DataVXAdvanced SciencePaper
journal article·2026-01Open access

The Adaptive Physical Activity Study in Stroke (TAPAS): A Feasibility Sequential Multiple Assignment Randomized Trial

Aoife Whiston, Emma Carr, Nathan Cardy, Padraic Rocliffe, Siobhan M. O'Reilly, Daniel Carter, Mairead O'Donoghue, Aine Cronin, James G. Bradley, Mike Butler, Liam Glynn, Jane C. Walsh, Cathal Walsh, Kelley Kidwell, Margaret O'Connor, Chris Macey, Lorna Paul, Claire Fitzsimons, Julie Bernhardt, Jon Salsberg, Sara Hayes

Advanced Science· Volume 13· Issue 1
Publisher pageOpen full text
Source abstract

Abstract

Abstract Physical inactivity post‐stroke increases risk of recurrent stroke. Adaptive physical activity (PA) interventions are recommended, and alternative designs, such as sequential multiple assignment randomized trials (SMARTs) can be used. This SMART investigates the feasibility of a mobile health (mHealth) PA intervention post‐stroke. People post‐stroke are randomized to 12‐week online exercise (EX) or lifestyle PA (LPA). Six‐week daily step count data are used to classify participants as responders or nonresponses. Nonresponders are re‐randomized to switch or augment their mHealth intervention, responders continue unchanged. Primary outcomes include recruitment, retention and adherence rates. Secondary outcomes include PA, sedentary behavior, fatigue, quality of life, psychological distress, and activities of daily living. General linear models estimate trends regarding first‐stage interventions, nonresponse strategies, and adaptive interventions are examined using weighted and replicated regressions. Fifty participants are included. Recruitment, retention, and adherence rates are 85%, 84%, and 82%. Positive trends are seen for nonresponse strategies, switching interventions, on step count, fatigue, and quality of life. Starting with EX and switching to LPA show potential benefits for fatigue, quality of life and return to normal living. Potential benefits of these interventions are preliminary and require validation in a full‐scale trial. This SMART offers novel evidence supporting the design of adaptive mHealth PA interventions post‐stroke, confirming the feasibility of a definitive SMART.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Stroke Rehabilitation and Recovery · Physical Activity and Health · Cardiac Health and Mental Health

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Health Research Institute University of Limerick County Limerick Limerick V94 T9PX Ireland

Department of Psychology University of Limerick County Limerick Limerick V94 T9PX Ireland

University of Limerick County Limerick Limerick V94 T9PX Ireland

Donnybrook Sports Medicine County Dublin Dublin D04 EY28 Ireland

Irish Physical Activity Research Collaboration Dublin D15 PNON Ireland

School of Allied Health University of Limerick County Limerick Limerick V94 T9PX Ireland

Palliative and Advanced Illness Research Center University of Pennsylvania Philadelphia PA 19104‐6021 USA

School of Public Health, Physiotherapy and Population Science University College Dublin Dublin 4 Belfield D04 C1P1 Ireland

School of Medicine University of Limerick County Limerick Limerick V94 T9PX Ireland

School of Psychology University of Galway Galway H91 TK33 Ireland

School of Medicine Trinity College Dublin Dublin D02 R590 Ireland

Department of Biostatistics School of Public Health University of Michigan Ann Arbor MI 48109 USA

Ageing Research Centre University of Limerick County Limerick Limerick V94 T9PX Ireland

Department of Ageing and Therapeutics University of Limerick Hospital Group County Limerick Limerick V94 F858 Ireland

Irish Heart Foundation Dublin D06 C780 Ireland

School of Health and Life Science Glasgow Caledonian University Glasgow G40BA Scotland

Physical Activity for Health Research Centre Institute for Sport Physical Education and Health Sciences Moray House School of Education and Sport The University of Edinburgh St. Leonard's Land, Holyrood Road Edinburgh EH8 8AQ Scotland

Florey Institute of Neuroscience and Mental Health University of Melbourne Melbourne VIC 3052 Australia

References (66)

