RESEARCH

The SMART Arm enables intensive and repetitive practice of a functional upper limb task during rehabilitation. SMART Arm training in combination with standard therapy, has the potential to improve recovery of upper limb function in those with severe motor disability. The immediate and long-term effects of SMART Arm training on upper limb impairment, activity and participation are currently being explored, in addition to the benefit of training with or without OT-stim to augment movement when compared to usual therapy alone. We will update you on this research as soon as the studies are completed.

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PUBLICATIONS – SMART Arm Clinical Trials

Hayward KS, Neibling BA, Barker RN.
Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report. Am J Occup Ther. 2015 Jul-Aug;69(4): p1-8.
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Brauer SG, Hayward KS, Carson RG, Cresswell AG, Barker RN. The efficacy of SMART Arm training early after stroke for stroke survivors with severe upper limb disability: a protocol for a randomised controlled trial. BMC Neurol. 2013 Jul 2;13:71.
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Hayward KS, Barker RN, Brauer SG, Lloyd D, Horsley SA, Carson RG. SMART Arm with outcome-triggered electrical stimulation: a pilot randomized clinical trial. Topics in Stroke Rehabilitation, 20, (4), 2013, p289 – 298
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Barker RN, Brauer SG, Carson RG. Training-induced changes in the pattern of triceps to biceps activation during reaching tasks after chronic and severe stroke. Experimental Brain Research, 2009, 196(4), 483-496.
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Barker RN, Brauer SG, Carson RG. Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel nonrobotic device: A randomized clinical trial. Stroke, 2008, 39(6), 1800-1807.
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Barker RN, Brauer SG, Barry BK, Gill TJ, Carson RG. Training-induced modifications of corticospinal reactivity in severely affected stroke survivors. Experimental Brain Research, 2012, 221(2), 211-221.
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PUBLICATIONS – SMART Arm Development

Barker RN and Brauer SG. Upper limb recovery after stroke: the stroke survivors perspective. Disability & Rehabilitation, 2005, 27:1213-1223.
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Hayward KS, Brauer SG. Dose of arm activity training during acute and subacute rehabilitation post stroke: A systematic review of the literature. Clin Rehabil. 2015 Jan 7. [Epub ahead of print]
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Eng XW, Brauer SG, Kuys SS, Lord M, Hayward KS. Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation. Stroke Res Treat. 2014;2014:626538. Epub 2014 Mar 27.
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Bower, K., Gustafsson, L., Hoffman, T., & Barker, R. Self-management of upper limb recovery after stroke: How effectively do occupational therapists and physiotherapists train clients and carers? British Journal of Occupational Therapy, 2012, 75(4), 180-187.
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Hayward KS, Kuys SS, Barker RN, Brauer SG. Can stroke survivors with severe upper arm disability achieve a clinically important change in arm function during inpatient rehabilitation? A multicentre, prospective, observational study. NeuroRehabilitation, 2014;35(1):17-23.
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Hayward KS, Barker RN, Carson RG, Brauer SG. The effect of altering a single component of a rehabilitation programme on the functional recovery of stroke patients: a systematic review and meta-analysis, Clinical Rehabilitation, 28, (2), 2014, p107-17
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Hayward KS, Barker RN, Wiseman AH, Brauer SG. Dose and content of training provided to stroke survivors with severe upper limb disability undertaking inpatient rehabilitation: An observational study. Brain Impairment. 2013, 14:392-405.

Hayward KS, Barker RN, Brauer SG. Advances in neuromuscular electrical stimulation for the upper limb post-stroke. Physical Therapy Reviews, 2010 15:309-19
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Hayward KS, Barker RN, Brauer SG. Interventions to promote upper limb recovery in stroke survivors with severe paresis: A systematic review. Disability and Rehabilitation, 2010, 32(24):1973–86.
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Barker RN, Gill TJ, Brauer SG. Factors contributing to upper limb recovery after stroke: a survey of stroke survivors. Disability & Rehabilitation, 2007, 29:981-989.
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SCIENTIFIC CONFERENCE PRESENTATIONS

Hayward KS, Ruddy KL, Lloyd D, Brauer SG, Barker RN, Carson RG. (2016). Repetitive reaching training combined with transcranial Random Noise Stimulation in stroke survivors with chronic and severe arm paresis: A triple blind pilot RCT. IV STEPS APTA, Ohio USA, April 2016. [Poster Presentation]

Brauer SG, Hayward KS, Carson RG, Lloyd D, Cresswell AC, Barker RN. (2015). SMART Arm with or without electrical stimulation compared to usual care in stroke inpatients with severe disability: Randomised controlled trial. Australian Physiotherapy Conference, Gold Coast Australia, October 2015.

