Increasing physical activity in older adults using STARFISH, an interactive smartphone application (app); a pilot study

Background:Increasing physical activity in older adults has preventative and therapeutic health benefits. We have developed STARFISH, a smartphone application, to increase physical activity. This paper describes the features of STARFISH, presents the views of older users on the acceptability and usability of the app and reports the results of a six week pilot study of the STARFISH app in older adults. Methods:The operationalisation of the behaviour change techniques (BCTs) within the STARFISH app was mapped against the BCT Taxonomy of Michie et al. Sixteen healthy older adults (eight women and eight men; age 71.1 ± 5.2 years) used the app, in groups of four, for six weeks. Focus groups explored the user experience and objective measure of steps per day recorded. Results:Participants were very positive about using the STARFISH app, in particular the embedded BCTs of self-monitoring, feedback and social support (in the form of group rewards). Objective step data, available for eight participants, showed that step counts increased by an average of 14% (p = 0.077, d = 0.56). Conclusion:The STARFISH app was acceptable and straightforward to use for older adults. STARFISH has potential to increase physical activity in older adults; however, a fully powered randomised controlled trial is required

Web-based physiotherapy for people undergoing stroke rehabilitation.

I conducted two trails throughout my PhD, qualitative study and mixed method study. The dataset I am intended to deposit include SPSS spreadsheets for the mixed method study, transcripts for focus groups for the qualitative study and copies of consent forms and information documents for all the participants in the two trial

Physical activity profiles and sedentary behaviour in people following stroke: a cross-sectional study

Purpose: To measure and compare physical activity profiles and sedentary time between community dwelling stroke survivors and healthy volunteers. Methods: Twenty-two stroke survivors (10 men, age 55.3 ± 9.9 years; 4.2 ± 4.0 years since their stroke) were recruited from local stroke support groups, and 22 controls were matched for sex, age and body mass index (BMI). All participants wore an ActivPAL™ physical activity monitor for seven days and from these data activity profiles, including the number of steps per day, time spent sedentary and time in different cadence bands, were recorded. Results: Stroke survivors took significantly fewer steps per day than the controls (4035 ± 2830 steps/day versus 8394 ± 2941 steps/day, p < 0.001) and sedentary time (including sleep time) was significantly higher for stroke participants compared to the controls (20.4 ± 2.7 h versus 17.5 ± 3.8 h, p < 0.001). People with stroke spent a significantly higher proportion of their walking time in lower self-selected cadences compared to the controls. Conclusions: Community dwelling stroke survivors spent more time sedentary, took fewer steps and walked at a slower self-selected cadence. Interventions to increase walking and reduce sedentary time following stroke are required which may have the added benefit of reducing cardiovascular risk in this group

Increasing physical activity in stroke survivors using STARFISH, an interactive mobile phone application: a pilot study

Background: Following stroke, people are generally less active and more sedentary which can worsen outcomes. Mobile phone applications (apps) can support change in health behaviours. We developed STARFISH, a mobile phone app-based intervention, which incorporates evidence-based behaviour change techniques (feedback, self-monitoring and social support), in which users’ physical activity is visualised by fish swimming. Objective: To evaluate the potential effectiveness of STARFISH in stroke survivors. Method: Twenty three people with stroke (12 women; age: 56.0 ± 10.0 years, time since stroke: 4.2 ± 4.0 years) from support groups in Glasgow completed the study. Participants were sequentially allocated in a 2:1 ratio to intervention (n=15) or control (n=8) groups. The intervention group followed the STARFISH programme for six weeks; the control group received usual care. Outcome measures included physical activity, sedentary time, heart rate, blood pressure, body mass index, Fatigue Severity Scale, Instrumental Activity of Daily Living Scale, Ten Metre Walk Test, Stroke Specific Quality of Life Scale, Psychological General Well-Being Index. Results: The average daily step count increased by 39.3% (4158 to 5791 steps/day) in the intervention group and reduced by 20.2% (3694 to 2947 steps/day) in the control group (p=0.005 for group-time interaction). Similar patterns of data and group-time interaction were seen for walking time (p=0.002) and fatigue (p= 0.003). There were no significant group-time interactions for other outcome measures. Conclusion: Use of STARFISH has the potential to improve physical activity and health outcomes in people after stroke and longer term intervention trials are warranted

Increasing physical activity in stroke survivors using STARFISH, an interactive smartphone application: protocol for a randomised controlled trial

BACKGROUND: Physical activity (PA) in stroke survivors is low however the ubiquitous nature of smartphone technology means smartphone-based interventions could be a feasible and cost-effective approach to increase PA. We developed STARFISH, a group behavioural change intervention delivered via a smartphone app to help increase PA. OBJECTIVE: Following the positive results of our pilot study the aim of this single-blind, Randomised Controlled Trial (RCT) is to examine the effect of the STARFISH intervention, on PA in stroke survivors, compared to usual care. METHODS: One hundred and twenty-eight community dwelling stroke survivors will be recruited, from four NHS boards in Scotland, and randomised to intervention or control groups. The interventional groups will use the STARFISH app. The control group will receive literature on PA post-stroke. Outcome measures will be taken at: baseline, four months (end of the intervention), two months post-intervention. The primary outcome will be objectively measured PA. Secondary outcome measures will be sedentary time, activity profiles, walking speed and endurance, fatigue, anxiety and depression, activities of daily living, quality of life and metabolic health-risk biomarkers. CONCLUSION: If improvements are found in the PA and health of stroke survivors then STARFISH could be deployed through app stores to allow implementation at scale