A Robotic Ball for Upper-Extremity Training in Stroke Patients: A New Approach in Neurorehabilitation

Abstract

Background Technology-supported therapy can contribute to the rehabilitation of distinctive upper-extremity symptoms resulting from stroke as neurons have the ability to reorganize. The robotic ball “Sphero 2.0”, an innovative therapeutic exergaming tool, was found to be suitable and hence used in neurorehabilitation for the first time. Objective The aim of this study was to evaluate the robotic-ball therapy concept and assess possible effects on motor parameters. Patients’ statements regarding the effects on rehabilitation after implementing the therapy concept over several weeks were included in the testing procedure. Furthermore, the study aimed to rate the technical suitability of the robotic ball. Methods 12 stroke patients (62.3±11.8 years, 170.8±10.9 cm, 82.5±16.6 kg, 6.37±5.53 months post-stroke) underwent 45-min training with the robotic ball, twice a week, over a period of 12 weeks. Regular therapy was complemented with this intervention. Pre and post intervention, grip strength, unilateral dexterity, self-reported disabilities of the arm, shoulder and hand and impairment, cognitive status and technical affinity were assessed. Results 10 patients were able to complete the training program and achieved significant improvement in grip strength (p=0.007, d=0.51) and unilateral dexterity (p=0.002, d=0.44) along with reduced self-reported disabilities of the arm, shoulder and hand and impairment (p=0.002, d=−1.12). The robotic ball was rated as excellent with 92.3±2.5 out of a maximum 100 points. Conclusions Patients severely or slightly impaired seemed to benefit less than moderately affected stroke patients. Specific improvements in dealing with activities of daily living contributed to a high motivation for the robotic-ball training. The training content can be adapted to users with heterogeneous impairments. The results of the present study should be confirmed with more patients in a future study with a crossover-design. Keywords: Stroke, motor function, robotic ball, upper extremities, exergaming