Hayward KS, Barker RN, Brauer SG. (2015). Promoting arm recovery in stroke survivors with severe paresis. Invited Post-Congress 1-day Workshop. World Congress of Physical Therapy, Singapore, 5 May 2015.

Eng X-W, Brauer SG, Kuys SS, Lord M, Hayward KS. (2015). What factors affect the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation. [Platform Presentation]. World Congress of Physical Therapy, Singapore, 1-4 May 2015.

Hayward KS, Ruddy KL, Lloyd D, Brauer SG, Barker RN, Carson RG. (2015). Feasibility of transcranial Random Noise Stimulation combined with repetitive reaching practice in stroke survivors with chronic and severe paresis: A triple blind pilot RCT. Society for Neuroscience, Chicago USA, October 2015. [Poster Presentation]

Hayward KS, Brauer SG. (2014). Stroke survivors are engaged in limited upper limb training: A systematic review. Canadian Stroke Congress, Vancouver Canada, 4-7 October 2014. [Poster Presentation].

Hayward, Kuys, Barker, Brauer. (2014) Stroke survivors with severe arm disability do have potential for motor recovery. Canadian Stroke Congress, Vancouver, Canada. [Platform Presentation].

Barker, Hayward. (2014) Drive your own recovery: A comprehensive Upper Limb Training Program for Stroke Survivors. Smart Strokes Conference. Sydney, Australia. Focus Topic. [Platform presentation].

Hayward, Kuys, Barker, Brauer. (2013) Stroke patients with severe motor disability can make clinically important improvements during rehabilitation. Australia Physiotherapy Association National Conference. Melbourne, Australia. [Platform Presentation].

Hayward, Kuys, Barker, Brauer. (2013) Can stroke patients with severe motor disability make clinically important improvements during rehabilitation? Stroke Society of Australasia, Darwin, Australia. Awarded Best Presentation.

Hayward, Roberston, Sataki, Mitchell, Ninness, Barker. (2013) Drive your own upper limb recovery after stroke: A multidisciplinary group during inpatient rehabilitation. Stroke Society of Australasia, Darwin, Australia. [Poster Presentation].

Hayward, Barker, Wiseman, Brauer. (2013) Stroke survivors with severe upper limb disability: How much and what do they do during inpatient rehabilitation? Stroke Society of Australasia, Darwin, Australia. [Poster Presentation].

Hayward, Tate, Barker. (2013) The SMART Arm can be used by a stroke survivor with severe and multiple impairments: A mixed methods, single case study. Smart Strokes Conference, Brisbane, Australia. [Platform Presentation].

Hayward, Neibling, Barker. (2013) Independent use of the SMART Arm in the home is feasible: A pre-post, single case study. Smart Strokes Conference, Brisbane, Australia. [Platform Presentation].

Kleim, Barker, Hayward, Brauer. (2012) Driving neuroplasticity to improve arm function after severe stroke. International Society of Electrophysiology and Kinesiology, Brisbane, Australia. [Invited Post-Conference Workshop].

Hayward, Kuys, Barker, Brauer. (2012) Can stroke patients with severe motor disability make clinically important improvements during rehabilitation? World Stroke Congress, Brasilia, Brazil. [Platform Presentation].

Ocampo, Hayward, Barker, Cresswell, Carson, Brauer. (2012) Effect of upper limb support on the kinematics of sagittal plane reaching in stroke. International Society of Electrophysiology and Kinesiology Conference, Brisbane, Australia. [Poster Presentation].

Cochrane, Chan, Cresswell, Barker, Carson, Hayward, Brauer. (2011) The effect of age, constraint and support on the kinematics of sagittal plane reaching. Australian Physiotherapy Association Conference, Brisbane, Australia. [Poster presentation].

