Supporting person-centred, team-based stroke rehabilitation with ICT : implementation and evaluation of F@ce 2.0

<p dir="ltr">Access to rehabilitation is crucial for resuming participation in meaningful daily activities. As stroke rehabilitation continues to evolve, key areas include person- centred practices and the integration of digital health. Although both professionals and stroke survivors value person-centred goal setting, achieving collaborative rehabilitation planning remains complex. Similarly, there are promising results regarding digital rehabilitation, but research has often focused on highly specialised solutions rather than accessible technology.</p><p dir="ltr">This thesis aimed to evaluate the impact and implementation of F@ce 2.0, a person-centred, team-based intervention for rehabilitation after stroke supported by information and communication technology (ICT).</p><p dir="ltr">Within the thesis project, F@ce 2.0 was implemented in seven Swedish rehabilitation teams, with an additional five teams serving as a control condition. In total, 100 stroke survivors, 48 significant others and 53 healthcare professionals participated in the project. To capture a broad perspective, the evaluation was based on both quantitative and qualitative data.</p><p dir="ltr">The findings from Study I revealed that both the intervention group and the control group had improved their self-rated activity performance and satisfaction at the 6-month follow-up, with no significant between-group differences. For significant others, only the intervention group showed a decreasing trend in caregiver burden. Findings from studies II-IV conveyed how person-centred rehabilitation was developed through dialogue and support, and revealed a potential for F@ce 2.0 as a means of resuming daily activities. The ICT component was found motivational, but improvements were suggested.</p><p dir="ltr">Study IV was a process evaluation of F@ce 2.0. Findings underline the importance of creating prerequisites for integrating clinical development and research. The study also contributes to the limited knowledge of using daily activities as an interdisciplinary lens for goal setting in rehabilitation.</p><p dir="ltr">In summary, this thesis suggests that a focus on daily activities may be fruitful for increasing person-centredness in stroke rehabilitation. It further illustrates the possibilities and challenges of using everyday technology to support goal achievement. The findings also underline the necessity of involving rehabilitation teams, stroke survivors and significant others in the development of new interventions to ensure feasibility.</p><h3>List of scientific papers</h3><p dir="ltr">I. <b>Söderhielm K,</b> Ytterberg C, Eriksson G, von Koch L, Tistad M, Guidetti S. A non-randomised between-group comparison of F@ce 2.0: a person-centred and interdisciplinary rehabilitation intervention after stroke supported by information and communication technology. [Submitted]</p><p dir="ltr">II. <b>Söderhielm K,</b> Tistad M, Ytterberg C, Guidetti S. (2025). Experiences of F@ce 2.0: a person-centred intervention for home-based rehabilitation after stroke supported by digital technology - a qualitative study. BMJ Open, 15(7), e089147. <a href="https://doi.org/10.1136/bmjopen-2024-089147" rel="noreferrer" target="_blank">https://doi.org/10.1136/bmjopen-2024-089147</a></p><p dir="ltr">III. Eriksson G*, <b>Söderhielm K*</b>, Erneby M, Guidetti S. (2025). Family Members' Experiences of a Person-Centered Information and Communication Technology-Supported Intervention for Stroke Rehabilitation (F@ce 2.0): Qualitative Analysis. JMIR Rehabilitation and Assistive Technologies, 12, e69878-e69878. *Shared position as first author. <a href="https://doi.org/10.2196/69878" rel="noreferrer" target="_blank">https://doi.org/10.2196/69878</a></p><p dir="ltr">IV. <b>Söderhielm K,</b> Hawkins J, Ytterberg C, Tistad M, Guidetti S. Process evaluation of F@ce 2.0, a team-based, person-centred intervention for rehabilitation after stroke supported by ICT. [Submitted]</p>