ActivABLES, a tangible interaction to promote home-based exercise and physical activity of community-dwelling stroke survivors: A development paper (Preprint)

2019 ◽  
Author(s):  
Steinunn Olafsdottir ◽  
Helga Jónsdóttir ◽  
Charlotte Magnusson ◽  
Héctor Caltenco ◽  
Mikko Kytö ◽  
...  
Keyword(s):  
Physical Activity ◽  
Feasibility Study ◽  
Development Process ◽  
Informal Caregivers ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Home Based ◽  
Balance Exercises ◽  
Mrc Framework ◽  
Human Centred Design

BACKGROUND Novel technical solutions are called for to promote home-based exercise and facilitate engagement in physical activity among community-dwelling stroke survivors supported by their caregivers in the home environment. Lack of knowledge and resources on what to do and how to accomplish this has been demonstrated. OBJECTIVE To describe in detail the development of a technical intervention, ActivABLES, to promote home-based exercise and physical activity engagement of community-dwelling stroke survivors with support from their informal caregivers. METHODS Technical development process of ActivABLES was guided by Human-Centred Design and participatory design/co-design as well as the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. The main steps included: (a) Synthesis of the evidence supported the inclusion of balance exercises, mobility and walking exercises, exercises for the upper arm and means to decrease sedentary behavior; b) Initial user studies with qualitative data collection from individual interviews with stroke survivors and focus group interviews with informal caregivers and health professionals; c) Preliminary testing of eight prototypes with seven stroke survivors and their informal caregivers which included introduction and testing of the prototypes; d) Feasibility study of six prototypes with ten stroke survivors and their informal caregivers which included use of ActivABLES for four weeks. RESULTS After the preliminary testing of eight prototypes, four prototypes were not further developed whereas four prototypes were modified further. In addition, two new prototypes were developed, leaving six prototypes constructed for use in the feasibility study. These included: 1) ActivFOAM, a soft mat for balance exercises, 2) WalkingSTARR, an iPhone application to facilitate walking, 3) ActivBALL, a soft ball for hand exercises, 4) ActivSTICKS, two linked plastic sticks for upper arm exercises and trunk rotation and 5) the ActivLAMP and 6) the ActivTREE which both give visual feedback (lights) for progress of daily exercise and physical activities. ActivFOAM, ActivBALL and ActivSTICKS are all connected to a tablet where exercise instructions are given. All the exercise prototypes can be connected to ActivLAMP and ActivTREE to give feedback on how much exercise the user has done. Settings can be individualized and recommended daily time and/or repetition can easily be changed as the user further progresses to higher activity levels. CONCLUSIONS The development process of ActivABLES was guided by the human-centred design, with iterative testing of future users, and the MRC framework of complex intervention, with repeated process of development and testing. This process resulted in six prototypes which aim to promote home-based exercise and facilitate physical activity engagement of community-dwelling stroke survivors and were used in a feasibility study. Further research with a larger sample of stroke survivors and a more robust design is needed to substantiate these results.

scholarly journals Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers: A mixed methods study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Steinunn A. Olafsdottir ◽  
Helga Jonsdottir ◽  
Ingibjörg Bjartmarz ◽  
Charlotte Magnusson ◽  
Héctor Caltenco ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Community Dwelling ◽  
Mixed Methods Study ◽  
Stroke Survivors ◽  
Home Based

scholarly journals Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers: A mixed methods study (Preprint)

2019 ◽  
Author(s):  
Steinunn A. Olafsdottir ◽  
Helga Jónsdóttir ◽  
Ingibjörg Bjartmarz ◽  
Charlotte Magnusson ◽  
Héctor Caltenco ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Qualitative Data ◽  
Community Dwelling ◽  
Mixed Methods Study ◽  
Stroke Survivors ◽  
Technical Problems ◽  
Home Based ◽  
Before And After ◽  
Need For Support

