12 weeks | 3 times per week | 30 min | seven telephone coaching sessions at weeks 1, 3, 6, 12, 16, 24, and 36 walking diary | encouraged to use a pedometer | walking manual sent by post at 0, 12 and 24 weeks with guidance for each stage | progressive walking intervention undertaken at participants preferred location |
| Ziden 2008 [46],2010 [64]* | supervised and unsupervised | general physical activity, cognitive behavioural interventions, involvement of family in discharge planning. Physiotherapy intervention focused on improving outdoor mobility. | 3 weeks | individually tailored | individually tailored | goal setting and motivation | no | no | physiotherapy intervention focussed on outdoor mobility |
| Author year . | Supervised/ unsupervised . | Type . | Duration . | Frequency . | Intensity . | Psychological . | Environment/ assistive technology . | Knowledge . | Outdoor . |
|---|---|---|---|---|---|---|---|---|---|
| Arija 2017 [20] | supervised | socio-cultural activities and walking itineraries (average 5 km circuits) accompanied and monitored by healthcare professionals | 9 months | 2 walking sessions per week, socio-cultural activities once per month | 120 min/week walking (396 METs min/week) | no | no | walking itineraries | outdoor sociocultural activities, walks encouraged in and around the city |
| Arkkukangas 2019 [60], Tuvemo Johnson 2021 [16]* | supervised | a: Otago exercise programme and walking programme b: Otago exercise programme, walking programme, and motivational interviewing | 12 weeks | a and b: exercise three times per week b: motivational interviewing five sessions | a and b: exercise 30 min | b: motivational interviewing | ankle weight | exercise manual with pictures and description of each exercise | walks encouraged in between exercise days |
| Bae 2019 [41] | supervised | four to five participants and two staff per group. Stretching, physical cognitive and social activities tailored to preference and available community resources near their residence. | 24 weeks | twice weekly | 90 min | social activities; group based | accelerometer | no | outdoor activity of choice e.g. walking, visiting temple, shopping |
| Boongird 2017 [40] | unsupervised following 1 h demonstration; telephone progress monitoring | modified Otago program and a walking plan | 12 weeks | exercise six times weekly; twice weekly walking | 20 min exercises; 30 min walking | weekly planners | video disc recorder | fall prevention education, exercise manual | walks encouraged 2 x 30 min weekly |
| Clemson 2004 [57] | supervised | 12 participants in each group. Lower limb balance and strengthening, community mobility and discrete skills. One session included a community mastery experience during which community mobility and discrete skills e.g. negotiating grass or curb ramps were practiced. | 7 weeks | once weekly | 120 min | group based. Reflections and sharing accomplishments, action planning, weekly homework | no | coping with visual loss and regular screening, medication management, environmental and behavioural home safety, community safety | community mobility session |
| Croteau 2007 [45] | supervised and unsupervised | intervention consisting of pedometer usage, counselling, and self-monitoring | 24 weeks (12 week intervention, 12 week maintenance) | monthly group sessions, daily walking | Individually tailored - step count 5% greater than participants baseline | counselling, goal setting, identifying strategies to increase step count | pedometer | step calendar, list of sample strategies to increase physical activity | list of walking strategies included outdoor mobility (e.g. talking dog for walks, walking with a friend) |
| Crotty2002 [48] | supervised | gait, balance, functional tasks, general physical activity | individually tailored | individually tailored | individually tailored | goal setting | home risk assessment, modifications, mobility aids | no | author confirmed outdoor mobility training included |
| de Roos 2018 [56] | supervised and unsupervised | incremental treadmill walking, cycling and extremity resistance exercise, education sessions, instructions to walk | 10 weeks | two times per week | 10 min incremental treadmill walking, cycling and resistance exercise Self-paced walking programme | no | no | instructions on exercise compliance and the importance staying active | ≥30 min walking 1 day per week |
| Echeverria 2020 [44] | Supervised (hospital group session) and unsupervised (individual home program) | SGB: 6 weeks at hospital +18 weeks at home LGB: 12 weeks at hospital +12 weeks at home Group = strength, power, balance, walking Individual = Otago Program e.g. balance, strength, walks | 24 weeks | Hospital: 2 x 1 h per week Home: walk 15–60 min daily | Strength training: weeks 1–3 40–50% 1RM, weeks 4 onwards 60–70% 1RM | No | No | No | home component included 7 days of walking recommendations aimed at perform outdoor walking without assistance. |
| Hauer2002 [38] | supervised | gait, balance and functional training, strength/resistance, general physical activity. | 3 months | 145 min 3 days/week | 70–0% max workload | no | no | no | author confirmed outdoor mobility training included |
