title: A review of the evidence underpinning the use of visual and auditory feedback for computer technology in post-stroke upper-limb rehabilitation.
abstract: OBJECTIVE
  To identify and review the evidence to determine the current scientific basis underpinning the use of visual and/or auditory feedback for computer technology in home-based upper-limb stroke rehabilitation.
  
  
  METHODS
  A systematic search was conducted using the following databases: CINAHL (EBSCO), MEDLINE (Ovid and CSA), PubMed, Science Direct (Elsevier) and Cochrane Library. Journals, book chapters and conference proceedings were also used in the systematic search. Relevant papers were critically appraised using the Critical Appraisal Skills Programme tool for randomised controlled trials/quantitative designs.
  
  
  RESULTS
  Four controlled trials were identified as being relevant. Although the evidence is scarce, existing findings suggest that extrinsic visual and auditory feedback may improve motor and functional performance. In addition, concurrent feedback, knowledge of performance, knowledge of results and explicit feedback may be key components in the promotion of improved performance.
  
  
  CONCLUSIONS
  There is a paucity of evidence to inform the development and the use of technological systems for home-based stroke rehabilitation and specifically how such systems might be developed to provide best forms of feedback in the absence of a therapist. Further work is required to first investigate the efficacy of visual and auditory feedback using technology systems and second to explore their utilisation with the end user.
authors.affiliation: The Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, S10 2BP, UK. jackparker63@googlemail.com
authors.forename: Jack
authors.initials: J
authors.lastname: Parker
authors.forename: Gail
authors.initials: G
authors.lastname: Mountain
authors.forename: Jackie
authors.initials: J
authors.lastname: Hammerton
mesh_terms: D003199:Computer Systems; D004185:Disability Evaluation; D056228:Feedback, Sensory; D006309:Hearing; D006699:Home Care Services; D006801:Humans; D012656:Self-Help Devices; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D034941:Upper Extremity / Q000473:pathology*