CompletedNot ApplicableInterventional

Rehabilitation using virtual gaming for hospital and home-based arm and hand exercise post stroke

After a stroke, regaining arm and hand movement takes lots of practice. Repeating the same movements can become tiring and boring. The RHOMBUS II study is testing a device called the NeuroBall, which turns arm exercises into interactive computer games. Researchers at Brunel University London want to see if using the NeuroBall early in recovery—either on a hospital stroke ward or at home—is safe, fun, and easy to use. Half of the participants will use the NeuroBall alongside their normal NHS care for seven weeks, while the other half will continue with standard care alone. A specialist neuro-physiotherapist visits all participants to guide them through physical checks and answer questions. The results will help researchers plan larger studies to discover whether gaming technology can improve stroke rehabilitation across the NHS.

At a glance

Status

Completed

Phase

Not Applicable

Sponsor

Brunel University London

Enrolment target

Start

19 Apr 2021

Estimated completion

31 Jan 2022

Stroke

What is this study about?

Having a stroke often causes weakness or loss of movement in one arm and hand. The most effective way to help the brain and muscles recover is to practice arm movements over and over again. However, doing repetitive arm exercises can quickly become dull, which can make it hard to stay motivated.

To solve this, engineers, therapists, and stroke survivors developed the 'NeuroBall'. It is an exercise device that links to a screen, turning physical movements into fun, interactive video games. It has already been tested safely with people who had a stroke more than six months ago. Now, researchers want to see if it works well for people in the earlier stages of recovery, while they are still in hospital or recently discharged home.

This trial is a 'feasibility' study. That means it is designed to find out whether patients enjoy using the device, whether it fits into daily hospital or home routines, and whether people are happy being randomly placed into different treatment groups. What the researchers learn will shape future, larger studies to improve NHS stroke rehabilitation.

Key takeaways

The study tests whether a gaming device called the NeuroBall helps arm and hand recovery after a recent stroke.
It takes place in hospital stroke units or at home with early discharge teams.
Participants are randomly assigned to standard care alone or standard care plus seven weeks with the NeuroBall.
A specialist neuro-physiotherapist supports you and tracks your progress throughout.
Taking part is voluntary and will not change your standard NHS stroke treatment.

Who may be eligible?

This study is open to adults aged 18 and older who have had a recent stroke that caused new weakness in one arm or hand. You must be an inpatient on a hospital stroke ward or receiving care at home through an early supported discharge team. You also need to have some basic movement in your shoulder or elbow, be able to follow simple two-step instructions, see a computer screen, and speak enough English to complete the tasks.

You cannot take part if you have uncontrolled light-sensitive epilepsy, severe arm pain that gets worse with movement, or an unstable medical condition. You also cannot join if you live in a care home, have significant memory or thinking difficulties that make it hard to follow the trial, or are already taking part in another arm recovery study.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years of age or older?
Have you recently had a stroke that caused weakness in one arm or hand?
Are you currently on a hospital stroke ward or supported at home by an early stroke discharge team?
Can you move your shoulder or bend your elbow at least a little bit?
Can you follow simple two-step instructions and see a computer screen?
Do you live independently at home rather than in a residential care home?

Answer every question to see your result.

What does participation involve?

If you take part, a specialist neuro-physiotherapist will visit you in hospital or at home to complete movement tests and questionnaires about your daily life. You will then be put into one of two groups by chance (like flipping a coin). One group receives standard NHS stroke care, while the other group receives standard care plus a NeuroBall device to use for seven weeks.

If you receive the NeuroBall, you will be shown how to use it safely. You can start with short sessions and gradually build up your practice time. The device tracks how often and for how long you exercise. If you start in hospital, you can take the device home when you are discharged, and the physiotherapist will check your home setup. At the end of the seven weeks, the physiotherapist repeats the physical tests and questionnaires. The study lasts around seven to eight weeks in total.

Potential risks and benefits

You may not get any direct personal benefit from taking part, though participants who receive the NeuroBall get extra support to practice arm movements. Those in the usual care group may get a chance to try the device later if the trial shows good results. Possible risks include normal muscle tiredness, temporary arm soreness, eye strain, or mild motion sickness from looking at the screen. There is an extremely small risk of a seizure from screen use, though this has not been seen in previous studies with this device. Taking part is completely voluntary, and you can leave the study at any time without your regular NHS care being affected.

Locations (2)

Hillingdon Hospital
Approximate
London, England
Central and North West London NHS Foundation Trust (Early Stroke Support Discharge team)
City only
London, England

Common questions

Will taking part cost me anything?

No. The NeuroBall and all study equipment are provided free of charge, and visits are carried out by the research physiotherapist in hospital or at your home.

Does the NeuroBall replace my normal physiotherapy?

No. The NeuroBall is designed to be used alongside your standard NHS therapy and exercises, not to replace them.

What happens if I leave the hospital during the seven weeks?

If you are discharged home, you can take the NeuroBall with you. The research physiotherapist will visit you at home to help set it up safely.

Can I choose which group I am in?

No. A computer puts you into a group at random. This makes sure the study is fair and gives reliable scientific results.

What if I feel too tired to use the device?

Stroke recovery can be tiring. You can use the device at your own pace, take regular breaks, and stop at any time if you feel unwell or fatigued.

How to find out more

Cherry Kilbride

cherry.kilbride@brunel.ac.uk +44 (0)1895 268675 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.