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Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions

Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions


Title: Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions
Author: Ólafsdóttir, Steinunn A.
Jonsdottir, Helga   orcid.org/0000-0002-3295-869X
Magnusson, Charlotte
Caltenco, Héctor
Kytö, Mikko
Maye, Laura
McGookin, David
Bjartmarz, Ingibjörg   orcid.org/0000-0003-1153-0587
Arnadottir, Solveig A   orcid.org/0000-0002-3017-113X
Hjaltadóttir, Ingibjörg   orcid.org/0000-0003-1193-1380
... 1 more authors Show all authors
Date: 2020-05-25
Language: English
Scope: 463
University/Institute: Háskóli Íslands
University of Iceland
School: Heilbrigðisvísindasvið (HÍ)
School of Health Sciences (UI)
Department: Hjúkrunarfræðideild (HÍ)
Faculty of Nursing (UI)
Læknadeild (HÍ)
Faculty of Medicine (UI)
Series: BMC Health Services Research;20(1)
ISSN: 1472-6963
DOI: 10.1186/s12913-020-05198-2
Subject: Home-based exercise; Stroke survivors; Technical intervention; Heilablóðfall; Sjúklingar; Líkamsrækt
URI: https://hdl.handle.net/20.500.11815/2423

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Citation:

Olafsdottir, S.A., Jonsdottir, H., Magnusson, C. et al. Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions. BMC Health Services Research 20, 463 (2020). https://doi.org/10.1186/s12913-020-05198-2

Abstract:

Background: Novel technical solutions are called for to promote home-based exercise among community-dwelling stroke survivors supported by their caregivers. Lack of resources and knowledge about how to accomplish it, has been demonstrated. The objective of this study is to describe in detail the development of ActivABLES, a technical intervention to promote home-based exercise and physical activity engagement of community-dwelling stroke survivors with support from their caregivers. Methods: The technical development process of ActivABLES was guided by the Medical Research Council (MRC) framework for development and evaluation of complex interventions as well as by principles of human-centred design and co-design. The main steps included: (1) Synthesis of evidence supporting the inclusion of balance exercises, mobility and walking exercises and exercises for the upper arm; (2) Implementation of initial user studies with qualitative data collection from individual interviews with stroke survivors, and focus group interviews with caregivers and health professionals; (3) Preliminary testing of eight prototypes with seven stroke survivors and their caregivers. 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 for further modification: 1) ActivFOAM for balance exercises, 2) WalkingSTARR to facilitate walking, 3) ActivBALL for hand exercises, 4) ActivSTICKS for upper arm exercises, and 5) ActivLAMP and 6) ActivTREE which both give visual feedback on 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 individualised and recommended daily time and/or repetition can easily be changed as the user progresses to higher activity levels. Conclusions: The development process of ActivABLES was guided by the principles of human-centred design, with iterative testing of future users, and by the MRC framework of complex intervention, with a repeated process of development and testing. This process resulted in six prototypes which are available for feasibility testing among a small group of community-dwelling stroke survivors.

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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