BACKGROUND Technical applications can promote home-based exercise and physical activity of community-dwelling stroke survivors to improve function and decrease physical inactivity and sedentary behavior. Informal caregivers are often able and willing to assist with home-based exercise and physical activity but may lack knowledge and practical resources. ActivABLES is an international collaboration which was established to promote home-based exercise and physical activity among community-dwelling stroke survivors, with support from their caregivers. OBJECTIVE The aim of this study is to investigate the feasibility of ActivABLES in terms of acceptability, demand, implementation and practicality. METHODS We conducted a mixed methods study with 10 community-dwelling stroke survivors, including five women and five men, with the median age of 72 years, who used ActivABLES for four weeks with support from their caregivers (seven women and three men, median age 68 years). Data collection included quantitative functional standardized measures of the stroke survivors before and after the 4-week use. Additionally, qualitative data was collected through individual semi-structured interviews with the stroke survivors and their caregivers after the 4-week use. Quantitative and qualitative data were also collected during the 4-week use. Descriptive statistics were used to analyze quantitative data and Wilcoxon signed rank test was used to analyze changes between the measures before and after the 4-week use. Qualitative data were analyzed with direct content analysis to identify subcategories to define the data further in context with the predetermined categories. RESULTS Acceptability was identified in four subcategories: appreciation, functional improvements, self-initiated activities and expressed potential use for future stroke survivors. Functional improvements of the stroke survivors were confirmed by quantitative and qualitative data and some mentioned changes in physical activity and self-initiated activities. All participants described ActivABLES to be feasible and to have potential for future stroke survivors. Demand was identified in three subcategories: reported use, interest in further use and need for follow-up. Most of the stroke survivors did follow the recommendation of using ActivABLES, confirmed by quantitative and qualitative data and showed interest in further use. Implementation was identified in three subcatagories: importance of feedback, variety of exercises and progression of exercises. Visual feedback was thought to be important and encouraging for continuing. About half of the stroke survivors felt that there was a lack of variation in exercises and about half used the progression of exercises. Practicality was identified in two subcatagories: need for support and technical problems. All participants agreed there was little need for support while using ActivABLES and the stroke survivors only needed minor assistance. All particants experienced some technical problems. CONCLUSIONS The results from this study indicate that ActivABLES is feasible and can be a good asset for stroke survivors with slight or moderate disability to use in their homes.

Personal and social factors that influence physical activity levels in community-dwelling stroke survivors: A systematic review of qualitative literature

2021 ◽  
pp. 026921552199369
Author(s):  
Karl R Espernberger ◽  
Natalie A Fini ◽  
Casey L Peiris
Keyword(s):  
Physical Activity ◽  
Social Factors ◽  
Self Efficacy ◽  
Data Extraction ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Activity Levels ◽  
Post Stroke ◽  
Physical Activity Levels ◽  
Mobile Community

Objectives: To determine the personal and social factors perceived to influence physical activity levels in stroke survivors. Data sources: Four electronic databases (MEDLINE, CINAHL, PubMed and Embase) were searched from inception to November 2020, including reference and citation list searches. Study selection: The initial search yielded 1499 papers, with 14 included in the review. Included articles were peer-reviewed, qualitative studies, reporting on the perceived factors influencing physical activity levels of independently mobile community-dwelling adults, greater than 3 months post stroke. Data extraction: Data extracted included location, study aim, design, participant and recruitment information and how data were collected and analysed. Data synthesis: Thematic analysis was undertaken to identify meanings and patterns, generate codes and develop themes. Five main themes were identified: (i) Social networks are important influencers of physical activity; (ii) Participation in meaningful activities rather than ‘exercise’ is important; (iii) Self-efficacy promotes physical activity and physical activity enhances self-efficacy; (iv) Pre-stroke identity related to physical activity influences post-stroke physical activity; and (v) Formal programmes are important for those with low self-efficacy or a sedentary pre-stroke identity. Conclusions: Physical activity levels in stroke survivors are influenced by social activities and support, pre-stroke identity, self-efficacy levels and completion of activities that are meaningful to stroke survivors.

