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M. Grau Pellicer1, J. Ferrer-Lalanza2, E. Jovell Fernandez3, L. Capdevila4
1Hospital-Consorci Sanitari de Terrassa, Rehabilitation Unit, Terrassa (Barcelona), Spain, 2Autonomous University of Barcelona, Department of Basic Psychology, Barcelona, Spain, 3Hospital-Consorci Sanitari de Terrassa, Department of Epidemiology, Terrassa (Barcelona), Spain, 4Autonomous University of Barcelona, Laboratory of Sport Psychology, Barcelona, Spain
Background: Physical activity (PA) is a key health behavior in people with stroke, including risk reduction of recurrent stroke. Despite the beneficial effects of PA, many community-dwelling stroke survivors are physically inactive. Information and communication technologies are emerging as a possible method to promote adherence to PA.
Purpose: The aim of this study was to investigate the effectiveness of a smartphone activity App in improving levels of PA and reducing sedentary time.
Methods: This was a pilot randomized trial with a baseline and a 3-months follow-up assessment in an outpatient rehabilitation setting at a university hospital. Forty-one chronic stroke survivors were randomized into an intervention group (IG) n=24 and a control group (CG) n=17. Participants in the IG were engaged in the Multimodal Rehabilitation Program (MMRP) that consisted on the implementation of a mobile-health app, to supervise adherence to PA, and the participation of an 8-week rehabilitation program, two alternate days a week, in sessions of one hour (16 sessions in total) that included: aerobic, task-oriented, balance and stretching exercises. Participants also performed an ambulation program at home. The CG received a conventional rehabilitation program. Outcome variables were: adherence to PA activity, reported by community ambulation and sedentary behavior (walking and sitting time/day), walking speed (10-m walking test); walking endurance (6MWT); risk of falling (TUG); ADLs (Barthel); QoL (Eq-5D5L) and participant’s self-reported satisfaction.
Results: At the end of the intervention, community ambulation increased by an average of 38.95 (SD 20.37) minutes in the IG (p≤.05) and 9.47 (SD 12.11) minutes in the CG. Sitting time was reduced by 2.96 (SD 2.0) hours/day in the IG (p≤.05) and by 0.53 (SD 0.24) hours in the CG. Comfortable and fast walking speed, measured with the 10MWT, increased 0.21 (SD 0.07) and 0.27 (SD 1.3) meters/second respectively in the IG (p≤.05) and the CG increased 0.12 (SD 0.04) and 0.06 (SD 0.03) meters/second respectively. Risk of falling, measured with the TUG test, decreased by 3.46 seconds in the IG (p≤.05) and the CG increased 4.67 seconds. Participants in the IG achieved independence in ADLs (p=.009), and the CG remained mildly dependent. Regarding QoL, assessed with the EQ-5D-5L, there is a statistical improvement of self-perceived QoL in the IG ( p<.001) and in the CG there were no changes in self-perceived QoL.
Conclusion(s): The results suggest that mHealth technology provides a novel way to promote adherence to home exercise programs post stroke. However, frequent support and guidance of caregiver is required to ensure the use of mobile devices.
Implications: The mHealth technology is increasingly accessible and provides a novel way to provide home exercise programs post stroke with a number of benefits.
Funding, acknowledgements: This study was funded by the 2018 PERIS grant (Strategic Plan of health research and innovation) by the Catalan Government.
Keywords: Stroke rehabilitation, Physical activity, M-Health
Topic: Neurology: stroke
Did this work require ethics approval? Yes
Institution: Consorci Sanitari de Terrassa
Committee: Consorci Sanitari de Terrassa Ethical Committe
Ethics number: ClinicalTrials.gov identifier: NCT03507894
All authors, affiliations and abstracts have been published as submitted.