| Hughes 2004 [59] Hughes 2006 [62]* | supervised | Fit and strong intervention: flexibility exercises, resistance training, walking, group discussion and education | 8 weeks | 90 min sessions, three times per week | Individually tailored | goal setting and systematic feedback on progress made, identify strategies for self-efficacy adherence | no | Performance records shared with participants. Exercise log, The Arthritis helpbook, and health education. | outdoor walking |
| Iliffe 2014 [39] | supervised and unsupervised | a: Otago exercise and walking programme b: community centre postural stability instructor led exercise programme, Otago home exercise, and walking programme | 24 weeks | a: three times per week; and at least twice weekly walking b: one group exercise class, twice weekly home exercise; and at least twice weekly walking | a: 30 min home exercise; walking 30 min at moderate pace b: 1 h group exercise, 30 min home exercise, walking 30 min moderate pace | coping strategies to reduce risk of complications from a long lie after a fall. | a: ankle cuff weights | a and b: instruction booklet | walks encouraged 2 x 30 min weekly |
| Karlsson 2016 [47] | supervised | comprehensive geriatric assessment, gait, balance and functional training, strength/resistance, general physical activity, monitoring -pain, wound care, medication, nutrition. Intervention specified walking ability indoors and outdoors. | 10 weeks | initially daily home visits | na | no | home risk assessment, modifications, assistive devices | no | walking indoors and outdoors with physiotherapist |
| Kerr 2018 [17] Crist 2021 [61]* | supervised and unsupervised | group walks led by staff and peer leaders from 6 weeks to 6 months, led by peer-leaders alone from 6 to 12 months. Goal setting for step count to achieve during group walks and independently. | 12 months | all participants encouraged to achieve a 3,000 step increase from baseline in first 12 weeks and maintain this for remainder of study. | four counselling phone calls in first 8 weeks to identify barriers and set goals. Goals achieved celebrated in group sessions. Progress charts of steps taken every two weeks for first 6 months. Weekly step logs. | pedometers | step counts for common locations around their area, and walking maps for their local community. Nine group education sessions led by research staff and peer-leaders for information e.g. local activity classes, safe walking tips, barriers and benefits of PA, goal setting, social support, disease specific recommendations. | encouraged to walk around community | |
| Kerse 2010 [43] | supervised and unsupervised | Otago exercise programme, progressive resistance training, progressive balance training, and walking programme | 6 months | three times per week; six visits in first 2 months, seventh at month, eighth at month 6 | walking 30 min; 60 min visits | calendars to record physical activity; functional goal setting; encouraged to identify a social companion for exercise | no | no | regular walking 3 x weekly and functional goal setting e.g. prune the roses |
| Lee 2007 [19] | supervised | Community-based walking intervention underpinned by self-efficacy theory delivered by a public health nurse | 6 months | individually tailored (median = 6) | NA | discuss ideas for overcoming perceived barriers, verbal encouragement; recognise interpretations of physiological and emotional responses to walking, identify performance accomplishments | pedometer | advise about regular walking and a walking log, shared practical information about pleasant walking routes and others experiences of success | community-based walking |
| Logan 2004 [54] | supervised | assessment of barriers to outdoor mobility, mobility goal setting and tailored interventions to achieve goals | up to 3 months | seven times | tailored | advice, encouragement, mobility goal setting, overcoming fear/apprehension by e.g. supervised mobility | walking aids, adaptations as needed | leaflets describing local mobility services, information on e.g. resuming driving, alternatives to cars and buses | intervention based on mobility goals e.g. getting public transport |
| Logan 2014 [18] | supervised | additional rehabilitation, exercise, practical activities, psychological interventions to improve confidence and targeted information; a treatment manual | 4 months | according to participants preference, maximum 12 visits | Individually tailored | goal planning, checklist of benefits and barriers of going outside, motivational and confidence-building strategies | Walking aids, referrals for additional equipment as needed | example of skills needed for outdoor mobility, case vignettes of treatment plans, personalised pack of local travel information | intervention based on mobility goals (e.g. long walk of >100 m), included a protocol for a first outing walking and practicing outdoor mobility |