Measurement of adherence to home‐based exercises among community‐dwelling stroke survivors in India

2020 ◽  
Vol 25 (2) ◽  
Author(s):  
Amreen Mahmood ◽  
John Michael Solomon ◽  
Coralie English ◽  
Unnikrishnan Bhaskaran ◽  
Girish Menon ◽  
...  
Keyword(s):  
Community Dwelling ◽  
Stroke Survivors ◽  
Home Based

scholarly journals Physical activity, sleep, and fatigue in community dwelling Stroke Survivors

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Anthony I. Shepherd ◽  
Richard Pulsford ◽  
Leon Poltawski ◽  
Anne Forster ◽  
Rod S. Taylor ◽  
...  
Keyword(s):  
Physical Activity ◽  
Community Dwelling ◽  
Stroke Survivors

scholarly journals Association Between Physical Activity and Mortality Among Community-Dwelling Stroke Survivors

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012535
Author(s):  
Raed A. Joundi ◽  
Scott B. Patten ◽  
Aysha Lukmanji ◽  
Jeanne VA Williams ◽  
Eric E. Smith
Keyword(s):  
Physical Activity ◽  
Risk Reduction ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Dependent Manner ◽  
Metabolic Equivalents ◽  
All Cause Mortality ◽  
The Relationship ◽  
Lower Hazard ◽  
Prior Stroke

Objective:To determine the relationship between physical activity and mortality in community-dwelling stroke survivors.Methods:The Canadian Community Health Survey was used to obtain self-reported physical activity (PA) across four survey cycles and was linked to administrative databases to obtain prior diagnosis of stroke and subsequent all-cause mortality. PA was measured as metabolic equivalents (METs) per week and meeting minimal PA guidelines was defined as 10 MET-hours/week. Cox proportional hazard regression models and restricted cubic splines were used to determine the relationship between PA and all-cause mortality in respondents with prior stroke and controls, adjusting for sociodemographic factors, co-morbidities, and functional health limitations.Results:The cohort included 895 respondents with prior stroke and 97805 controls. Adhering to PA guidelines was associated with lower hazard of death for those with prior stroke (adjusted hazard ratio [aHR] 0.46, 95% CI 0.29-0.73) and controls (aHR 0.69, 95% CI 0.62-0.76). There was a strong dose-response relationship in both groups, with a steep early slope and the vast majority of associated risk reduction occurring between 0 and 20 MET-hours/week. In the group of stroke respondents, PA was associated with greater risk reduction in those <75 years of age (aHR 0.21, 95% CI 0.10-0.43) compared to those >75 years of age (aHR 0.68, 95% CI 0.42-1.12).Conclusions:PA was associated with lower all-cause mortality in an apparent dose-dependent manner among those with prior stroke, particularly in younger stroke survivors. Our findings support efforts towards reducing barriers to PA and implementation of PA programs for stroke survivors in the community.Classification of Evidence:This study provides Class IV evidence that in community-dwelling survivors of stroke, adhering to physical activity guidelines was associated with lower hazard of death.

scholarly journals The performance of balance exercises during daily tooth brushing is not sufficient to improve balance and muscle strength in healthy older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Urs Granacher ◽  
Thomas Muehlbauer ◽  
Gerd Göstemeyer ◽  
Stefanie Gruber ◽  
Markus Gruber
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Muscle Strength ◽  
Balance Training ◽  
Tooth Brushing ◽  
Healthy Older Adults ◽  
Home Based ◽  
Balance Exercises ◽  
Romberg Test ◽  
Steady State Balance

Abstract Background High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (i.e., muscle strength) and skill-related components of physical fitness (i.e., balance), particularly in times of restricted physical activity due to pandemics. Objective The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults. Methods Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age: 65.1 ± 1.1 years) or a passive control group (n = 24; age: 66.2 ± 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Pre- and post-intervention, tests were included for the assessment of static steady-state balance (i.e., Romberg test), dynamic steady-state balance (i.e., 10-m single and dual-task walk test using a cognitive and motor interference task), proactive balance (i.e., Timed-Up-and-Go Test [TUG], Functional-Reach-Test [FRT]), and muscle strength (i.e., Chair-Rise-Test [CRT]). Results Irrespective of group, the statistical analysis revealed significant main effects for time (pre vs. post) for dual-task gait speed (p < .001, 1.12 ≤ d ≤ 2.65), TUG (p < .001, d = 1.17), FRT (p = .002, d = 0.92), and CRT (p = .002, d = 0.94) but not for single-task gait speed and for the Romberg-Test. No significant group × time interactions were found for any of the investigated variables. Conclusions The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60–72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength.

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