Device helps retrain arm reach after stroke

NEW YORK (Reuters Health) - A novel nonrobotic device called the Sensorimotor Active Rehabilitation Training (SMART) Arm can help stroke survivors with partial arm paralysis re-learn the task of reaching, a study shows.

Severe arm paralysis "is a major contributor to disability after stroke," note Dr. Ruth N. Barker and colleagues of University of Queensland, Australia note in the June issue of the journal Stroke.

"Our findings indicate that training of reaching using the SMART Arm can reduce impairment and improve activity in stroke survivors with severe and chronic upper limb paresis (partial motor paralysis), highlighting the benefits intensive task-oriented practice, even in the context of severe paresis," they write.

Barker and colleagues investigated the efficacy of the SMART Arm -- a low-cost arrangement of a pulley, weights and near-friction less linear track -- with or without electrical stimulation, to augment elbow extension in 42 stroke survivors with severe and chronic partial arm paralysis.

Thirty-three participants completed the study, of whom 10 received training using the SMART Arm with electrical stimulation, 13 received training with the SMART Arm alone, and 10 received no intervention (control). Training consisted of 12 hour-long sessions over 4 weeks.

The primary outcome was upper arm function. Secondary outcomes included various impairment measures including triceps muscle strength and reaching force, and various activity measures such as reaching distance. Assessments were made at the outset, after training at 4 weeks and at 2 months follow up.

According to Barker and colleagues, both SMART Arm groups "demonstrated significant improvements in all impairment and activity measures" after training and at 12 weeks post-training. There was no significant difference between the two SMART Arm groups and there was no change in the control group.

SOURCE: Stroke June 2008.