| Magaziner 2019 [49] | supervised | gait, balance and functional training, strength/resistance, endurance | 4 months | 60 min every other day | Strength:3x8 repetitions at eight repetition max Endurance: 50% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor ambulation (if able) on flat surface or up and down steps |
| Mangione 2005 [50] | supervised | group 1: strength/resistance, group 2: endurance | 3 months | 30–40 min x2/week month 1 and 2, then x1/week month 3 | Strength: eight repetition max Endurance: 65-75% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor and indoor walking included in endurance training |
| Orwig2011 [53] | supervised x3/week month 1 and 2, x2/week month 3 and 4, x1/1-2 weeks for remainder | strength/resistance, endurance, flexibility, cognitive behavioural interventions | 12 months | strength x2/week 30 min aerobic x3/week | Strength: 3 × 10 repetitions x 11 exercises TheraBand at individual level | motivational phone calls | no | no | author confirmed aerobic activity incorporated outdoor walking |
| Pfeiffer2020 [21] | supervised (eight sessions) and unsupervised | cognitive behavioural interventions, gait, balance, and functional training, strength/resistance | 3 months | 30–60min ≥2/week | NA | no | home risk assessment, modifications | written exercise programme with photos and instructions or recorded instructions with music player, exercise diary | intervention targeting mobility-based goals example specifies travelling by bus using a wheeled walker |
| Pol2019 [51] | supervised and unsupervised | cognitive behavioural interventions, gait, balance and functional training | 3 months | 60 min/week coaching, on discharge: four phone calls over 10 weeks | NA | no | home risk assessment, modifications | information and education sessions on importance of physical activity | specified monitoring of outdoor physical activity; appendix describes case addressing poor outdoor mobility in goal setting |
| Resnick 2007 [52] | supervised | strength/resistance, endurance, flexibility | 12 months | Strength: x2/week Aerobic: 30 min x3/week | NA | goal setting, group 2 + 3: verbal encouragement, removal of unpleasant sensations, cueing | no | group 2 + 3 booklet on exercise benefits after hip fracture | author confirmed aerobic activity incorporated outdoor walking |
| Vander Walde 2021 [58] | unsupervised | walking programme | tailored | from 3 days to 5 days/week | from 15 min to 30 min | walking diary | no | exercise workbook; information of exercise to improve fatigue during radiotherapy | encouraged 150 min walking per week |
| Varas 2018 [55] | supervised and unsupervised | exercise training and plan to increase physical activity level | 8 weeks | walking 5 days a week | walking for 30–60 min (incremental cycles of 15–20 min) at individualised predetermined speeds | weekly phone calls for encouragement, objective setting, analyse reasons of noncompliance | pedometer | activity diary to note gait and steps per day | walking programme |
| Voukelatos 2015 [42] Merom 2015 [63] * | unsupervised | walking programme: stage 1 -12 weeks focused on frequency and duration, stage 2 -12 weeks focused on intensity, and stage 3 -24 weeks of maintenance | 12 weeks | 3 times per week | 30 min | seven telephone coaching sessions at weeks 1, 3, 6, 12, 16, 24, and 36 walking diary | encouraged to use a pedometer | walking manual sent by post at 0, 12 and 24 weeks with guidance for each stage | progressive walking intervention undertaken at participants preferred location |
| Ziden 2008 [46],2010 [64]* | supervised and unsupervised | general physical activity, cognitive behavioural interventions, involvement of family in discharge planning. Physiotherapy intervention focused on improving outdoor mobility. | 3 weeks | individually tailored | individually tailored | goal setting and motivation | no | no | physiotherapy intervention focussed on outdoor mobility |
*two articles from one RCT
| Author year . | Supervised/ unsupervised . | Type . | Duration . | Frequency . | Intensity . | Psychological . | Environment/ assistive technology . | Knowledge . | Outdoor . |
|---|---|---|---|---|---|---|---|---|---|
| Arija 2017 [20] | supervised | socio-cultural activities and walking itineraries (average 5 km circuits) accompanied and monitored by healthcare professionals | 9 months | 2 walking sessions per week, socio-cultural activities once per month | 120 min/week walking (396 METs min/week) | no | no | walking itineraries | outdoor sociocultural activities, walks encouraged in and around the city |
| Arkkukangas 2019 [60], Tuvemo Johnson 2021 [16]* | supervised | a: Otago exercise programme and walking programme b: Otago exercise programme, walking programme, and motivational interviewing | 12 weeks | a and b: exercise three times per week b: motivational interviewing five sessions | a and b: exercise 30 min | b: motivational interviewing | ankle weight | exercise manual with pictures and description of each exercise | walks encouraged in between exercise days |
