## 4 Discussion  
The present study showed that it is possible to engage a frail older population in a home-based resistance training program even years after an FNF, with a high level of completion and satisfaction. After completing the training program, the participants  
Figure 3: Participants’ activity was measured using an accelerometer at the baseline (blue) and the 3-month follow-up (red), showing the participants standing more and sitting less but no significant difference in walking or cycling. improved important parameters for balance and fall prevention, such as step length, walking speed, and muscle strength. An impaired gait is one of the most prevalent and sensitive risk factors for falling [3,4]; a low walking speed and a short step length especially indicate a poor gait and an increased risk for falling among the elderly [4,30]. Conversely, an improvement in the gait parameters is an indirect sign of improved balance and a decreased fall risk. Previous studies have found 0.1 to 0.17 m/s to be a clinically significant change in walking speed [31,32]. In the present study, the participants achieved an increase of 0.23 m/s, indicating a clinically significant increase in their walking speed at the three-month follow-up. The participants had a baseline walking speed of 2.26 m/s, which was higher than that found in other studies despite their having focused on community-dwelling older adults [33, 34, 35]. This suggests that the participants were not as frail as anticipated. However, the participants had a much higher baseline TUG time of 15.6 s compared to the reported norm between 8.12 s and 12 s for frail women without FNFs between 65-85 years of age [36,37]. The step length of 0.41 m at the baseline was shorter than the 0.7 m reported by [PERSON] et al. ; however, the participants in that study were community-dwelling older adults, which may indicate a better function [34]. A long TUG time and a short step length indicate poor balance and low function, and they confirm that the participants in the present study were in fact frail and at a greater fall risk. Following the three-month resistance training intervention, the participants increased their walking distance on the 6 WT by 20 m, which correlates to a higher walking speed. [PERSON] et al. found that a change in 6 WT should be at least 21.4 m to count as an improvement, rather than a learning effect [12]. However, [PERSON] et al. [12] investigated hip fracture patients only a few weeks after their surgery, and pain improvement over time was a crucial factor for improvement in their walking abilities. The participants in the present study were a mean three years post-surgery and presumably way past their surgery-related pain. [PERSON] et al. tested healthy subjects and found that a learning effect alone could explain a 12 m improvement for the 6 WT [38]. Therefore, the 20 m improvement in our study group was most likely a real positive effect of the training, which was further supported by the increase in the step length and walking speed. Several studies have shown positive results for hip fracture patients after resistance training; however, most studies have been performed within a few months after surgery [39, 40, 41]. [PERSON] et al. showed that resistance training even years after a hip fracture can improve gait and function among these patients [5]. Like the present study, the participants in [PERSON]'s study were a mean of 3 years after their hip fractures and similar in baseline characteristics. [PERSON] et al., found, as we did in our study, that resistance training is feasible for elderly patients with a history of hip fracture, as well as increased physical function [5]. The spatiotemporal parameters showed no general decrease in asymmetry despite the participants being quicker to ascend and descend during the block step test and STS30. This might be explained by participants moving their upper bodies more during the tests simply to gain speed in order to perform the exercise.