Development and validation of two physical exercise programme to prevent Hospital associated disability (HAD) during hospitalisation, a protocol of two Delphi studies.

Summary Background: Hospitalised older people are prone to rapid functional decline due to a lack of activity; a phenomenon known as hospital-associated disability (HAD). Exercises have a more positive impact on the functional independence and physical performance of older hospitalised patients than usual care. However, the details of the exercises and their modalities are frequently insufficiently detailed to be implemented effectively in clinical practice Aim: The aim of this project is to use the findings of an ongoing living systematic review with network-meta-analysis to reach a consensus on the two training programmes for hospitalised older patients that have been shown to be the most effective. One programme will involve resistance training exercises, while the other will be a multicomponent exercise programme of combined balance, resistance, and gait training. The analysis of each training programme will be conducted in two distinct Delphi studies: one focusing on resistance training and the other on balance, resistance and gait training. Methodology: A modified Delphi study design to reach a consensus among 30 participants will be used. Clinicians, prescribing physical exercises to older adults and researchers in these fields will be invited to participate. Our two studies will each consist of three modified Delphi rounds, using only electronic surveys. Potential significance: These two studies are part of a broader project aimed at improving access to recent scientific evidence on the prevention of HAD in older adults for both clinicians and their patients. These studies will inform the development of clinical training programmes for geriatric hospitals in Switzerland. Keywords: Physical exercises programme, hospital-associated disability, older adults, prevention