| Bae 2019 [41] | supervised | four to five participants and two staff per group. Stretching, physical cognitive and social activities tailored to preference and available community resources near their residence. | 24 weeks | twice weekly | 90 min | social activities; group based | accelerometer | no | outdoor activity of choice e.g. walking, visiting temple, shopping |
| Boongird 2017 [40] | unsupervised following 1 h demonstration; telephone progress monitoring | modified Otago program and a walking plan | 12 weeks | exercise six times weekly; twice weekly walking | 20 min exercises; 30 min walking | weekly planners | video disc recorder | fall prevention education, exercise manual | walks encouraged 2 x 30 min weekly |
| Clemson 2004 [57] | supervised | 12 participants in each group. Lower limb balance and strengthening, community mobility and discrete skills. One session included a community mastery experience during which community mobility and discrete skills e.g. negotiating grass or curb ramps were practiced. | 7 weeks | once weekly | 120 min | group based. Reflections and sharing accomplishments, action planning, weekly homework | no | coping with visual loss and regular screening, medication management, environmental and behavioural home safety, community safety | community mobility session |
| Croteau 2007 [45] | supervised and unsupervised | intervention consisting of pedometer usage, counselling, and self-monitoring | 24 weeks (12 week intervention, 12 week maintenance) | monthly group sessions, daily walking | Individually tailored - step count 5% greater than participants baseline | counselling, goal setting, identifying strategies to increase step count | pedometer | step calendar, list of sample strategies to increase physical activity | list of walking strategies included outdoor mobility (e.g. talking dog for walks, walking with a friend) |
| Crotty2002 [48] | supervised | gait, balance, functional tasks, general physical activity | individually tailored | individually tailored | individually tailored | goal setting | home risk assessment, modifications, mobility aids | no | author confirmed outdoor mobility training included |
| de Roos 2018 [56] | supervised and unsupervised | incremental treadmill walking, cycling and extremity resistance exercise, education sessions, instructions to walk | 10 weeks | two times per week | 10 min incremental treadmill walking, cycling and resistance exercise Self-paced walking programme | no | no | instructions on exercise compliance and the importance staying active | ≥30 min walking 1 day per week |
| Echeverria 2020 [44] | Supervised (hospital group session) and unsupervised (individual home program) | SGB: 6 weeks at hospital +18 weeks at home LGB: 12 weeks at hospital +12 weeks at home Group = strength, power, balance, walking Individual = Otago Program e.g. balance, strength, walks | 24 weeks | Hospital: 2 x 1 h per week Home: walk 15–60 min daily | Strength training: weeks 1–3 40–50% 1RM, weeks 4 onwards 60–70% 1RM | No | No | No | home component included 7 days of walking recommendations aimed at perform outdoor walking without assistance. |
| Hauer2002 [38] | supervised | gait, balance and functional training, strength/resistance, general physical activity. | 3 months | 145 min 3 days/week | 70–0% max workload | no | no | no | author confirmed outdoor mobility training included |
| Hughes 2004 [59] Hughes 2006 [62]* | supervised | Fit and strong intervention: flexibility exercises, resistance training, walking, group discussion and education | 8 weeks | 90 min sessions, three times per week | Individually tailored | goal setting and systematic feedback on progress made, identify strategies for self-efficacy adherence | no | Performance records shared with participants. Exercise log, The Arthritis helpbook, and health education. | outdoor walking |
| Iliffe 2014 [39] | supervised and unsupervised | a: Otago exercise and walking programme b: community centre postural stability instructor led exercise programme, Otago home exercise, and walking programme | 24 weeks | a: three times per week; and at least twice weekly walking b: one group exercise class, twice weekly home exercise; and at least twice weekly walking | a: 30 min home exercise; walking 30 min at moderate pace b: 1 h group exercise, 30 min home exercise, walking 30 min moderate pace | coping strategies to reduce risk of complications from a long lie after a fall. | a: ankle cuff weights | a and b: instruction booklet | walks encouraged 2 x 30 min weekly |
| Karlsson 2016 [47] | supervised | comprehensive geriatric assessment, gait, balance and functional training, strength/resistance, general physical activity, monitoring -pain, wound care, medication, nutrition. Intervention specified walking ability indoors and outdoors. | 10 weeks | initially daily home visits | na | no | home risk assessment, modifications, assistive devices | no | walking indoors and outdoors with physiotherapist |
