ADAPT-NMD: A hybrid II feasibility study of a co-designed self-management support intervention for people living with neuromuscular disorders

Objective To 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. Design A hybrid type II feasibility study employing mixed methods to evaluate clinical and implementation feasibility, incorporating quantitative outcomes with qualitative process evaluation. Setting A specialist neuromuscular tertiary centre in the United Kingdom. Participants Thirty-three adults with diverse neuromuscular disorders and six trained clinicians (physiotherapists and clinical nurse specialists). Intervention NM-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 measures Recruitment, 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. Results Of 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. Conclusion NM-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.