Dr Peter Hartley

How physically active someone is during their time in hospital after a stroke can have significant long-term consequences on their degree of disability and quality of life. There is, therefore, a key window of opportunity during a patient’s time in hospital that we must make best use of. Despite this, much research has highlighted very low levels of physical activity during this time, and changing levels of physical activity has been shown to be very challenging.

Physical activity levels are influenced by many different factors such as the level of disability, the importance of physical activity as perceived by patients, staff and family, the hospital environment, and processes of care. To change physical activity behaviour, we believe we need to appreciate fully all influences, using a systems approach, in order to design an effective multi-component intervention.

To achieve the long term aims of changing levels of physical activity, we plan first to develop an acceptable and practical method of measuring physical activity. To do this I am working with PhysiGo, a company specialising in artificial intelligence-driven wearables, to develop an algorithm to estimate positions and movements of patients from data collected by a small sensor clipped to clothing. Patients we have spoken to find this more acceptable than current alternatives.

To understand the system-wide influences on physical activity in hospital, we plan first to conduct a systematic review to synthesise the existing understanding, followed by a mixed-methods observational study to understand local context of physical activity and develop a behavioural system map.

To develop a multicomponent intervention to support the achievement of physical activity recommendations, we plan to work with patients, clinicians and academics to use our understanding of behavioural influences and the behavioural systems map to develop and refine a multicomponent intervention. The process will take into account all elements of the system influencing patient physical activity, and select interventions based on expected acceptability, practicality, effectiveness, affordability, side effects and equity.