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- Olafsdottir, Steinunn A., et al.
(författare)
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Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions
- 2020
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20
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Tidskriftsartikel (refereegranskat)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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| 2. |
- Olafsdottir, Steinunn A., et al.
(författare)
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Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers : A mixed methods study
- 2020
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)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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| 3. |
- Omelekhina, Yuliya, et al.
(författare)
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Effect of energy renovation and occupants' activities on airborne particle concentrations in Swedish rental apartments
- 2021
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697. ; 806
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Tidskriftsartikel (refereegranskat)abstract
- Exposure to airborne particles causes detrimental health effects, hence their assessment in indoor environments, where people spend most of the time, is important. The influence of energy renovation and occupants' activities on airborne particle concentrations was assessed in seven occupied Swedish residences. Ultrafine particle (UFP, <100 nm) number concentrations, PM2.5 (<2.5 μm) and black carbon (BC, <900 nm) mass concentrations were simultaneously measured inside and outside before, after renovation, and during follow-up. The average indoor UFP number concentrations increased from 6200 (±4070) cm-3 before renovation to 12,700 (±6040) cm-3 during the follow up, as the number of indoor activities doubled. Indoor UFP number concentrations depended mainly on frequency and type of occupants' activities in studied residences (e.g., cooking, candle burning). The average indoor PM2.5 concentration decreased from 8.6 (±5.8) μg m-3 before renovation to 2.5 (±1.3) μg m-3 during follow up, as the activities that generated PM2.5 decreased, and infiltration of outdoor particles could have been decreased due to renovation measures. However, the indication of infiltration decrease during the follow up, assessed on the basis of indoor to outdoor ratios during non-activity times (with no influence of occupants' activities), was not observed after the renovation and should be treated with caution. In this study indoor PM2.5 and BC were influenced by activities and outdoor concentrations. Reduction of exposure to indoor UFP, might be obtained by optimization of kitchen exhaust flows. An improved design of supply air inlets in mechanical exhaust ventilation systems may reduce PM2.5 infiltration. Occupants' logbook records, needed for identification of sources contributing to particle exposure, proved useful but not always accurate compared to technical measurements of activities and UFP concentrations. Development of simple and reliable activity detection systems is needed to complement logbooks and allow accurate assessment of source contribution to particle exposure in homes and associated health effects.
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