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Table 1 The incorporation of theory-driven ingredients within the SMART system

From: Stroke patients’ utilisation of extrinsic feedback from computer-based technology in the home: a multiple case study realistic evaluation

Theory Topic Theories Ingredients How the feedback from the SMART system incorporates these
Theory Topic 1: The theoretical approach to post-stroke rehabilitation incorporated within the SMART system. Underpinning Theories: Neuroplasticity; Motor-learning Independent practice Used in the absence of a therapist.
Intensity Increased rehabilitation activity.
Problem solving Self-monitoring, self-interpretation, overcoming problems encountered in the absence of a therapist.
Goal setting Choosing which exercises to perform.
Specificity Matched movement patterns.
Repetition Increased rehabilitation activity.
Salience Relevant (meaningful) feedback.
Motor learning The SMART system provides an opportunity to learn implicitly and explicitly through trial and error and explicit feedback.
Theory Topic 2: Feedback in Post-Stroke Rehabilitation. Underpinning Theories: Motivation; Operant Conditioning; Motor-learning Feedback content The SMART system provides KP, KR, verbal and visual feedback. It also provides prescriptive feedback (in part).
Feedback schedule The SMART system provides feedback concurrently, terminally, after each performance and in summary.
Rewards The SMART system provides the user with the rewards of good performance through a red, amber, green chart and through scores (depending on exercise).
Theoretical Outcome: Behaviour change and Self-management. Underpinning Theories: Self-regulation, Social cognition, and goal-setting theories; Self-efficacy. Goal-setting The user is able to set specific, measurable, realistic, and time specified goals (targets) to achieve that are confirmed by the computer feedback.
Action planning The user can choose when to use the system and how many sets/repetitions they do.
Self-monitoring The user is able to monitor performance(s) independently.
Reinforcement The SMART system provides the user with positive feedback (depending on performance). Others are able to observe results.
Self-management The SMART system provides the user with an opportunity to problem-solve, make decisions, utilise resources, collaborate with others, and take action depending on their interpretation of the feedback provided.
   Self-efficacy The SMART system provides the user with an opportunity to evaluate achievement(s), observe demonstrations (the avatar), interpret performance(s) and changes in physical and emotional feelings as a result of usage, and receive feedback which may include verbal persuasion from significant others.