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

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 (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.

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 Factors influencing adherence to home-based exercises among community-dwelling stroke survivors in India: a qualitative study

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Amreen Mahmood ◽  
Pradeepa Nayak ◽  
Gerjo Kok ◽  
Coralie English ◽  
Natarajan Manikandan ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Factors Influencing ◽  
Home Based

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Phoebe Ullrich ◽  
Christian Werner ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Bastian Abel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older Persons ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Life Space ◽  
Home Based ◽  
Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

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.

scholarly journals Perseverance with technology-facilitated home-based upper limb practice after stroke: a systematic mixed studies review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Bridee A. Neibling ◽  
Sarah M. Jackson ◽  
Kathryn S. Hayward ◽  
Ruth N. Barker
Keyword(s):  
Mixed Methods ◽  
Upper Limb ◽  
Stroke Survivors ◽  
Full Potential ◽  
Design Strategies ◽  
Home Based ◽  
Mixed Studies Review ◽  
Assess Quality ◽  
Surrogate Measures ◽  
Systematic Mixed Studies Review

Abstract Background Technology is being increasingly investigated as an option to allow stroke survivors to exploit their full potential for recovery by facilitating home-based upper limb practice. This review seeks to explore the factors that influence perseverance with technology-facilitated home-based upper limb practice after stroke. Methods A systematic mixed studies review with sequential exploratory synthesis was undertaken. Studies investigating adult stroke survivors with upper limb disability undertaking technology-facilitated home-based upper limb practice administered ≥ 3 times/week over a period of ≥ 4 weeks were included. Qualitative outcomes were stroke survivors’ and family members’ perceptions of their experience utilising technology to facilitate home-based upper limb practice. Quantitative outcomes were adherence and dropouts, as surrogate measures of perseverance. The Mixed Methods Appraisal Tool was used to assess quality of included studies. Results Forty-two studies were included. Six studies were qualitative and of high quality; 28 studies were quantitative and eight were mixed methods studies, all moderate to low quality. A conceptual framework of perseverance with three stages was formed: (1) getting in the game; (2) sticking with it, and; (3) continuing or moving on. Conditions perceived to influence perseverance, and factors mediating these conditions were identified at each stage. Adherence with prescribed dose ranged from 13 to 140%. Participants were found to be less likely to adhere when prescribed sessions were more frequent (6–7 days/week) or of longer duration (≥ 12 weeks). Conclusion From the mixed methods findings, we propose a framework for perseverance with technology-facilitated home-based upper limb practice. The framework offers opportunities for clinicians and researchers to design strategies targeting factors that influence perseverance with practice, in both the clinical prescription of practice and technology design. To confirm the clinical utility of this framework, further research is required to explore perseverance and the factors influencing perseverance. Registration: PROSPERO CRD42017072799—https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=72799

scholarly journals The effectiveness of home-based therapy on functional outcome, self-efficacy and anxiety among discharged stroke survivors

Medicine ◽  
2020 ◽  
Vol 99 (47) ◽  
pp. e23296
Author(s):  
Chong Pui Kei ◽  
Nor Azlin Mohd Nordin ◽  
Aznida Firzah Abdul Aziz
Keyword(s):  
Functional Outcome ◽  
Self Efficacy ◽  
Stroke Survivors ◽  
Home Based ◽  
Home Based Therapy
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