"One size” fits no one: precision-based digital promotion of physical activity after stroke or transient ischemic attack – a multicenter adaptive intervention
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.
About the Project
This project is a Sequential Multiple Assignment Randomized Trial (SMART) starting in 2026. Around 400 individuals who have had a stroke or TIA will be randomized to receive either a personalized mHealth intervention or standard care.
The personalized mHealth intervention is a 12-month, co-designed digital program that combines tailored support for physical exercise with self-management strategies for increasing physical activity.
The project aims to answer the following questions:
- What are the effects of a personalized mHealth intervention on physical activity, leg strength, walking ability, fatigue, self-efficacy, impact of stroke, wellbeing, and quality of life, compared with standard care?
- What are the effects of the personalized mHealth intervention on complications after stroke and healthcare use, compared to a registry-based matched reference group up to five years after starting the program?
- What is the cost-effectiveness of the personalized mHealth intervention compared to standard care?
- How is the personalized mHealth intervention implemented, and what are the potential mechanisms of change and contextual factors that influence outcomes?
This clinical trial will take place through a clinical network across Stockholm, Västerbotten, Dalarna, Gävleborg, and Skåne.
Significance
The project targets major societal challenges related to promoting physical activity after stroke/TIA, with a focus on equity, accessibility, and cost-effectiveness.
Currently, no intervention effectively meets the long-term needs of people after stroke or TIA while also being sustainable for clinics and scalable for society. Many individuals post stroke or TIA do not have access to the necessary long-term support for physical activity. Available services are often short-term and lack the personalized approach needed for lasting behavior change.
This study aims to address this gap by providing personalized support for physical activity, delivered digitally by physiotherapists experienced in stroke rehabilitation. Combining a scalable digital model with a cost-effectiveness analysis creates an opportunity for national implementation.
This study aims to bridge this gap by offering personalized support for physical activity, delivered digitally by physiotherapists with expertise in stroke rehabilitation. By combining a scalable digital model with a cost-effectiveness analysis, the study creates potential for national implementation.