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ADAPT-NMD: A hybrid II feasibility study of a co-designed self-management support intervention for people living with
Laurence Edward Lee1, Stefan Tino Kulnik2, Annette Boaz3
1Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.
Abstract:
ObjectiveTo examine the feasibility and acceptability of Neuromuscular Bridges, a personalised self-management support intervention adapted for people with neuromuscular disorders, and to explore contextual factors influencing its implementation in specialist care.DesignA hybrid type II feasibility study employing mixed methods to evaluate clinical and implementation feasibility, incorporating quantitative outcomes with qualitative process evaluation.SettingA specialist neuromuscular tertiary centre in the United Kingdom.ParticipantsThirty-three adults with diverse neuromuscular disorders and six trained clinicians (physiotherapists and clinical nurse specialists).InterventionNM-Bridges, a co-designed, person-centred self-management support intervention delivered in a single clinical consultation, underpinned by the Bridges approach and Social Cognitive Theory.Main measuresRecruitment, retention, fidelity, and patient-reported outcomes were collected at baseline, post-intervention, and 3-month follow-up. Implementation was assessed using validated instruments and qualitative interviews.ResultsOf 106 eligible patients invited, 33 (31.1%) enrolled, with full retention and no missing data. Quantitative outcomes showed moderate pre- and post-improvements in patient-centred care, especially goal setting and activation. Small positive changes were noted in social participation, emotional well-being, mood, and self-efficacy, with effects generally sustained at follow-up. Fidelity was high, and implementation measures indicated strong clinician engagement. Qualitative data reinforced these findings, highlighting collaboration, relevance, and acceptability within routine care.ConclusionNM-Bridges was feasible and acceptable within specialist neuromuscular care. By integrating clinical outcomes with implementation learning, this hybrid feasibility study provides early evidence and a foundation for future evaluation of self-management support as a relational and sustainable component of neuromuscular rehabilitation.
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