| Kerr 2018 [17] Crist 2021 [61]* | supervised and unsupervised | group walks led by staff and peer leaders from 6 weeks to 6 months, led by peer-leaders alone from 6 to 12 months. Goal setting for step count to achieve during group walks and independently. | 12 months | all participants encouraged to achieve a 3,000 step increase from baseline in first 12 weeks and maintain this for remainder of study. | four counselling phone calls in first 8 weeks to identify barriers and set goals. Goals achieved celebrated in group sessions. Progress charts of steps taken every two weeks for first 6 months. Weekly step logs. | pedometers | step counts for common locations around their area, and walking maps for their local community. Nine group education sessions led by research staff and peer-leaders for information e.g. local activity classes, safe walking tips, barriers and benefits of PA, goal setting, social support, disease specific recommendations. | encouraged to walk around community | |
| Kerse 2010 [43] | supervised and unsupervised | Otago exercise programme, progressive resistance training, progressive balance training, and walking programme | 6 months | three times per week; six visits in first 2 months, seventh at month, eighth at month 6 | walking 30 min; 60 min visits | calendars to record physical activity; functional goal setting; encouraged to identify a social companion for exercise | no | no | regular walking 3 x weekly and functional goal setting e.g. prune the roses |
| Lee 2007 [19] | supervised | Community-based walking intervention underpinned by self-efficacy theory delivered by a public health nurse | 6 months | individually tailored (median = 6) | NA | discuss ideas for overcoming perceived barriers, verbal encouragement; recognise interpretations of physiological and emotional responses to walking, identify performance accomplishments | pedometer | advise about regular walking and a walking log, shared practical information about pleasant walking routes and others experiences of success | community-based walking |
| Logan 2004 [54] | supervised | assessment of barriers to outdoor mobility, mobility goal setting and tailored interventions to achieve goals | up to 3 months | seven times | tailored | advice, encouragement, mobility goal setting, overcoming fear/apprehension by e.g. supervised mobility | walking aids, adaptations as needed | leaflets describing local mobility services, information on e.g. resuming driving, alternatives to cars and buses | intervention based on mobility goals e.g. getting public transport |
| Logan 2014 [18] | supervised | additional rehabilitation, exercise, practical activities, psychological interventions to improve confidence and targeted information; a treatment manual | 4 months | according to participants preference, maximum 12 visits | Individually tailored | goal planning, checklist of benefits and barriers of going outside, motivational and confidence-building strategies | Walking aids, referrals for additional equipment as needed | example of skills needed for outdoor mobility, case vignettes of treatment plans, personalised pack of local travel information | intervention based on mobility goals (e.g. long walk of >100 m), included a protocol for a first outing walking and practicing outdoor mobility |
| Magaziner 2019 [49] | supervised | gait, balance and functional training, strength/resistance, endurance | 4 months | 60 min every other day | Strength:3x8 repetitions at eight repetition max Endurance: 50% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor ambulation (if able) on flat surface or up and down steps |
| Mangione 2005 [50] | supervised | group 1: strength/resistance, group 2: endurance | 3 months | 30–40 min x2/week month 1 and 2, then x1/week month 3 | Strength: eight repetition max Endurance: 65-75% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor and indoor walking included in endurance training |
| Orwig2011 [53] | supervised x3/week month 1 and 2, x2/week month 3 and 4, x1/1-2 weeks for remainder | strength/resistance, endurance, flexibility, cognitive behavioural interventions | 12 months | strength x2/week 30 min aerobic x3/week | Strength: 3 × 10 repetitions x 11 exercises TheraBand at individual level | motivational phone calls | no | no | author confirmed aerobic activity incorporated outdoor walking |
| Pfeiffer2020 [21] | supervised (eight sessions) and unsupervised | cognitive behavioural interventions, gait, balance, and functional training, strength/resistance | 3 months | 30–60min ≥2/week | NA | no | home risk assessment, modifications | written exercise programme with photos and instructions or recorded instructions with music player, exercise diary | intervention targeting mobility-based goals example specifies travelling by bus using a wheeled walker |
| Pol2019 [51] | supervised and unsupervised | cognitive behavioural interventions, gait, balance and functional training | 3 months | 60 min/week coaching, on discharge: four phone calls over 10 weeks | NA | no | home risk assessment, modifications | information and education sessions on importance of physical activity | specified monitoring of outdoor physical activity; appendix describes case addressing poor outdoor mobility in goal setting |
