Table 3.
Description of land-based therapy protocol
| Exercise blocks | Exercise descriptions | Repetitions/Action/Pause |
|---|---|---|
| Warm-up (15 min) | 1. Vigorous Walking: Patients will have to walk forwards, backwards, snaking and changing direction energetically. 2. Standing exercises: a. On one leg, with an UL and its contralateral LL, patients will do a simultaneous abduction followed by addution. b. The shoulder flexion movement is combined with contralateral knee elevation. c. Patients will perform jumping jacks. 3. Ball Jumps: Patients will be sitting on a Bobath ball and will have to jump. 4. Pedaling: Patients will be positioned face up, with the hips and knees bent 90° and will have to do a pedaling motion with their legs, keeping the pelvis in a neutral position. 5. Relay Race: 2 groups. The winner will be the group that return the baton to the first participant in the shortest time. | 1. 3 min of uninterrupted activity. 2. a. and b. 6 (3 for each diagonal)/15 s/5 s; c. 3/20 s/10 s. 3. 3/45 s/20 s. 4. 3/45 s/20 s. 5. 3/1 min/20 s. |
| Proprioceptive exercises (25 min) | 1. Playing Catch: Patients will be placed in a circle and sitting on a Bobath ball. With single-foot support, they will have to maintain a good position while throwing and catching the ball. | 1. 3 min of uninterrupted activity. |
| 2. The bridge: a. Patients will be positioned face up on a mat, with arms along the body and feet on a Bobath ball. They will have to raise their buttocks off the floor and hold this position (the bridge). b. Starting from the previous position, patients will do the bridge raising one of the LL supported on the ball together with the contralateral UL at the same time. | 2. a. 2/1 min/20 s.; b. 4 (2 for each diagonal)/40 s/5 s. | |
| 3. The knight: With one knee on a Dynair and the contralateral foot on a hedgehog (Erizo Senso® Balance), patients will have to maintain the position without losing balance. | 3. 6 (3 for each side)/30 s/10 s. | |
| 4. Standing balance: Standing on a Dynair, patients will have to maintain their balance while moving their center of gravity forward, backward and sideways. There can not be any contact with the floor through the Dynair. The exercise will also be performed on one leg. | 4. 3/1 min/15 s. | |
| 5. Superman: On all fours, with hands holding a roll (SISSEL® Pilates Roller), patients will have to perform and hold the superman position (simultaneous extension of an UL and contralateral LL). The exercise will also be performed dynamically: Hand touching the knee and then moving away, while keeping the pelvis in a neutral position. | 5. 8 (4 for each diagonal: 2 dynamic and 2 keeping the position)/30 s/10 s. | |
| 6. Exercises with the roll (SISSEL® Pilates Roller): a. Patients will be sitting on one of the roll’s ends and must move their trunk backward (reaching the stability limit), while keeping both feet fully supported on the floor. b. With the spine resting on the roll and hands and feet on the floor, patients will place their hips and knees in a flexion of 90°, without losing balance. This exercise will also be performed dynamically (raising and lowering the legs) and removing one of the hand supports. | 6. a. 3/15 s/10 s.; b. 4 (2 dynamic y 2 keeping the position)/50 s/10 s. | |
| Stretching (8 min) | Gastrocnemius, quadriceps, ischiotibial, adductors, quadratus lumborum, deltoid, triceps brachii, superior trapezius. | 2 (right and left side)/30 s/5 s. |
| Relaxation (12 min) | Jacobson Progressive muscle relaxation, with classical music. | 12 min of uninterrupted activity. |
UL upper limb, LL lower limb, Dynair Balance Soft Disc