Intervention and participation schedule
| Week | Phase | Description | OnTrack consultation | Assessments |
| 0 | Information and consent | NHS therapists screen for eligible patients, provide information and consent participants | Screening, information, and consent | |
| 1 | Baseline assessment (initial) | Participants complete outcome measures and wear activity trackers (Axivity AX3) on both arms during waking hours (typically 12 hours/day) for 1 week to gather accelerometer data that are translated into minutes of activity. These data create a baseline of activity allowing left-to-right arm usage comparison | PAM, FMA-UE, MAL, mRS, VAS, MoCA, AT, EQ-5D-5L, LTT | |
| 2 | OnTrack intervention | Participants wear a smartwatch (Apple Watch Series 3 or 4) on their impaired arm only during waking hours (typically 12 hours/day). They will receive real-time feedback on the amount of movement completed (measured in minutes) and daily motivational messages. Participants will receive fortnightly consultations with a researcher to troubleshoot and receive self-management skills training Baseline assessments are repeated during week 8 (halfway) | Onboarding | |
| 3 | Check-in and self-management skills training (problem solving) | |||
| 4 | ||||
| 5 | Check-in and self-management skills training (self-discovery) | |||
| 6 | ||||
| 7 | Check-in and self-management skills training (goal setting) | |||
| 8 | Halfway assessment Check-in and self-management skills training (goal setting cont.) | PAM, FMA-UE, MAL, mRS, VAS, MoCA, AT, EQ-5D-5L, LTT, FFT | ||
| 9 | ||||
| 10 | Check-in and self-management skills training (reflection) | |||
| 11 | ||||
| 12 | Check-in and self-management skills training (sign-posting) | |||
| 13 | ||||
| 14 | Baseline assessment (exit) | Participants complete outcome measures and wear activity trackers (Axivity AX3) on both arms during waking hours (typically 12 hours/day) for 1 week to gather accelerometer data that are translated into minutes of activity. These data create a baseline of activity allowing left-to-right arm usage comparison | PAM, FMA-UE, MAL, mRS, VAS, MoCA, AT, EQ-5D-5L, LTT, FFT, SUS | |
| 15 | Feedback | Independent evaluator leads feedback sessions with participants who have completed the intervention End of participation | Semistructured interview, online survey (therapists) |
AT, Albert’s Test; FMA-UE, Fugl-Meyer Assessment for Upper Extremity; FTT, Friends and Family Test; LTT, Lap-to-Table; MAL, Upper Extremity Motor Activity Log-14; MoCA, Montreal Cognitive Assessment; mRS, modified Rankin Scale; NHS, National Health Service; PAM, Patient Activation Measure; SUS, System Usability Scale; VAS, Visual Analogue Scale.