| Resnick 2007 [52] | supervised | strength/resistance, endurance, flexibility | 12 months | Strength: x2/week Aerobic: 30 min x3/week | NA | goal setting, group 2 + 3: verbal encouragement, removal of unpleasant sensations, cueing | no | group 2 + 3 booklet on exercise benefits after hip fracture | author confirmed aerobic activity incorporated outdoor walking |
| Vander Walde 2021 [58] | unsupervised | walking programme | tailored | from 3 days to 5 days/week | from 15 min to 30 min | walking diary | no | exercise workbook; information of exercise to improve fatigue during radiotherapy | encouraged 150 min walking per week |
| Varas 2018 [55] | supervised and unsupervised | exercise training and plan to increase physical activity level | 8 weeks | walking 5 days a week | walking for 30–60 min (incremental cycles of 15–20 min) at individualised predetermined speeds | weekly phone calls for encouragement, objective setting, analyse reasons of noncompliance | pedometer | activity diary to note gait and steps per day | walking programme |
| Voukelatos 2015 [42] Merom 2015 [63] * | unsupervised | walking programme: stage 1 -12 weeks focused on frequency and duration, stage 2 -12 weeks focused on intensity, and stage 3 -24 weeks of maintenance | 12 weeks | 3 times per week | 30 min | seven telephone coaching sessions at weeks 1, 3, 6, 12, 16, 24, and 36 walking diary | encouraged to use a pedometer | walking manual sent by post at 0, 12 and 24 weeks with guidance for each stage | progressive walking intervention undertaken at participants preferred location |
| Ziden 2008 [46],2010 [64]* | supervised and unsupervised | general physical activity, cognitive behavioural interventions, involvement of family in discharge planning. Physiotherapy intervention focused on improving outdoor mobility. | 3 weeks | individually tailored | individually tailored | goal setting and motivation | no | no | physiotherapy intervention focussed on outdoor mobility |
| Author year . | Supervised/ unsupervised . | Type . | Duration . | Frequency . | Intensity . | Psychological . | Environment/ assistive technology . | Knowledge . | Outdoor . |
|---|---|---|---|---|---|---|---|---|---|
| Arija 2017 [20] | supervised | socio-cultural activities and walking itineraries (average 5 km circuits) accompanied and monitored by healthcare professionals | 9 months | 2 walking sessions per week, socio-cultural activities once per month | 120 min/week walking (396 METs min/week) | no | no | walking itineraries | outdoor sociocultural activities, walks encouraged in and around the city |
| Arkkukangas 2019 [60], Tuvemo Johnson 2021 [16]* | supervised | a: Otago exercise programme and walking programme b: Otago exercise programme, walking programme, and motivational interviewing | 12 weeks | a and b: exercise three times per week b: motivational interviewing five sessions | a and b: exercise 30 min | b: motivational interviewing | ankle weight | exercise manual with pictures and description of each exercise | walks encouraged in between exercise days |
| Bae 2019 [41] | supervised | four to five participants and two staff per group. Stretching, physical cognitive and social activities tailored to preference and available community resources near their residence. | 24 weeks | twice weekly | 90 min | social activities; group based | accelerometer | no | outdoor activity of choice e.g. walking, visiting temple, shopping |
| Boongird 2017 [40] | unsupervised following 1 h demonstration; telephone progress monitoring | modified Otago program and a walking plan | 12 weeks | exercise six times weekly; twice weekly walking | 20 min exercises; 30 min walking | weekly planners | video disc recorder | fall prevention education, exercise manual | walks encouraged 2 x 30 min weekly |
| Clemson 2004 [57] | supervised | 12 participants in each group. Lower limb balance and strengthening, community mobility and discrete skills. One session included a community mastery experience during which community mobility and discrete skills e.g. negotiating grass or curb ramps were practiced. | 7 weeks | once weekly | 120 min | group based. Reflections and sharing accomplishments, action planning, weekly homework | no | coping with visual loss and regular screening, medication management, environmental and behavioural home safety, community safety | community mobility session |
| Croteau 2007 [45] | supervised and unsupervised | intervention consisting of pedometer usage, counselling, and self-monitoring | 24 weeks (12 week intervention, 12 week maintenance) | monthly group sessions, daily walking | Individually tailored - step count 5% greater than participants baseline | counselling, goal setting, identifying strategies to increase step count | pedometer | step calendar, list of sample strategies to increase physical activity | list of walking strategies included outdoor mobility (e.g. talking dog for walks, walking with a friend) |
| Crotty2002 [48] | supervised | gait, balance, functional tasks, general physical activity | individually tailored | individually tailored | individually tailored | goal setting | home risk assessment, modifications, mobility aids | no | author confirmed outdoor mobility training included |
