Olafsdottir SA1, Bjartmarz I2, Magnusson C3, Caltenco H3, McGookin D4, Kytö M4, Maye L4, Jonsdottir H5, Arnadottir SA6, Hjaltadottir I5, Hafsteinsdottir TB7
1University of Iceland, School of Health Sciences, Reykjavík, Iceland, 2Landspital National Hospital, Neurologic Department, Reykjavík, Iceland, 3Lund University, Department of Design Sciences, Lund, Sweden, 4Aalto University, Department of Computer Science, Espoo, Finland, 5University of Iceland, Faculty of Nursing, Reykjavík, Iceland, 6University of Iceland, Department of Physical Therapy, Reykjavík, Iceland, 7University Medical Center Utrecht, Department of Rehabilitation, Nursing Science and Sport, Utrecht, Netherlands
Background: Lack of motivation and confidence diminish stroke survivors´ participation in exercises and physical activity despite importance of these factors in maintaining and improving their function. Researchers have shown that informal caregivers of stroke survivors can assist them to deliver home-based exercise programs that are supervised by physical therapists or other members of the rehabilitation team. Moreover, technical interactive devices can strengthen motivation of stroke survivors to do exercises at home and be more physically active in activities of daily living. Interactive devices can also offer repetitive and challenging tasks that can encourage plasticity of the brain and improve function. Based on this background an international collaborative project, ActivABLES, was established between researchers in Iceland, Sweden and Finland.
Purpose: The aim was to develop tangible interaction tools to increase motivation for activities and exercise training of home-dwelling stroke survivors with support from caregivers.
Methods: We used the steps of the Medical Research Council Framework for development of complex interventions.
Step 1. Collecting evidence: Based on the literature, the evidence for effective training interventions and important outcomes for stroke survivors was identified.
Step 2. Interviews: Focus group interviews and individual interviews were conducted with stroke survivors, caregivers and health care professionals about stroke survivors´ needs and experiences of exercising at home.
Step 3. Prototypes constructed: Based on information from the interviews, a total of eight ActivABLES prototypes were constructed focusing on various stroke survivor's outcomes.
Step 4. First testing: The ActivABLES prototypes were tested with seven stroke survivors and their informal caregivers following qualitative interviews with the participants. Quantitative data was also collected to describe the status of the stroke survivors.
Step 5. Further construction and adaptation of the tools based on the findings of step 4.
Step 6. Feasibility testing: A mixed methods study with quantitative measures describing the health status of 10 stroke survivors before and after a 4-week use of the ActivABLES prototypes and qualitative interviews with the stroke survivors and their informal caregivers after the intervention.
Step 7. Finalizing the ActivABLES-toolkit.
Results: The ActivABLES-toolkit includes six prototypes focusing on various outcomes: ActivFOAM to exercise balance and mobility, ActivBALL to exercise hand function, ActivSTICKS ot exersice arm function, ActivLAMP and ActivTREE to provide feedback and motivate for exercise and physical activity, and WalkingSTARR which in a mobile application to motivate walking and increase mobility.
Conclusion(s): The ActivABLES-toolkit is a complex intervention which was developed based on scientific literature and inputs from stroke survivors and rehabilitation professionals. Further research is needed to measure the effects of the intervention with robust randomized design and in a larger sample of stroke survivors.
Implications: The ActivABLES-toolkit may be a promising application to stimulate activation and exercise of home-dwelling stroke survivors residing at home with support from informal caregivers and under supervision of a physical therapist or other members of a rehabilitation team.
Keywords: stroke survivors, technical interactive devices, exercises at home
Funding acknowledgements: The Icelandic Physiotherapy Association, NordForsk, Öldrunarráð Íslands
Purpose: The aim was to develop tangible interaction tools to increase motivation for activities and exercise training of home-dwelling stroke survivors with support from caregivers.
Methods: We used the steps of the Medical Research Council Framework for development of complex interventions.
Step 1. Collecting evidence: Based on the literature, the evidence for effective training interventions and important outcomes for stroke survivors was identified.
Step 2. Interviews: Focus group interviews and individual interviews were conducted with stroke survivors, caregivers and health care professionals about stroke survivors´ needs and experiences of exercising at home.
Step 3. Prototypes constructed: Based on information from the interviews, a total of eight ActivABLES prototypes were constructed focusing on various stroke survivor's outcomes.
Step 4. First testing: The ActivABLES prototypes were tested with seven stroke survivors and their informal caregivers following qualitative interviews with the participants. Quantitative data was also collected to describe the status of the stroke survivors.
Step 5. Further construction and adaptation of the tools based on the findings of step 4.
Step 6. Feasibility testing: A mixed methods study with quantitative measures describing the health status of 10 stroke survivors before and after a 4-week use of the ActivABLES prototypes and qualitative interviews with the stroke survivors and their informal caregivers after the intervention.
Step 7. Finalizing the ActivABLES-toolkit.
Results: The ActivABLES-toolkit includes six prototypes focusing on various outcomes: ActivFOAM to exercise balance and mobility, ActivBALL to exercise hand function, ActivSTICKS ot exersice arm function, ActivLAMP and ActivTREE to provide feedback and motivate for exercise and physical activity, and WalkingSTARR which in a mobile application to motivate walking and increase mobility.
Conclusion(s): The ActivABLES-toolkit is a complex intervention which was developed based on scientific literature and inputs from stroke survivors and rehabilitation professionals. Further research is needed to measure the effects of the intervention with robust randomized design and in a larger sample of stroke survivors.
Implications: The ActivABLES-toolkit may be a promising application to stimulate activation and exercise of home-dwelling stroke survivors residing at home with support from informal caregivers and under supervision of a physical therapist or other members of a rehabilitation team.
Keywords: stroke survivors, technical interactive devices, exercises at home
Funding acknowledgements: The Icelandic Physiotherapy Association, NordForsk, Öldrunarráð Íslands
Topic: Robotics & technology; Neurology: stroke; Health promotion & wellbeing/healthy ageing
Ethics approval required: Yes
Institution: Landspitali National Hospital
Ethics committee: The Icelandic National Bioethics Committee
Ethics number: VSNb2015110001/03/01
All authors, affiliations and abstracts have been published as submitted.
