Aktuelle Neurologie 2018; 45(02): 117-126
DOI: 10.1055/s-0043-115379
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Training der oberen Extremitäten mit einem Roboterball bei Schlaganfallpatienten

Training of Upper Extremities with a Robotic Ball in Stroke Patients
Tilo Neuendorf
Technische Universität Chemnitz, Sportmedizin/-biologie, Chemnitz, Germany
,
Daniel Zschäbitz
Technische Universität Chemnitz, Sportmedizin/-biologie, Chemnitz, Germany
,
Nico Nitzsche
Technische Universität Chemnitz, Sportmedizin/-biologie, Chemnitz, Germany
,
Henry Schulz
Technische Universität Chemnitz, Sportmedizin/-biologie, Chemnitz, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
20 September 2017 (online)

Zusammenfassung

Hintergrund Technik-gestützte Bewegungstherapie kann dazu beitragen, die charakteristischen Symptome der oberen Extremitäten infolge eines Schlaganfalls durch die Fähigkeit der neuronalen Reorganisation zu rehabilitieren. Der Roboterball „Sphero 2.0“ wurde als potenziell geeignetes innovatives Exergaming-Instrument festgestellt und zum ersten Mal in der Neurorehabilitation angewendet.

Ziel der Arbeit Das entwickelte Therapiekonzept mit dem Roboterball soll erprobt und mögliche Effekte auf motorische Parameter geprüft werden. Patientenangaben sollen dazu beitragen, den Einsatz in der Rehabilitation zu testen sowie Auswirkungen einer mehrwöchigen Anwendung zu überprüfen. Außerdem wird die technische Eignung des Roboterballs bewertet.

Methoden Zwölf Schlaganfallpatienten (62,3 ± 11,8 Jahre, 170,8 ± 10,9 cm, 82,5 ± 16,6 kg, 6,37 ± 5,53 Monate post-stroke) trainierten an 24 Einheiten in 12 Wochen zweimal pro Woche für 45 min mit dem Roboterball. Bisherige Therapiemaßnahmen wurden ergänzt. Vor und nach der Intervention wurden Greifkraft, unilaterale Geschicklichkeit, Krankheitsempfinden, kognitiver Status sowie Technikaffinität getestet.

Ergebnisse 10 Patienten konnten die Intervention abschließen und erzielten signifikante Verbesserungen der Greifkraft (p = 0,007, d = 0,51) und der unilateralen Geschicklichkeit (p = 0,002, d = 0,44) bei reduziert wahrgenommenen Krankheitsbeschwerden (p = 0,002, d = −1,12). Der Roboterball wurde mit 92,3 ± 2,5 von maximal 100 Punkten als exzellent bewertet.

Diskussion Sehr stark und schwach betroffene Patienten scheinen von den allgemein positiven Ergebnissen weniger zu profitieren als moderat eingeschränkte. Konkrete Verbesserungen im Alltag tragen zur hohen Motivation für das Training mit dem Roboterball bei. Die Therapieinhalte können variabel gestaltet und bei unterschiedlich stark betroffenen Anwendern erfolgreich angewendet werden. Die Ergebnisse sollten im nächsten Schritt mit weiteren Patienten im Crossover-Design überprüft werden.

Abstract

Background Technology-supported therapy can contribute to rehabilitate the distinctive symptoms of upper extremities due to stroke because of the ability of neuronal reorganization. The robotic ball “Sphero 2.0” was ascertained as a possible applicable innovative therapeutic exergaming tool and was used within neurorehabilitation for the first time.

Objective The therapy-concept with the robotic ball is to be put to the test and possible effects to motor parameters are assessed. The patients’ statements are to contribute to test the implementation within the rehabilitation as well as to check ramifications of a multiple week execution. Furthermore the technical applicability will be rated.

Methods Twelve stroke patients (62,3 ± 11,8 years, 170,8 ± 10,9 cm, 82,5 ± 16,6 kg, 6,37 ± 5,53 months post-stroke) trained in 24 × 45 min sessions within 12 weeks, two times a week. Regular therapy was complemented. Pre and post intervention the grip strength, unilateral dexterity, perceived disease awareness and impairment, cognitive status and technical affinity was tested.

Results Ten patients were able to complete the intervention and achieved significant improvements of grip strength (p = 0.007, d = 0.51) and unilateral dexterity (p = 0.002, d = 0.44) with downscaled perceived disease awareness and impairment (p = 0.002, d = −1.12). The robotic ball was rated excellent with 92.3 ± 2.5 out of 100 points maximum.

Conclusions Strong and slightly impaired patients seem to benefit less from the generally positive results than moderate affected stroke patients. Specific improvements in dealing with activities of daily living contributed to a high motivation for the robotic ball training. The training contents can be adapted variably in order to be applied by heterogeneous impaired users. In a following crossover-design study the results should be checked with more patients.

 
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