SMART Arm with outcome-triggered electrical stimulation: a pilot randomized clinical trial
Kathryn S Hayward1, Ruth N Barker, Sandra G Brauer
1Discipline of Physiotherapy, School of Public Health, Tropical Medicine & Rehabilitation Sciences, James Cook University, Townsville, Australia.
Topics in Stroke Rehabilitation
|July 30, 2013
Summary
SMART Arm training, with or without outcome-triggered electrical stimulation (OT-stim), significantly improved upper arm function in stroke survivors compared to usual care alone. This rehabilitation approach shows promise for inpatient recovery.
Area of Science:
- Neurorehabilitation
- Biomedical Engineering
- Physical Therapy
Background:
- Stroke survivors with severe paresis often face challenges in regaining upper limb function.
- The SensoriMotor Active Rehabilitation Training (SMART) Arm is a non-robotic device designed to aid reaching practice.
- Outcome-triggered electrical stimulation (OT-stim) can be integrated with the SMART Arm to enhance movement.
Purpose of the Study:
- To evaluate the efficacy of SMART Arm training, with or without OT-stim, as an adjunct to usual care.
- To compare the combined approach against usual care alone in stroke survivors during inpatient rehabilitation.
Main Methods:
- A randomized controlled trial involving 8 stroke survivors receiving 20 hours of SMART Arm training over 4 weeks.
- Participants were assigned to either SMART Arm training with OT-stim or SMART Arm training alone.
- A historical control group of 20 stroke survivors received only usual therapy; Motor Assessment Scale Item 6 (Upper Arm Function) was the primary outcome.
Main Results:
- SMART Arm training, regardless of OT-stim, resulted in significantly greater improvement in upper arm function compared to usual therapy alone (P = .024).
- No significant difference in functional improvement was observed between the SMART Arm with OT-stim and SMART Arm alone groups.
- Initial motor severity and the presence of OT-stim affected the training repetitions and progression.
Conclusions:
- SMART Arm training, combined with usual therapy (with or without OT-stim), is more effective than usual therapy alone for stroke survivors with severe paresis.
- Further research is warranted to explore the full benefits of SMART Arm training for stroke survivors in the subacute inpatient rehabilitation phase.
