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Am J Occup Ther. 2015 Jul-Aug;69(4):6904210020p1-8. doi: 10.5014/ajot.2015.016055.

Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

Author information

1
Kathryn S. Hayward, PhD, is Senior Research Officer, Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Queensland, Australia, and Senior Research Officer, Mount Isa Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia.
2
Bridee A. Neibling, BPhtyHons, was Honours Student, Discipline of Physiotherapy, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia, at the time of the study.
3
Ruth N. Barker, PhD, is Adjunct Senior Lecturer, Discipline of Physiotherapy, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia, and Clinical Leader, Community Rehab Northern Queensland, Townsville Mackay Medicare Local, Townsville, Queensland, Australia; ruth.barker@jcu.edu.au.

Abstract

This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability.

PMID:
26114456
DOI:
10.5014/ajot.2015.016055
[Indexed for MEDLINE]

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