Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Engagement strategies for subacute post-stroke upper limb rehabilitation: a co-design study. (139706)

Matthew Wingfield 1 2 , Gavin Williams 1 2 , Amy Brodtmann 3 , Kevin English 2 , Sarah Newton 2 4 , Ruth Barker 5 , Kathryn S Hayward* 2 6 7 , Natalie A Fini* 2 , . . 8
  1. Physiotherapy, Epworth Healthcare, Melbourne, VIC, Australia
  2. Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
  3. Medicine, Monash University, Melbourne, VIC, Australia
  4. Occupational Therapy, Austin Health, Melbourne, VIC, Australia
  5. The Cairns Institute, James Cook University, Cairns, QLD, Australia
  6. Medicine (RMH), University of Melbourne, Melbourne, VIC, Australia
  7. The Florey, University of Melbourne, Melbourne, VIC, Australia
  8. *denotes co-senior author, .

Aim: To co-design strategies that support stroke survivor engagement during face-to-face upper limb interventions in the subacute phase of recovery.

Methods: A four-stage integrated knowledge translation co-design study was conducted. The research team defined research scope (stage 1). Stroke survivor, clinician, and scientist knowledge-users were purposively recruited to participate in online workshops or semi-structured interviews to identify engagement concepts (stage 2). Workshops and interviews were analysed using iterative content analysis. Researchers used prespecified criteria and anonymous voting to develop a draft of engagement strategies (stage 3). These strategies were presented to knowledge-users via online workshops and semi-structured interviews for feedback and refinement (stage 4).

Results: Scope was confirmed (stage 1). Thirty knowledge-users participated (10 scientists from 5 countries; 11 clinicians from 5 Australian states; 9 stroke survivors from 3 Australian states) and identified 13 engagement concepts (stage 2). These concepts were synthesised into 10 engagement strategies (e.g., keep tasks challenging but achievable, reflect goals in therapy tasks), framed as clinician actions targeting moment-to-moment states of cognitive, emotional, or behavioural engagement (stage 3). Eighteen knowledge-users participated (5 scientists from 3 countries; 8 clinicians from 4 Australian states; 5 stroke survivors from 2 Australian states) and endorsed all strategies, refined strategy phrasing, and positioned personalisation to underpin all strategies. Personalisation was described in terms of two parameters: timing (proactive or reactive) and emphasis (subtle to explicit) (stage 4).

Conclusion: A co-designed set of 10 engagement strategies for clinicians to use during post-stroke upper limb interventions is ready for feasibility and validity testing.