Show source-provided references
1. 10.1159/00050639610.1159/000506396 ↗
2. 10.1161/STROKEAHA.110.60261510.1161/STROKEAHA.110.602615 ↗
3. 10.1161/CIR.000000000000105210.1161/CIR.0000000000001052 ↗
4. 10.1053/apmr.2002.3398410.1053/apmr.2002.33984 ↗
5. 10.2522/ptj.2013017510.2522/ptj.20130175 ↗
6. 10.1161/01.CIR.100.13.148110.1161/01.CIR.100.13.1481 ↗
7. Caspersen C. J. · Public Health Rep. · 1985 · 100 · 126
8. 10.1161/STR.000000000000002210.1161/STR.0000000000000022 ↗
9. 10.1002/14651858.CD003316.pub10.1002/14651858.CD003316.pub ↗
10. 10.1080/21642850.2022.206653410.1080/21642850.2022.2066534 ↗
11. 10.1161/STROKEAHA.123.04459610.1161/STROKEAHA.123.044596 ↗
12. 10.1016/j.apmr.2013.12.01610.1016/j.apmr.2013.12.016 ↗
13. World Health Organization · 2011
14. 10.1080/10749357.2019.169181610.1080/10749357.2019.1691816 ↗
15. 10.1161/STROKEAHA.123.04379410.1161/STROKEAHA.123.043794 ↗
16. 10.1002/14651858.CD012543.pub210.1002/14651858.CD012543.pub2 ↗
17. 10.1186/s12874-024-02439-410.1186/s12874-024-02439-4 ↗
18. 10.2147/JMDH.S42053010.2147/JMDH.S420530 ↗
19. 10.1001/jama.2022.2432410.1001/jama.2022.24324 ↗
20. 10.1161/STROKEAHA.124.04652710.1161/STROKEAHA.124.046527 ↗
21. 10.1002/sim.451210.1002/sim.4512 ↗
22. 10.1002/sim.202210.1002/sim.2022 ↗
23. 10.1007/s13142-014-0265-010.1007/s13142-014-0265-0 ↗
24. 10.1136/bmjopen-2023-07281110.1136/bmjopen-2023-072811 ↗
25. 10.7326/0003-4819-152-11-201006010-0023210.7326/0003-4819-152-11-201006010-00232 ↗
26. 10.1186/s40814-019-0423-810.1186/s40814-019-0423-8 ↗
27. 10.1111/j.2002.384.doc.x10.1111/j.2002.384.doc.x ↗
28. S.Michie L.Atkins R.West The Behaviour Change Wheel: A Guide to Designing Interventions Vol.1 Silverback Publishing Sutton UK2014 pp.1003–1010 https://doi.org/10.17990/Axi/2016_9789726972679_041.10.17990/Axi/2016_9789726972679_041 ↗
29. 10.1016/j.ypmed.2004.06.00310.1016/j.ypmed.2004.06.003 ↗
30. 10.1016/j.jsams.2024.01.00710.1016/j.jsams.2024.01.007 ↗
31. 10.1123/jpah.7.6.69710.1123/jpah.7.6.697 ↗
32. 10.1001/archneur.1989.0052046011502210.1001/archneur.1989.00520460115022 ↗
33. 10.1161/01.STR.30.7.136210.1161/01.STR.30.7.1362 ↗
34. 10.1007/s11136-011-9903-x10.1007/s11136-011-9903-x ↗
35. 10.1111/j.1600-0447.1983.tb09716.x10.1111/j.1600-0447.1983.tb09716.x ↗
36. SL W.‐D. · Arch. Phys. Med. Rehabil. · 1988 · 69 · 583
37. 10.1016/j.rehab.2021.10159410.1016/j.rehab.2021.101594 ↗
38. 10.1037/a002937210.1037/a0029372 ↗
39. 10.12688/hrbopenres.13838.210.12688/hrbopenres.13838.2 ↗
40. 10.1177/1747493023120136010.1177/17474930231201360 ↗
41. 10.1177/1747493025131562810.1177/17474930251315628 ↗
42. 10.1093/ptj/pzx03810.1093/ptj/pzx038 ↗
43. 10.1016/j.apmr.2017.09.11710.1016/j.apmr.2017.09.117 ↗
44. 10.1123/jpah.2023‐026710.1123/jpah.2023‐0267 ↗
45. 10.3390/ijerph1604064510.3390/ijerph16040645 ↗
46. 10.1186/s40814-022-01139-410.1186/s40814-022-01139-4 ↗
47. 10.1038/s41366-021-00767-910.1038/s41366-021-00767-9 ↗
48. D.Wetter 2022: Cochrane Central Register of Controlled Trials (CENTRAL)ID number: CN‐02509910.https://www.cochranelibrary.com/central/doi/10.1002/central/CN‐02509910/full(accessed: June 2025).
49. 10.1016/j.cct.2018.08.00810.1016/j.cct.2018.08.008 ↗
50. 10.1093/pm/pnaa33810.1093/pm/pnaa338 ↗
51. J.Wilroy 2021: Cochrane Central Register of Controlled Trials (CENTRAL)https://www.cochranelibrary.com/central/doi/10.1002/central/CN‐02218088/full(accessed: June 2025).
52. 10.1093/eurjpc/zwad22910.1093/eurjpc/zwad229 ↗
53. 10.1161/STROKEAHA.124.04612910.1161/STROKEAHA.124.046129 ↗
54. 10.1093/abm/kaab06110.1093/abm/kaab061 ↗
55. 10.2196/1970110.2196/19701 ↗
56. 10.1089/cap.2018.013610.1089/cap.2018.0136 ↗
57. 10.1016/j.jsat.2020.10826410.1016/j.jsat.2020.108264 ↗
58. 10.1158/1078‐0432.CCR‐17‐135510.1158/1078‐0432.CCR‐17‐1355 ↗
59. 10.1007/s13142‐014‐0265‐010.1007/s13142‐014‐0265‐0 ↗
60. 10.1177/109821401561701310.1177/1098214015617013 ↗
61. 10.1016/j.jclinepi.2021.11.00710.1016/j.jclinepi.2021.11.007 ↗
62. 10.1146/annurev‐statistics‐022513‐11555310.1146/annurev‐statistics‐022513‐115553 ↗
63. 10.2196/1432210.2196/14322 ↗
64. 10.1111/ijs.1243910.1111/ijs.12439 ↗
65. W. N.Kernan B.Ovbiagele H. R.Black D. M.Bravata M. I.Chimowitz M. D.Ezekowitz M. C.Fang M.Fisher K. L.Furie D. V.Heck S. C.Johnston S. E.Kasner S. J.Kittner P. H.Mitchell M. W.Rich D.Richardson L. H.Schwamm J. A.Wilson on behalf of the American Heart Association et al. Stroke2014 45 2160 https://doi.org/10.1161/STR.0000000000000024.10.1161/STR.0000000000000024 ↗
66. 10.1161/STR.000000000000037510.1161/STR.0000000000000375 ↗