How can promotion of physical activity after stroke or transient ischemic attack work remotely? Evaluation of a digital tool to improve cardiovascular health and wellbeing

Support for physical activity is necessary to sustain health after stroke and transient ischemic attack (TIA).

Still, rehabilitation services are not available to many of those who potentially would benefit due to barriers related to accessibility.

While telerehabilitation is a promising strategy to support physical activity, there is a gap of knowledge regarding the implementation of technology that meet the needs of people post stroke or TIA in order to foster adherence and engagement in physical activity.Purpose is to improve health and wellbeing after stroke or TIA by increasing the access to physical activity through telerehabilitation.

This will be accomplished by building on a national collaboration within secondary stroke prevention and through testing of an existing telerehabilitation program (ENAbLE) developed in Australia.The ENAbLE program seeks to strengthen physical functioning and self-efficacy for exercise through home-based physical exercise and to equip the person with knowledge and confidence to sustain physical activity through behavior change techniques.

The program will be accessible via a recent developed mobile application which will be used to reinforce autonomy and patient-therapist partnership.We will first evaluate if the ENAbLE program can be delivered as intended through a pilot RCT to determine the feasibility, processes, end-users experiences and preliminary effects of the program in urban and rural regions of Sweden.

We will thereafter initiate a full-scale RCT to investigate the effects of the ENAbLE program on risk factors for recurrent stroke, well-being and its cost-effectiveness across Sweden.The project will draw on socio-technical theory, depicting technologies as part of a dynamic system in order to explore its potential use in rehabilitation.

The ENAbLE program offers a sustainable strategy to support exercise and physical activity which could benefit a large group of people with stroke and TIA regardless of where they live.