P10-10 Technology-supported exercise may increase self-reported health status in people with residual movement impairments after neurological event

Abstract Background After a neurological event (e.g. stroke) people are often restricted to a sedentary lifestyle due to chronic impairment. Their need for assistance to perform any form of physical activity (PA) is one factor that limits their PA and results in a negative impact on health. Rehabilitation technology, designed for gait rehabilitation during sub-acute rehabilitation, may be used to achieve the recommended levels of PA in people with gait impairments. However, it is unknown if there are effects on the quality of life resulting from such exercise regimen. Therefore, the aim of this study was to determine the effect of technology-supported exercise (TSE) on self-reported health status. Methods Twelve people with severe residual gait impairment after a neurological event participated in the study. They performed TSE (with Lokomat, Andago or C-Mill) for three months (M3) with a minimum of 10 trainings per month. At baseline and M3, the following questionnaires were answered: EQ-5D-3L, WHODAS 2.0, patient global impression of scale (PGIC, only at M3). Wilcoxon-signed-rank-test was used to test for statistically significant differences between start and M3 (p > 0.05). Results The median EQ-5D Visual Analog Scale (VAS) score at baseline was 60, which is lower than the population mean. The VAS of the EQ-5D showed significant improvements (median: 7.5 points). The median of the PGIC was ‘minimally improved’ while all other outcomes (EQ-5D domains and WHODAS) remained constant. Conclusion Prior to TSE, the self-rated health status was low. There is evidence, that people with residual gait impairment may benefit from continuous TSE by improving health status, as has been represented by the improvement of the EQ-5D VAS score. Most chosen questionnaires may not be sensitive enough to detect subtle changes, indicating that for this population more sensitive instruments may be needed. However, future research investigating the sensitivity of the questionnaires is advisable. In addition, the training period of three months might be too short to be effective. This study is still ongoing with the training period extended to six months and additional participants included which will provide more data about the effect of TSE on self-reported health status.


Background
The effectiveness of technology-based physical activity interventions (TbPAI) has recently been shown for obese women (Cotie et al., 2018). However, the acceptability of TbPAI has often been considered through the measure of satisfaction, and not through the theoretical concepts of acceptability. To our knowledge, TbPAI acceptability has never been explored in bariatric surgery. The purpose of this study was to explore indepth the facilitators of and barriers to TbPAI acceptability according to the theoretical concepts of the UTAUT2 model (Venkatesh et al., 2012). Methods Twenty-six women with a mean age of 32.9 (SD=5.5) and a BMI of 30.1 (SD=6.5) were interviewed at least 6 months after bariatric surgery. Participants were selected in a panel of obese women who completed measures of acceptability (Hayotte et al., 2020) for each TbPAI, and expressed preference in using at least one of the technologies (10 active video games, 10 mobile application, 6 videoconferencing). Interviews were audiorecorded, transcribed verbatim, and analysed using thematic content analysis. Ethical approval was gained by local committee, and informed consent were obtained from the participants before data collection.

Results
Autonomy, monitoring and feedback were identified as facilitators of mobile application acceptability. Lack of external regulation was perceived as a barrier. Regarding the acceptability of active video games, the playful dimension was perceived as a facilitator, despite several participants showing resistance to any game experience. For videoconferencing, individualization of practice was perceived as a facilitator, whereas appointment constraints were seen as a barrier.

Conclusions
These preliminary results highlighted areas to be considered for the dissemination of these TbPAI in a healthcare setting.
Abstract citation ID: ckac095.149 P10-10 Technology-supported exercise may increase self-reported health status in people with residual movement impairments after neurological event

Background
After a neurological event (e.g. stroke) people are often restricted to a sedentary lifestyle due to chronic impairment. Their need for assistance to perform any form of physical activity (PA) is one factor that limits their PA and results in a negative impact on health. Rehabilitation technology, designed for gait rehabilitation during sub-acute rehabilitation, may be used to achieve the recommended levels of PA in people with gait impairments. However, it is unknown if there are effects on the quality of life resulting from such exercise regimen. Therefore, the aim of this study was to determine the effect of technology-supported exercise (TSE) on self-reported health status.

Methods
Twelve people with severe residual gait impairment after a neurological event participated in the study. They performed TSE (with Lokomat, Andago or C-Mill) for three months (M3) with a minimum of 10 trainings per month. At baseline and M3, the following questionnaires were answered: EQ-5D-3L, WHODAS 2.0, patient global impression of scale (PGIC, only at M3). Wilcoxon-signed-rank-test was used to test for statistically significant differences between start and M3 (p > 0.05).

Results
The median EQ-5D Visual Analog Scale (VAS) score at baseline was 60, which is lower than the population mean. The VAS of the EQ-5D showed significant improvements (median: 7.5 points). The median of the PGIC was 'minimally improved' while all other outcomes (EQ-5D domains and WHODAS) remained constant. Conclusion Prior to TSE, the self-rated health status was low. There is evidence, that people with residual gait impairment may benefit from continuous TSE by improving health status, as has been represented by the improvement of the EQ-5D VAS score. Most chosen questionnaires may not be sensitive enough to detect subtle changes, indicating that for this population more sensitive instruments may be needed. However, future research investigating the sensitivity of the questionnaires is advisable. In addition, the training period of three months might be too short to be effective. This study is still ongoing with the training period extended to six months and additional participants included which will provide more data about the effect of TSE on self-reported health status. Keywords: technology-supported exercise, gait impairment, neurological, training 2022 HEPA Europe Conference ii119