Hayward, Lloyd, Brauer, Carson, Barker. (2011) Use of the SMART Arm with outcome-triggered electrical stimulation to train reaching after acute stroke: A pilot RCT. World Congress of Physical Therapy, Amsterdam, The Netherlands. [Poster Presentation].

Hayward, Horsley, Brauer, Barker. (2011) Clinical guidelines for use of the SMART Arm. Society Stroke Australasia, Adelaide, Australia. [Platform Presentation].

Hayward, Barker, Brauer. (2011) Advances in neuromuscular stimulation. Smart Strokes Conference, Gold Coast, Australia. [Platform presentation].

Hayward, Barker, Brauer. (2011) Upper limb electrical stimulation advances. Smart Strokes, Gold Coast, Australia. [Platform presentation].

Hayward, Barker, Brauer. (2010) Do training strategies influence functional outcome? A systematic review. Australian Society for the Study of Brain Impairment. Gold Coast, Australia. [Platform presentation].

Hayward, Barker, Brauer. (2010) Severe stroke: How can we promote recovery? A systematic review. Australian Society for the Study of Brain Impairment. Gold Coast, Australia. [Platform presentation].

Hayward, Barker, Brauer. (2008) Outcome triggered FES to train reaching after acute severe stroke. SMART Strokes Conference. Sydney, Australia. [Poster presentation].

Barker, Brauer, Carson. (2006) Training-induced brain plasticity in stroke survivors with severe and chronic upper limb paresis as revealed with TMS. Society for Neuroscience Annual Meeting, Atlanta, Georgia, USA. [Poster presentation].

Barker, Brauer, Carson. (2006) Training improves upper limb motor function in chronic stroke survivors with severe paresis. Society for Neuroscience Annual Meeting. Atlanta, Georgia, USA. [Poster presentation].

Barker, Brauer, Carson. (2005) EMG triggered FES to train reaching after severe stroke. Joint Conference of the National Neurology & Gerontology Groups of the Australian Physiotherapy Association. Melbourne, Australia [Platform presentation].

INVENTORS

ruth-barker

Ruth Barker is the Clinical Leader at Community Rehab nQ, Northern Australia Primary Health Ltd and adjunct senior lecturer at James Cook University. Ruth’s PhD studies on recovery of the arm after stroke led to the development of the SMART ArmTM. Ruth has continued with research to refine the SMART ArmTM for use in the acute hospital, community and home environment. In addition, Ruth has developed the ‘Drive your own recovery’ program which incorporates SMART Arm training into a comprehensive upper limb training program. Ruth has a strong clinical background in neurological rehabilitation and experience in service delivery across settings in metropolitan, rural and remote locations in Australia.

richard-carson

Richard Carson is currently Chair in Cognitive Neuroscience of Ageing at Trinity College Institute of Neuroscience. Prof Carson brings international expertise to the SMART ArmTM team in the understanding and measurement of central nervous system plasticity within the context of human movement and mechanisms of neuromuscular coordination. Much of his current clinical and pre-clinical research has a specific emphasis upon the neuro-rehabilitation of stroke survivors. He was a co-investigator on the recent NHMRC clinical trial.

kate-hayward

Kate Hayward has completed her PhD on the rehabilitation potential of stroke survivors with severe upper limb disability, use of the SMART ArmTM being one intervention explored, at the University of Queensland. Kate also completed her honours project on the SMART ArmTM, which led to refinement of the device for use in the hospital environment.

sandy-brauer

Sandy Brauer is a Professor in the Division of Physiotherapy, The University of Queensland, where she leads the Neurology Research Team. She brings expertise to the SMART ArmTM team in the area of clinical trials to test intervention efficacy and has been involved in the development and evaluation of the SMART ArmTM from its inception. Currently she leads several clinical trials, including the current trial on the use of the SMART ArmTM device with acute stroke patients with severe paresis.

david-lloyd

David Lloyd is a Laboratory Manager at Queensland Brain Institute, University of Queensland. He has been involved in research in the areas of UWB Radar, Magnetic Resonance Micro-imaging, Speech Pathology, Sensorimotor Control, and Cognitive Neuroscience. He has been instrumental in the design, development, and programming of the prototype control/feedback software for the SMART ArmTM.