Self-Management and Rehabilitation Technologies (SMART)
The SMART project was initially funded by the Engineering and Physical Science Research Council (EPSRC) and was match funded into CLAHRC SY with the agreement that follow on work would be undertaken in CLAHRC. The initial SMART project looked at how technologies can be used to help individuals and their families manage the consequences of long-term conditions (LTCs) and maintain quality of life, potentially without the support of professionals. 

The project identified firstly the technologies that are capable of providing relevant information to users with LTCs so that they can be helped to achieve realistic life goals. 

Secondly, the project worked with users and healthcare staff to test which were the best technologies for this purpose, how devices can be most appropriately used and what the best forms of information feedback are. 

The project focused on three conditions: stroke, chronic pain and heart failure. The aim of the project was to improve understanding of the potential for technology to support self management of chronic LTCs through an iterative health and social care and user-centred design methodology. 

The technology resulting from this project is called a 'Personalised Self-Management System' (PSMS), an integrated platform with a touchscreen home hub and a touchscreen mobile device with additional functions for people living with these three health conditions.

Tomorrow Options

The system for people who have had a stroke includes a technology solution supplied by a Small and Medium-sized Enterprise (SME), Tomorrow Options. The research team in Sheffield have adapted an existing technology to monitor gait within a new patient group, stroke survivors. They have repurposed a multi-sensored insole originally designed for use as a pressure monitor for the analysis of the diabetic foot. 

The PSMS has been designed for use at home and in the community, thereby assisting the individual in identifying realistic lifestyle goals that can then be achieved through therapeutic rehabilitation exercises, providing guidance that is specific to the specific LTC and the user's progress. The system displays easy to understand feedback showing people's progress and exercises for people to work through online designed to improve motivation. The initial results appear promising and further work by the research team in the TaCT theme of CLAHRC SY has led to the incorporation of the SMART insole technology into the prototype system with both innovative feedback screens and the opportunity for the self assessment of health and wellbeing prior to exercise participation, and gait monitoring.
For the purpose of this project the important characteristics of gait to be measured and fed back to the stroke survivor are symmetry and heel strike. The reason why these two were chosen was the evidencebased link between poor symmetry of gait and the risk of falling, and the cosmetic improvements in gait when a stroke survivor walks more normally, striking the heel in a forward step. During the final research year in CLAHRC SY a Realistic Evaluation of the system is being undertaken to establish whether the theoretical basis for the system and the underlying propositions are correct and whether the system can be integrated into the stroke care pathway in community services in Sheffield. Ultimately the researchers wish to establish what works for whom and in what circumstances.

Whilst still early in the innovation pipeline this proof of concept project has demonstrated how researchers in CLAHRC have worked with an industrial partners to translate their developed technologies to new chronic disease groups. The evaluation is providing an evidence base that may support the adoption of such technologies in the future.
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