REACH – digital treatment and prevention – David Moulaee Conradsson's research group

Our research focuses on creating the conditions for more equitable health through digital interventions and applications, from development to evaluation.

Part of the:

Research focus

REACH - Researching and Evaulating Accessible digital Care for Health

Our research aims to improve access to healthcare and promote health equity through the development and evaluation of digital services for treatment and prevention. We focus particularly on lifestyle interventions, such as the promotion of physical activity, with a special emphasis on individuals living with neurological conditions or injuries.

We explore the needs for digital interventions among people with diseases or injuries and their families, as well as the use, accessibility, and satisfaction with such services. These issues are examined from individual, group, and societal perspectives, while also considering the broader implications for healthcare efficiency and the cost-effectiveness of new interventions.

We are strongly committed to cross-sectoral collaboration—across academia, healthcare, and industry—and our work is grounded in close partnerships with stakeholders and representatives from patient communities to ensure that digital interventions are relevant, accessible, and fit for purpose.

News and activities

Valuable contributions from people with lived experience of stroke/TIA
Photo: REACH forskargrupp.

Valuable contributions from people with lived experience of stroke/TIA

Creativity and innovative thinking guided our way when we developed the self-management components of our digital intervention. For more information, see the section titled "Development of self-management components to support physical activity" on the project page.

Seminar on digital physiotherapy after stroke, part 1 (in Swedish)

Seminar on digital physiotherapy after stroke, part 2 (in Swedish)

Publications

Selected publications

Funding

Grants

  • An AI chatbot to support self-management of physical activity after stroke: co-production and evaluation
    Strategiska forskningsområdet vårdvetenskap (SFO-V)
    1 April 2026 - 31 March 2027
  • Swedish Heart-Lung Foundation
    1 January 2026 - 31 December 2028
    Background: The prevalence of stroke-related disability is expected to rise globally, significantly impacting families, healthcare systems, and economies. Although strong evidence supports the role of physical activity (PA) in improving health and preventing complications after stroke or transient ischemic attack (TIA), access to support for PA remains limited. When available, such support is often short-term and lacks the long-term personalization needed to sustain behavior change. Objective: This project investigates whether a personalized digital intervention (REACH) can enhance PA and health while reducing secondary complications in individuals post stroke or TIA. The specific objectives are to determine whether the REACH intervention: - Improves PA, physical functioning, well-being, and quality of life immediately after the intervention. - Reduces post-stroke complications and healthcare utilization for up to 5 years post-baseline. - Is cost-effective compared to standard care. We hypothesize that the REACH intervention will improve PA, functioning, well-being, and quality of life
    reduce the incidence of recurrent stroke, comorbidities, mortality, and healthcare utilization
    and be cost-effective, supporting large-scale implementation. Work Plan: In a multicenter Sequential Multiple Assignment Randomized Trial, 371 individuals post-stroke/TIA no longer receiving rehabilitation and with low PA will be randomized to one of two groups: - REACH, a 12-month mHealth intervention incorporating adaptive, personalized treatment trajectories, with physiotherapist-led support for exercise and self-management of PA. - Standard care, without active intervention. Recruitment and trial implementation will be conducted through an established clinical network across 5 Swedish regions. The primary outcome is steps per day, assessed via accelerometry immediately post-intervention. Stroke recurrence, comorbidity, mortality, and healthcare utilization will be tracked for up to 5 years using registry data. Cost-effectiveness will be evaluated through both within-trial and model-based economic analyses. Significance: If REACH improves PA and reduces the risk of secondary complications, it would represent a breakthrough in secondary stroke prevention, offering profound benefits for individuals, healthcare systems, and society. The cost-effectiveness analysis, combined with a scalable digital intervention model, will support national implementation.
  • “One size” fits no one – towards the development of a person-centered adaptive mobile health solution for physical activity after stroke or transient ischemic attack
    Swedish Research Council
    1 January 2024 - 31 December 2024
  • Swedish Research Council
    1 January 2024 - 31 December 2024
  • Swedish Research Council
    1 January 2023 - 31 December 2026
    The overarching purpose is to improve secondary stroke prevention post stroke or transient ischemic attack (TIA) by increasing access to physical activity through telerehabilitation. This will be accomplished by building on a national collaboration within secondary stroke prevention and by testing a new 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 a digital version of the ENAbLE program could be delivered as intended through a pilot randomized controlled trial to determine the feasibility, end-users experiences and preliminary effects in people post stroke/TIA living in urban and rural regions of Sweden. We will thereafter perform a full-scale randomized controlled trial to assess the effectiveness of the ENAbLE program on cardiovascular health, physical activity, function, well-being and its cost-effectiveness across Sweden.This project will address the unmet need of providing accessible and sustainable support for physical activity to people post stroke or TIA to decrease the risk of stroke recurrence through adherence to physical activity.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2022 - 31 December 2026
    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.
  • VINNOVA
    14 June 2021 - 30 April 2023

Staff and contact

Group leader

All members of the group

Visiting address

Karolinska Institutet, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Zanderska Huset (Alfred Nobels Alle 23, Plan B3), Stockholm, Sweden

Postal address

Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy 23100, Huddinge, SE-141 83, Sweden

Projects

mHealth delivered physical activity after stroke or transient ischemic attack – development and feasibility

The overall aim is to develop and test the feasibility, acceptability, and preliminary effects of mHealth delivered physical activity among individuals post-stroke or transient ischemic attack (TIA). The development is carried out in collaboration with individuals who have experienced stroke or TIA, physiotherapists, patient organizations, and the MedTech industry.

mHealth delivered physical activity after stroke or transient ischemic attack – development and feasibility

"One size” fits no one: precision-based digital promotion of physical activity after stroke or transient ischemic attack – a multicenter randomised controlled trial

This multicenter study evaluates a personalized mHealth intervention designed to support people after stroke or transient ischemic attack (TIA) in becoming more physically active and improving their health. The project also assesses the intervention’s impact on secondary stroke complications and includes a cost-effectiveness evaluation to guide future implementation.

"One size” fits no one: precision-based digital promotion of physical activity after stroke or transient ischemic attack – a multicenter randomised controlled trial

An AI-based solution for physical activity after stroke: co-production and evaluation

This project aims to co-design, develop and test the feasibility of an AI-based chatbot providing tailored support for self-management of physical activity among people who have experienced stroke or transient ischaemic attack (TIA). The project will explore how AI chatbot technology can be integrated into physical activity self-management support, including how it can respond to individual needs, barriers and changing circumstances over time.

An AI-based solution for physical activity after stroke: co-production and evaluation