| de Roos 2018 [56] | supervised and unsupervised | incremental treadmill walking, cycling and extremity resistance exercise, education sessions, instructions to walk | 10 weeks | two times per week | 10 min incremental treadmill walking, cycling and resistance exercise Self-paced walking programme | no | no | instructions on exercise compliance and the importance staying active | ≥30 min walking 1 day per week |
| Echeverria 2020 [44] | Supervised (hospital group session) and unsupervised (individual home program) | SGB: 6 weeks at hospital +18 weeks at home LGB: 12 weeks at hospital +12 weeks at home Group = strength, power, balance, walking Individual = Otago Program e.g. balance, strength, walks | 24 weeks | Hospital: 2 x 1 h per week Home: walk 15–60 min daily | Strength training: weeks 1–3 40–50% 1RM, weeks 4 onwards 60–70% 1RM | No | No | No | home component included 7 days of walking recommendations aimed at perform outdoor walking without assistance. |
| Hauer2002 [38] | supervised | gait, balance and functional training, strength/resistance, general physical activity. | 3 months | 145 min 3 days/week | 70–0% max workload | no | no | no | author confirmed outdoor mobility training included |
| Hughes 2004 [59] Hughes 2006 [62]* | supervised | Fit and strong intervention: flexibility exercises, resistance training, walking, group discussion and education | 8 weeks | 90 min sessions, three times per week | Individually tailored | goal setting and systematic feedback on progress made, identify strategies for self-efficacy adherence | no | Performance records shared with participants. Exercise log, The Arthritis helpbook, and health education. | outdoor walking |
| Iliffe 2014 [39] | supervised and unsupervised | a: Otago exercise and walking programme b: community centre postural stability instructor led exercise programme, Otago home exercise, and walking programme | 24 weeks | a: three times per week; and at least twice weekly walking b: one group exercise class, twice weekly home exercise; and at least twice weekly walking | a: 30 min home exercise; walking 30 min at moderate pace b: 1 h group exercise, 30 min home exercise, walking 30 min moderate pace | coping strategies to reduce risk of complications from a long lie after a fall. | a: ankle cuff weights | a and b: instruction booklet | walks encouraged 2 x 30 min weekly |
| Karlsson 2016 [47] | supervised | comprehensive geriatric assessment, gait, balance and functional training, strength/resistance, general physical activity, monitoring -pain, wound care, medication, nutrition. Intervention specified walking ability indoors and outdoors. | 10 weeks | initially daily home visits | na | no | home risk assessment, modifications, assistive devices | no | walking indoors and outdoors with physiotherapist |
| Kerr 2018 [17] Crist 2021 [61]* | supervised and unsupervised | group walks led by staff and peer leaders from 6 weeks to 6 months, led by peer-leaders alone from 6 to 12 months. Goal setting for step count to achieve during group walks and independently. | 12 months | all participants encouraged to achieve a 3,000 step increase from baseline in first 12 weeks and maintain this for remainder of study. | four counselling phone calls in first 8 weeks to identify barriers and set goals. Goals achieved celebrated in group sessions. Progress charts of steps taken every two weeks for first 6 months. Weekly step logs. | pedometers | step counts for common locations around their area, and walking maps for their local community. Nine group education sessions led by research staff and peer-leaders for information e.g. local activity classes, safe walking tips, barriers and benefits of PA, goal setting, social support, disease specific recommendations. | encouraged to walk around community | |
| Kerse 2010 [43] | supervised and unsupervised | Otago exercise programme, progressive resistance training, progressive balance training, and walking programme | 6 months | three times per week; six visits in first 2 months, seventh at month, eighth at month 6 | walking 30 min; 60 min visits | calendars to record physical activity; functional goal setting; encouraged to identify a social companion for exercise | no | no | regular walking 3 x weekly and functional goal setting e.g. prune the roses |
| Lee 2007 [19] | supervised | Community-based walking intervention underpinned by self-efficacy theory delivered by a public health nurse | 6 months | individually tailored (median = 6) | NA | discuss ideas for overcoming perceived barriers, verbal encouragement; recognise interpretations of physiological and emotional responses to walking, identify performance accomplishments | pedometer | advise about regular walking and a walking log, shared practical information about pleasant walking routes and others experiences of success | community-based walking |
