Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers: A mixed methods study
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Abstract
Background: Technical applications can promote home-based exercise and physical activity of community-dwelling stroke survivors. Caregivers are often able and willing to assist with home-based exercise and physical activity but lack the knowledge and resources to do so. ActivABLES was established to promote home-based exercise and physical activity among community-dwelling stroke survivors, with support from their caregivers. The aim of our study is to investigate the feasibility of ActivABLES in terms of acceptability, demand, implementation and practicality. Methods: A convergent design of mixed methods research in which quantitative results were combined with personal experiences of a four-week use of ActivABLES by community-dwelling stroke survivors with support from their caregivers. Data collection before, during and after the four-week period included the Berg Balance Scale (BBS), Activities-Specific Balance Confidence Scale (ABC), Timed-Up-and-Go (TUG) and Five Times Sit to Stand Test (5xSST) and data from motion detectors. Semi-structured interviews were conducted with stroke survivors and caregivers after the four-week period. Descriptive statistics were used for quantitative data. Qualitative data was analysed with direct content analysis. Themes were identified related to the domains of feasibility: acceptability, demand, implementation and practicality. Data was integrated by examining any (dis)congruence in the quantitative and qualitative findings. Results: Ten stroke survivors aged 55–79 years participated with their informal caregivers. Functional improvements were shown in BBS (+ 2.5), ABC (+ 0.9), TUG (− 4.2) and 5xSST (− 2.7). More physical activity was detected with motion detectors (stand up/sit down + 2, number of steps + 227, standing + 0.3 h, hours sitting/lying − 0.3 h). The qualitative interviews identified themes for each feasibility domain: (i) acceptability: appreciation, functional improvements, self-initiated activities and expressed potential for future stroke survivors ; (2) demand: reported use, interest in further use and need for follow-up; (3) implementation: importance of feedback, variety of exercises and progression of exercises and (4) practicality: need for support and technical problems. The quantitative and qualitative findings converged well with each other and supported the feasibility of ActivABLES. Conclusions: ActivABLES is feasible and can be a good asset for stroke survivors with slight or moderate disability to use in their homes. Further studies are needed with larger samples.
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Olafsdottir, S. A., Jónsdóttir, H., Magnusson, C., Caltenco, H. A., Kytö, M., Maye, L., McGookin, D. K., Árnadóttir, S. Á., Hjaltadóttir, I., & Hafsteinsdøttir, T. B. (2019) · doi:10.2196/preprints.14573 · Cited by 1 · see citing works
Self-citation
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1 of the 101 references couldn’t be matched to a known paper.
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van Dongen, L. J. C., Hafsteinsdøttir, T. B., Parker, E., Bjartmarz, I., Hjaltadóttir, I., & Jónsdóttir, H. (2021) · Nursing Open · doi:10.1002/nop2.788 · Cited by 39 · see citing works
Self-citationGamified devices for stroke rehabilitation: A systematic review
Sánchez-Gil, J. J., Sáez, A., López-Luque, R., Ochoa-Sepúlveda, J. J., & Cañete, E. (2024) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2024.108476 · Cited by 35 · see citing works
Gagnon, M.-A., Batcho, C. S., Bird, M., Labbé, B. M., & Best, K. L. (2022) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2021.2012008 · Cited by 20 · see citing works
Dubbeldam, R., Stemplewski, R., Павлова, Ю., Cyma-Wejchenig, M., Lee, S., Esser, P., Bentlage, E., Alcan, V., Çevik, Ö. S., Epiphaniou, E., et al. (2024) · JMIR Aging · doi:10.2196/65746 · Cited by 24 · see citing works
Vadas, D., Prest, K., Turk, A., & Tierney, S. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2021.1968512 · Cited by 18 · see citing works
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Firmawati, E., Setyopanoto, I., & Pangastuti, H. S. (2022) · Open Access Macedonian Journal of Medical Sciences · doi:10.3889/oamjms.2021.7859 · Cited by 10 · see citing works
