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SMART Program in Chronic Stroke

An elderly woman is typing on a laptop surrounded by books and plants.

Annals of International Occupational Therapy

Asha Vas, Alisa Woods, Molly Keebler and Stephen Spees

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Long-term functional cognitive impairments are common consequence of stroke, often resulting in decreased participation in daily life activities. Prior research shows benefits of cognitive training targeting memory, attention and executive functions. This study examined the benefits of Strategic Memory Advanced Reasoning Tactics (SMART™), a cognitive training program that teaches strategies to improve abstract reasoning skills, in adults between 54 and 77 years of age who had a history of chronic stroke. Participants engaged in 10 sessions of SMART training over 6 weeks. Findings show significant gains in abstract reasoning and participation in daily activities following SMART training, and relatively stability in these gains 6 months later. These outcomes suggest the potential of cognitive training in promoting recovery, even years after experiencing a stroke.
Figure A. Mean of Test of Strategic Learning (TOSL) scores across SMART testing periods.

Figure A. Mean of Test of Strategic Learning (TOSL) scores across SMART testing periods. The TOSL score increased significantly from pre-SMART (M = 1.08, SD = 0.79) to post-SMART (M = 2.33, SD = 1.55; Z = −2.04, p = .041).

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