Movement Therapy of the Upper Extremities with a Robotic Ball in Stroke Patients: Results of a Randomized Controlled Crossover Study

Background Stroke is associated with motor impairments of the upper extremities. The defining goal of rehabilitation is independent execution of activities of daily living. New therapy procedures use different hardware components to implement digital therapy contents. These can be useful complements to established therapy protocols. Objectives The aim of this study was to examine the effect of movement therapy with a robotic ball on motor function parameters in stroke patients. Materials and Methods 25 patients (60.0±10.0 years, 172.5±13.8 cm, 79.5±13.8 kg, 89.8±72.6 months post-stroke) took part in this crossover study. The intervention and control periods comprised 12 weeks each. Training with the robotic ball was done in addition to standard therapy two times a week for 45 min each. Different game activities were carried out with the help of a tablet and a smartphone. Results Isometric grip strength improved by 4.5±3.6 kg (p=0.000), and unilateral dexterity increased by 7.5±6.3 successful tries (p=0.000) in the round block test. The self-reported disabilities of the arm, shoulder and hand were assessed using the QuickDASH questionnaire and showed improvements by 12.4±13.0 points (p=0.001). Conclusions Additional therapy using the robotic ball improved upper extremity motor function and self-perceived health status in chronic stroke patients. However, performance stagnated when standard therapy was implemented alone. Moderately affected patients seem to benefit the most. The presence of very severe motor or cognitive symptoms led, in part, to some dropouts. The results need to be verified using larger patient populations.