Stroke has debilitative effects on the body and can hinder physical and cognitive function. Recovery after stroke depends on participating in a structured exercise program of meaningful activities. However, older adults with stroke find it challenging to maintain an optimal level of physical activity for brain recovery due to physical and cognitive impairments, lack of motivation and age-related factors such as frailty, losing muscle mass and depression. The current exercise setting for older adults with stroke is not feasible to encourage participation in physical activity. The main challenges are muscle spasticity and weakness, difficulty in grip, limb deformity and inappropriate exercise modes to strengthen the upper-body limbs. The main motivation for this project was to design an exercise system that could facilitate upper-body exercises and address personal constraints with minimum supervision. Thus, the aim of this study was to co-design an interactive and digital resistance exercise solution for community-dwelling older stroke survivors with moderate to severe impairments in the upper limbs. We used co-design and co-production procedures to address our aim. The method of data collection was qualitative and through semi-structured interviews in 2 phases: co-designing for idea generation and co-production for prototype evaluation. We non-randomly recruited 33 older adults with chronic stroke (6 months after stroke) from community rehabilitation centres to take part in this study. The interviews were in person or online via Zoom. The topics of the interview were the perceived barriers, the shape/size of user-friendly exercise equipment and how is it feasible to use the system at home. The design team made a system and the research team demonstrated to the participants for evaluation and recommendations for further changes. We used the thematic analysis method to analyse the qualitative data and grouped the raw data into main themes. The collection consists of excerpts of qualitative data from interviews.Stroke has debilitative effects on the body and can hinder physical and cognitive function. Recovery after stroke depends on participating in a structured exercise program of meaningful activities. However, older adults with stroke find it challenging to maintain an optimal level of physical activity for brain recovery due to physical and cognitive impairments, lack of motivation and age-related factors such as frailty, losing muscle mass and depression. To encourage participation in physical activity, the exercise programme should be structured, home/community-based, simple, efficient, patient-led and with minimum supervision to increase exercise adherence, especially for the patients with severe limb impairments. In this study, we aim to co-design an interactive and digital resistance exercise solution for community-dwelling older stroke survivors with moderate to severe impairments in upper limbs. We will co-design it by testing accessible and affordable fitness equipment such as rubber bands and barbells and will involve older adults (>65 years) with chronic stroke (6 months after stroke) to take part in this process throughout the study period to share their viewpoints. First, we will co-develop a multimedia exercise package to use with fitness equipment for upper limbs, lower limbs and trunk that would be feasible even for people with upper limb paralysis to perform at home with maximum safety and minimum mental efforts and supervision, then we will co-design the solutions (app and hardware design) that make the fitness equipment interactive, digital and patient-centred to increase physical activity and limbs mobility.
The method of data collection was qualitative and through semi-structured interviews in 2 phases: co-designing for idea generation and co-production for prototype evaluation. We non-randomly recruited 33 older adults with chronic stroke (6 months after stroke) from community rehabilitation centres to take part in this study. The interviews were in person or online via Zoom. The topics of the interview were the perceived barriers, the shape/size of user-friendly exercise equipment and how is it feasible to use the system at home. The design team made a system and the research team demonstrated to the participants for evaluation and recommendations for further changes.
