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E-bikes have the potential to overcome some of the barriers that stroke survivors face with regards to physical activity. This study aims to explore the factors that affect e-bike usage by stroke survivors. A mixed methods multiple case studies design, using semi-structured interviews and GPS data. Subject to GP approval, participants loaned an e-bike or e-trike for up to three months. Interviews were undertaken pre and post intervention. The COM-B behaviour change model acted as a framework for analysis. GPS data relating to journey duration and distance travelled was collected fortnightly. Six participants were recruited; only three loaned an e-bike/e-trike (with adaptations as required). Storage, being unable to get GP approval, and safety were withdrawal reasons. Level of impairment was a factor influencing the type of e-bike used, level of support required and the motivation of the participants. Stroke survivors can use e-bikes although barriers exist. Electrical assistance was a positive factor in enabling some of the participants to cycle outdoors. Due to the small sample size and the number of participants who were able to loan an e-bike, further research is required to determine whether e-bikes are a feasible and effective intervention to increase physical activity for stroke survivors. The assistance provided by the e-bike/e-trike could provide stroke survivors the opportunity to cycle outdoors. E-bikes/e-trikes could facilitate participation of activities of everyday living such as shopping, hobbies and increase levels of physical activity. Rehabilitation could focus on physical impairment, its effects on self-confidence, and knowledge surrounding the e-bike to overcome barriers to cycling. Social support, the belief that e-bike was an enjoyable mode of physical activity that was good for their health were reported by the participants as important factors for using the e-bike/e-trike. [ABSTRACT FROM AUTHOR]

In dressage, horse-rider combinations must demonstrate harmony whilst performing a test of gaits and movements, scored by judge(s) using predetermined criteria. The para dressage governing body is working towards compliance with the International Paralympic Committee's mandate for evidence-based classification, which requires a comprehensive understanding of key performance determinants. This study aimed to explore stakeholder perceptions surrounding the key determinants of, and impact of impairment on, para dressage performance. Semi-structured interviews with 30 para dressage stakeholders (athletes, classifiers, judges, coach) were analysed using the Framework method. Themes relating to the equine and human athlete were associated with overall dressage performance and discussed within the context of impairment and horse-rider partnership. Key performance determinants were summarised as the athlete's ability to maintain dynamic postural control for absorbing the horse's movement and coordinating leg, hand, and seat aids, which directly influence the horse's quality and accuracy of movements during dressage. Thus, muscular coordination, joint mobility that influences rider posture, and personality traits that influence the horse-rider partnership were considered performance determinants. These themes will inform the development of an evidence-based classification system, through the establishment of standardised, sport-specific performance measures for assessing the relationship between impairment and activity limitation in para dressage. [ABSTRACT FROM AUTHOR]

Background. The evidence base for stroke rehabilitation recommends intensive and repetitive task-specific practice, as well as aerobic exercise. However, translating these evidence-based interventions from research into clinical practice remains a major challenge. Objective. The objective of this study was to investigate factors influencing implementation of higher-intensity activity in stroke rehabilitation settings. Design. This qualitative study used a cross-sectional design. Methods. Semi-structured interviews were conducted with rehabilitation therapists from 4 sites across 2 Canadian provinces who had experience in delivering a higher-intensity intervention as part of a clinical trial (Determining Optimal post-Stroke Exercise [DOSE]). An interview guide was developed, and data were analyzed using implementation frameworks. Results. Fifteen therapists were interviewed before data saturation was reached. Therapists and patients generally had positive experiences regarding high-intensity interventions. However, therapists felt they would adapt the protocol to accommodate their beliefs about ensuring movement quality. The requirement for all patients to have a graded exercise test and the use of sensors (eg, heart rate monitors) gave therapists confidence to push patients harder than they normally would. Paradoxically, a system that enables routine graded exercise testing and the availability of staff and equipment contribute challenges for implementation in everyday practice. Conclusions. Even therapists involved in delivering a high-intensity intervention as part of a trial wanted to adapt it for clinical practice; therefore, it is imperative that researchers are explicit regarding key intervention components and what can be adapted to help ensure implementation fidelity. Changes in therapists' beliefs and system-level changes (staffing and resources) are likely necessary to facilitate higher-intensity rehabilitation in practice. [ABSTRACT FROM AUTHOR]