Self-Management for Amputee Rehabilitation using Technology (SMART) program: A peer supported mHealth approach for rehabilitation after lower limb amputation

Lower Limb Amputations (LLAs) are a substantial burden on the Canadian health services with nearly 50,000 cases reported between 2006 and 2011. To address the challenging nature of a LLA (e.g., decreased mobility, pain, depression), patients need to go through extensive rehabilitation programs. Effective self-management programs can help those with LLA to monitor their own condition and improve their quality of life. However, a lack of self-management programs, a limited healthcare budget, and a decrease in quality of services (e.g. shorter lengths of stay for inpatients and rapid movement to outpatient services) pose further challenges for patients with LLA. Self-management programs can be provided to clients through online mobile technologies (e.g., tablet) and offer accessible, low-cost, and potentially augmentative rehabilitation after discharge, in both urban and rural areas. To address these needs, we designed and developed an online educational and training platform for individuals with LLA called, Self-Management for Amputee Rehabilitation using Technology (SMART). SMART focuses on LLA education, prosthetic limb management, and weekly support of peers. It is monitored by a trainer through a website. We aim to evaluate SMART in men and women with LLA aged 50 years and over, admitted to prosthetic rehabilitation throughout Vancouver, BC and London, ON. SMART has the potential to influence a client's post-LLA needs with direct (e.g., individual's health) and indirect (e.g., healthcare utilization) benefits. The purpose of our randomized controlled trial is to evaluate the effect of SMART in community dwelling older adults with unilateral, above or below, knee amputation.