W. Hendrickx1,2,3, R. Wondergem1,2,3, C. English4,5, C. Veenhof1,2,6, J. Vissser-Meilij1,7, M.F. Pisters1,2,3
1University Medical Center Utrecht, Utrecht University, Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht, Netherlands, 2Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, Netherlands, 3Fontys University of Applied Sciences, Department of Health Innovations and Technology, Eindhoven, Netherlands, 4School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia, 5Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience and Hunter Medical Research Institute, Newcastle, Australia, 6Research Group Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, Netherlands, 7Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, Netherlands
Background: People who have suffered a stroke are at high risk for recurrent stroke, functional decline and premature mortality. Therefore, secondary prevention is urgent. High amounts of sedentary behaviour, accumulated in prolonged bouts, and low amounts of moderate to vigorous physical activity increase the risk of cardiovascular disease. In total 32% of the people with stroke have such a movement behaviour pattern.
Purpose: The aim of this study was to develop the RISE intervention to support highly sedentary and inactive people who have had a stroke to sit less and move more.
Methods: The development process used an iterative co-design methodology including all stakeholders by using the CeHRes roadmap model. The behaviour change wheel was used to determine the content of the intervention. First, a literature search was conducted to gather information on sedentary behaviour after stroke and interventions to reduce sedentary behaviour in other populations. Second, focus groups and interviews were held with physiotherapists and international movement behaviour change researchers to determine the Behaviour Change Techniques to reduce and interrupt sedentary behaviour after stroke. Third, interviews with highly sedentary people who have had a stroke were conducted to determine barriers and facilitators. Fourth, stakeholders, including patient, relatives, physiotherapist, researchers, insurance companies and ICT experts were closely involved in the design and development of the RISE intervention including the m-health application.
Results: The developed RISE-Intervention is a blended intervention that runs for 15 weeks and combines 10 face to face coaching sessions by a physiotherapist with eCoaching by using an activity monitor and a m-health application. It is a personalised behaviour change intervention that includes components such as creating intention, insight in relevant self-management information e.g. health information on sedentary behaviour and physical activity and feedback on personal movement behaviour. Also included are goal setting, action planning, improving self-efficacy and social support. The RISE intervention is opted to including participatory support which means a self-selected member from the participant’s immediate social environment provides meaningful support by acting as a buddy in the intervention. They will get insight in relevant self-management information, the individual goals of the participant and how to provide meaningful support, and preform the same movement behavioural change tasks in reducing and interrupting sedentary behaviour as the participant. The participatory support buddy will be able to facilitate changes, provide encouraging support, increase enjoyment and provide greater accountability for a more active lifestyle in highly sedentary people with stroke participating in the RISE intervention.
Conclusion(s): The RISE-intervention is a comprehensively designed blended intervention that aims to support highly sedentary and inactive people who have had a stroke to sit less and move more.
Implications: The RISE intervention is expected to help reduce sedentary behaviour and improve movement behaviour in people who have had a stroke and thereby be of great added value to the secondary prevention after stroke. It is an innovative blended intervention combining face to face physiotherapy coaching with the support of an m-health application, activity monitor and real-time feedback.
Funding, acknowledgements: SIA-RAAK, The Dutch Organisation for Scientific Research (NWO), number RAAK.PUB05.021
Keywords: Stroke, Sedentary behaviour, Behaviour change intervention
Topic: Neurology: stroke
Did this work require ethics approval? Yes
Institution: University Medical Centre Utrecht
Committee: Medical Ethics Research Committee of the University Medical Centre Utrecht
Ethics number: 16/715
All authors, affiliations and abstracts have been published as submitted.
