[Abstract] Impact of mHealth technology on adherence to healthy PA after stroke: a randomized study

ABSTRACT

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.

Objective

The aim of this study is to investigate the effectiveness of a mobile-health (mHealth) App in improving levels of PA.

Methods

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 supervising adherence to PA through a mHealth app, participating in an 8-week rehabilitation program 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, (walking and sitting time/day), walking speed (10MWT); walking endurance (6MWT); risk of falling (TUG); ADLs (Barthel); QoL (Eq-5D5L) and participant’s satisfaction.

Results

At the end of the intervention, community ambulation increased more in IG (38.95 min; SD: 20.37) than in the CG (9.47 min; SD: 12.11) (p≤.05). Sitting time was reduced by 2.96 (SD 2.0) hours/day in the IG and by 0.53 (SD 0.24) hours in the CG (p≤.05).

Conclusions

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.

Source: https://www.tandfonline.com/doi/full/10.1080/10749357.2019.1691816?scroll=top&needAccess=true

[Study] Home Is a Better Bet Than Hospitals for Achieving More PA Poststroke

There’s no place like home for engaging in the levels of physical activity (PA) that can aid in recovery poststroke—at least compared with the current hospital setting—according to a small study from Australia.

For the study, researchers used accelerometers and self-reports to track the PA and sitting time of 32 participants (mean age of 68, 53% male) who had experienced a stroke, comparing data gathered during their last week in the hospital with data gathered during their first week home. Participants were also assessed in a number of areas during their final week in the hospital, including physical function, functional independence, pain, anxiety, and depression.

The researchers were interested in finding out if an individual’s environment plays a role in PA poststroke—something they describe as “pivotal” to recovery—and whether other factors, such as depression, have an effect on any changes in PA levels. Results were e-published ahead of print in theArchives of Physical Medicine and Rehabilitation (abstract only available for free).

They found that environment does seem to make a difference—and a fairly big one at that. While the amount of time spent awake didn’t change much from hospital to home (13.1 hours a day in the hospital vs 13.5 hours per day at home), the amount of PA achieved—and time spent in sedentary behaviors—varied significantly. Participants sat for an average of 45 fewer minutes a day at home than they did in their last week in the hospital, were upright for 45 more minutes a day, spent 12 more minutes a day walking, and completed an average of 724 additional daily steps.

The results were similar when adjusted for demographic variables and didn’t seem to be significantly affected by any of the secondary factors assessed in the hospital, save one—depression, which when present was associated with no gains in PA at home.

The researchers don’t pin the improvement to any single factor but speculate that “the home environment may provide greater opportunity for activities of daily living such as cooking, cleaning, social and community activities, and there may be fewer external restrictions such as hospital routines and safety concerns around mobilization.”

Authors of the study also believe the gap between home and hospital PA poststroke could be closed if hospitals were to take more cues from the home environment.

“Physically, cognitively, and socially enriched stroke rehabilitation environments appear to increase activity by 20%,” they write. “Wards [that] include communal areas to promote more time spent upright, and the need to transport patients further for personal care may create opportunities for activity. The low activity levels in [the] hospital and at home found in our study, and in prior reports…indicate that there is clearly more work to be done in promoting activity after stroke.”

via Study: Home Is a Better Bet Than Hospitals for Achieving More PA Poststroke