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

About the Project

This project builds on research initiated by our Australian collaborators, who developed i-REBOUND – Let’s Get Moving, a telehealth intervention designed to support physical activity among individuals post-stroke. We adapted and tested a mHealth version of the program to increase accessibility and uptake of physical activity support across diverse settings in Sweden. The project has been carried out in three phases:

Phase 1

In collaboration with people post stroke/TIA, physiotherapists and the MedTech industry, we developed a Swedish mHealth version of the i-REBOUND program. The development consisted of an iterative process including prototype development, end-users workshops for feedback and prototype adaptation. This work led to the creation of STAAR (Stroke Treatment through Active and Accessible Rehabilitation), a fully digital intervention delivered via a mobile application. 

Phase 2

We evaluated the feasibility and acceptability of the mHealth intervention among 114 individuals post-stroke or TIA across Sweden. The study included both quantitative assessments—focusing on implementation factors such as adherence, engagement, and process delivery—and qualitative interviews with participants and physiotherapists. The results supported the intervention’s feasibility in terms of reach, safety, and acceptance, while also identifying areas for improvement, such as personalized tailoring, engagement among socioeconomically diverse populations, and support for sustained self-management of physical activity.

Phase 3

Guided by insights from Phase 2, we are conducting a series of co-production studies to refine and enhance the mHealth intervention. Key areas of development include:

• Expanding mHealth support for physical exercise to improve accessibility for individuals with more pronounced balance and motor impairments.
• Strengthening self-management components to better support behavior change, motivation, and resilience.
• Re-designing the intervention to enhance individulization to address diverse support needs.

Significance

Staying physically active after a stroke or TIA can reduce the risk of disability and another stroke by nearly half. Despite these benefits, many people do not receive the support for exericse or physcial activity—especially those living in rural areas.

To address this challenge, this project has contributed to the development of an mHealth intervention that provides tailored support through a smartphone app. It is designed to help individuals build and maintain active habits, with digital guidance from a physiotherapist—no matter where they live.

By working closely with stroke survivors, physiotherapists, and MedTech experts, we have created a digital intervention responsive to diverse support needs. The refined intervention will be tested for efficacy and cost-effectiveness in a multicenter study starting in 2026.