Table 5.

Five domains of the treatment fidelity framework in line with assessments to record fidelity

1	Study design issues will ensure the ‘treatment dose’ in each condition is fixed
2	Monitoring and improving the intervention will involve standardising the process by providing interventionists with a protocol
3	Fidelity of intervention delivery will involve a single observation of an exercise class to ensure delivery is per-protocol. A checklist will then be completed at 6 monthly intervals to ensure consistency in delivery
4	Receipt of treatment by patients (did they understand how to undergo the exercises)
5	Enactment of treatment skills by patients (eg, did they engage in a home exercise programme) will be assessed during focus groups conducted within the qualitative substudy