Effective evaluations of community nursing on rehabilitation for stroke survivors: A meta-analysis
Mi, Y., Qu, S., Huang, J.-W., Yin, Y., Luo, S., Li, W., & Wang, X. (2024) · Geriatric Nursing · doi:10.1016/j.gerinurse.2024.03.004 · Cited by 5 · see citing works
Noukpo, S. I., Kossi, O., Amanzonwé, E. R., Coninx, K., Spooren, A. I. F., Bonnechère, B., Adoukonou, T., & Feys, P. (2024) · Journal of Sports Sciences · doi:10.1080/02640414.2024.2419221 · Cited by 5 · see citing works
Olafsdottir, S. A., Hjaltadóttir, I., Galvin, R., Hafsteinsdøttir, T. B., Jónsdóttir, H., & Árnadóttir, S. Á. (2022) · PLoS ONE · doi:10.1371/journal.pone.0273644 · Cited by 5 · see citing works
Self-citationJohar, M. N., Nordin, N. A. M., & Azreen, Y. (2022) · Asian Journal of Medicine and Biomedicine · doi:10.37231/ajmb.2021.5.s2.454 · Cited by 3 · see citing works
Jovic, E., Ahuja, K., Lawler, K., Hardcastle, S., & Bird, M. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2256663 · Cited by 3 · see citing works
Purohit, R., Appelgren, J. P. G., Varas‐Díaz, G., Wang, S., Hosiasson, M., Covarrubias‐Escudero, F., & Bhatt, T. S. (2025) · Sensors · doi:10.3390/s25041254 · Cited by 3 · see citing works
Exploring physical activity in people after stroke: a substudy of the Falls After Stroke Trial
Lin, I., Dean, C. M., Glinsky, J. V., Clemson, L. M., Preston, E., Graham, P. L., & Scrivener, K. (2024) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2438255 · Cited by 2 · see citing works
Impact of Stroke Impairment and Phases in Daily Steps of Stroke Survivors Living in Community
Guediri, A., Mandigout, S., Agbohessou, K. G., Daviet, J., & Compagnat, M. (2024) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000002649 · Cited by 1 · see citing works
Online Community Support for Stroke Survivors and Caregivers: Scoping Review
Handayani, P. W., Imanuddin, K. A., Sutanto, J., Erlina, E., Davies, S. G., Mawuntu, A. H. P., Jusuf, M. I., & Warren, N. (2026) · Journal of Medical Internet Research · doi:10.2196/71190 · Cited by 1 · see citing works
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- Authors
- Olafsdottir, S. A., Jonsdottir, H., Bjartmarz, I., Magnusson, C., Caltenco, H., Kytö, M., Maye, L., McGookin, D., Arnadottir, S. A., Hjaltadottir, I., & Hafsteinsdottir, T. B.
- Affiliations
- University of Iceland (IS)
- National University Hospital of Iceland (IS)
- Lund University (SE)
- University of Helsinki (FI)
- Aalto University (FI)
- Corresponding author
- Olafsdottir, Steinunn A.
- ORCID
- Venue
- BMC Health Services Research
- Published
- 2020-06-22
- Volume
- 20
- Issue
- 1
- Pages
- 562-562
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC7310069
- OpenAlex
- W3036797731
- Cited by
- 20
- References
- 101
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 6 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 1
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Aaltodoc (Aalto University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Työväentutkimus Vuosikirja (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Opin vísindi (Opin vísindi) (submittedVersion, cc-by)
- Hirsla (Landspítali University Hospital) (submittedVersion, other-oa)
- Funders
- NordForsk (Activables)
- The Icelandic Centre of Research (190634-051)
- The Icelandic Physiotherapy Association
- The Icelandic Ministry of Welfare
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- stroke survivors, home-based exercise, physical activity, caregiver support, feasibility, acceptability, implementation, practicality, balance, gait, motion sensors, wearable sensors, community-dwelling stroke survivors, informal caregivers, exercise feedback, exercise progression, technology-assisted rehabilitation, Berg Balance Scale, Timed Up and Go test, Five Times Sit-to-Stand Test
- MeSH terms
- Stroke Rehabilitation, Aged, Exercise Therapy, Feasibility Studies, Female, Persons with Disabilities, Disabled Persons, Home Care Services, Humans, Male, Middle Aged, Social Support, Caregivers, Survivors, Qualitative Research, Independent Living
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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