| Logan 2004 [54] | supervised | assessment of barriers to outdoor mobility, mobility goal setting and tailored interventions to achieve goals | up to 3 months | seven times | tailored | advice, encouragement, mobility goal setting, overcoming fear/apprehension by e.g. supervised mobility | walking aids, adaptations as needed | leaflets describing local mobility services, information on e.g. resuming driving, alternatives to cars and buses | intervention based on mobility goals e.g. getting public transport |
| Logan 2014 [18] | supervised | additional rehabilitation, exercise, practical activities, psychological interventions to improve confidence and targeted information; a treatment manual | 4 months | according to participants preference, maximum 12 visits | Individually tailored | goal planning, checklist of benefits and barriers of going outside, motivational and confidence-building strategies | Walking aids, referrals for additional equipment as needed | example of skills needed for outdoor mobility, case vignettes of treatment plans, personalised pack of local travel information | intervention based on mobility goals (e.g. long walk of >100 m), included a protocol for a first outing walking and practicing outdoor mobility |
| Magaziner 2019 [49] | supervised | gait, balance and functional training, strength/resistance, endurance | 4 months | 60 min every other day | Strength:3x8 repetitions at eight repetition max Endurance: 50% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor ambulation (if able) on flat surface or up and down steps |
| Mangione 2005 [50] | supervised | group 1: strength/resistance, group 2: endurance | 3 months | 30–40 min x2/week month 1 and 2, then x1/week month 3 | Strength: eight repetition max Endurance: 65-75% heart rate max or 3–5/10 perceived exertion | no | no | no | intervention specified outdoor and indoor walking included in endurance training |
| Orwig2011 [53] | supervised x3/week month 1 and 2, x2/week month 3 and 4, x1/1-2 weeks for remainder | strength/resistance, endurance, flexibility, cognitive behavioural interventions | 12 months | strength x2/week 30 min aerobic x3/week | Strength: 3 × 10 repetitions x 11 exercises TheraBand at individual level | motivational phone calls | no | no | author confirmed aerobic activity incorporated outdoor walking |
| Pfeiffer2020 [21] | supervised (eight sessions) and unsupervised | cognitive behavioural interventions, gait, balance, and functional training, strength/resistance | 3 months | 30–60min ≥2/week | NA | no | home risk assessment, modifications | written exercise programme with photos and instructions or recorded instructions with music player, exercise diary | intervention targeting mobility-based goals example specifies travelling by bus using a wheeled walker |
| Pol2019 [51] | supervised and unsupervised | cognitive behavioural interventions, gait, balance and functional training | 3 months | 60 min/week coaching, on discharge: four phone calls over 10 weeks | NA | no | home risk assessment, modifications | information and education sessions on importance of physical activity | specified monitoring of outdoor physical activity; appendix describes case addressing poor outdoor mobility in goal setting |
| Resnick 2007 [52] | supervised | strength/resistance, endurance, flexibility | 12 months | Strength: x2/week Aerobic: 30 min x3/week | NA | goal setting, group 2 + 3: verbal encouragement, removal of unpleasant sensations, cueing | no | group 2 + 3 booklet on exercise benefits after hip fracture | author confirmed aerobic activity incorporated outdoor walking |
| Vander Walde 2021 [58] | unsupervised | walking programme | tailored | from 3 days to 5 days/week | from 15 min to 30 min | walking diary | no | exercise workbook; information of exercise to improve fatigue during radiotherapy | encouraged 150 min walking per week |
| Varas 2018 [55] | supervised and unsupervised | exercise training and plan to increase physical activity level | 8 weeks | walking 5 days a week | walking for 30–60 min (incremental cycles of 15–20 min) at individualised predetermined speeds | weekly phone calls for encouragement, objective setting, analyse reasons of noncompliance | pedometer | activity diary to note gait and steps per day | walking programme |
| Voukelatos 2015 [42] Merom 2015 [63] * | unsupervised | walking programme: stage 1 -12 weeks focused on frequency and duration, stage 2 -12 weeks focused on intensity, and stage 3 -24 weeks of maintenance | 12 weeks | 3 times per week | 30 min | seven telephone coaching sessions at weeks 1, 3, 6, 12, 16, 24, and 36 walking diary | encouraged to use a pedometer | walking manual sent by post at 0, 12 and 24 weeks with guidance for each stage | progressive walking intervention undertaken at participants preferred location |
| Ziden 2008 [46],2010 [64]* | supervised and unsupervised | general physical activity, cognitive behavioural interventions, involvement of family in discharge planning. Physiotherapy intervention focused on improving outdoor mobility. | 3 weeks | individually tailored | individually tailored | goal setting and motivation | no | no | physiotherapy intervention focussed on outdoor mobility |
*two articles from one RCT
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