Comparison between left and right hand after using of soft robot and rubber ball in patients with stroke: A Randomized control trail
Abstract
Introduction: Stroke patients often experience hand function issues, affecting daily tasks and motor skills. Left or right hemispheric strokes may cause bilateral coordination issues. The study aimed to assess the difference between right- and left-hand outcomes according to the use of soft robot and rubber ball.
Methods: A randomized control trial was conducted from July 21 to November 20, 2024, dividing patients into two groups using robotic gloves and rubber balls. Twenty rehabilitation sessions were conducted over four months, with hand functions measured using the Action Research Arm tool.
Results: The study included 68 patients with an average age of 60.13 years, over 60% of whom were right-handed. The soft robotic glove significantly enhanced gross finger and thumb movements, achieving a post-intervention score of 6.04. The overall ARAT score improved markedly, with patients using the glove scoring an average of 14.14 before the intervention, which increased to 28.50 for the left hand and from 15.23 to 30.14 for the right hand. Rubber ball users showed slight improvements for both hands. Males exhibited a stronger response in the right hand, while females responded better in the left. Both genders had similar average reflexes for each hand.
Conclusion: The average age of the patients was 60, and there were more males than females in both groups. The right hand improved at a higher rate than the left with both the soft robotic glove and rubber ball, and rehabilitation outcomes were better for men than women.
Downloads
Metrics
References
Lilu, F, Al-Jubouri MB. Challenges Facing Nurses Toward Providing Care to Patients with Cerebrovascular Accidents: A Mixed Methods Study. Bahrain Medical Bulletin. 2024 Mar 1;46(1).
Umeki N, Murata J, Higashijima M. Effects of training for finger perception on functional recovery of hemiplegic upper limbs in acute stroke patients. Occupational therapy international. 2019;2019(1):6508261. https://doi.org/10.1155/2019/6508261.
Mohammed EI. The role of spiral Computerized Tomography in diagnosis of stroke. Iraqi National Journal of Nursing Specialties. 2013;26(2).
AL‐Fayyadh S. Predicting the functional independence during the recovery phase for poststroke patients. Nursing Open. 2019 Oct;6(4):1346-53. https://doi.org/10.1002/nop2.335.
Basheti IA, Ayasrah SM, Al-Fayyadh S, Abuadas FH, Abu-Snieneh HM, Bachi GE. Medications Adherence and Associated Factors Among Patients with Stroke in Iraq. Patient preference and adherence. 2024 Dec 31:2027-39. https://doi.org/10.2147/PPA.S459289.
Salih AN, Allo RR. Evaluation of Nursing Intervention Measures in Infection Control at Dialysis Units in Mosul City Hospitals. Medical Journal of Babylon. 2024 Apr 1;21(2):245-50. https://doi.org/10.4103/MJBL.MJBL_360_22.
Kurosaki M, Tosaka M, Ibe Y, Arii H, Tomono J, Tazawa M, Shimizu T, Aihara M, Yoshimoto Y, Wada N. Functional recovery after rehabilitation in patients with severe post-stroke hemiplegia. Progress in rehabilitation medicine. 2022;7:20220039. https://doi.org/10.2490/prm.20220039.
AL‐Fayyadh S, Mohammed W. Patients' knowledge about chronic diseases towards risk factors and warning signs of stroke. Iraqi National Journal of Nursing Specialties. 2010;2(23):1-4.
Keramiotou K, Anagnostou C, Konstantonis G, Kataxaki E, Sfikakis PP, Tektonidou MG. Impaired hand function and performance in activities of daily living in systemic lupus erythematosus, even in patients achieving lupus low disease activity state (LLDAS). Rheumatology Advances in Practice. 2021;5(2):rkab029. https://doi.org/10.1093/rap/rkab029.
Parry R, Macias Soria S, Pradat-Diehl P, Marchand-Pauvert V, Jarrassé N, Roby-Brami A. Effects of hand configuration on the grasping, holding, and placement of an instrumented object in patients with hemiparesis. Frontiers in neurology. 2019 Mar 19;10:240. https://doi.org/10.3389/fneur.2019.00240.
David I. Anderson, Keith R. Lohse b, Thiago Costa Videira Lopes b, A. Mark Williams. Individual differences in motor skill learning: Past, present and future. Human Movement Science 78 (2021) 102818. https://doi.org/10.1016/j.humov.2021.102818.
Mohammed WK. Patients' Knowledge about Chronic Diseases towards Risk Factors and Warning Signs of Stroke. Iraqi National Journal of Nursing Specialties. 2010;23(2).
Jasim AH, Majeed HM, Mohammed TR. Knowledge and protective health behaviors concerning risk factors for coronary heart disease among Baghdad University students. Medico Legal Update. 2020 Apr 1;20(2):234-9.
Wang T, Liu Z, Gu J, Tan J, Hu T. Effectiveness of soft robotic glove versus repetitive transcranial magnetic stimulation in post-stroke patients with severe upper limb dysfunction: A randomised controlled trial. Frontiers in Neurology. 2023 Jan 11;13:887205. https://doi.org/10.3389/fneur.2022.887205.
Lilu FK, Al-Jubouri MB. Assessment of Challenges Encountering Nurses in Delivering Care to Patients with Cerebrovascular Accident. Iraqi National Journal of Nursing Specialties. 2023 Dec 30;36(2):80-91. https://doi.org/10.58897/z4e4z448.
Shih PC, Steele CJ, Hoepfel D, Muffel T, Villringer A, Sehm B. The impact of lesion side on bilateral upper limb coordination after stroke. Journal of Neuro Engineering and Rehabilitation. 2023 Dec 13;20(1):166. https://doi.org/10.1186/s12984-023-01288-4.
Oquita R, Cuello V, Uppati S, Mannuru S, Salinas D, Dobbs M, Potter-Baker KA. Moving toward elucidating alternative motor pathway structures post-stroke: the value of spinal cord neuroimaging. Frontiers in Neurology. 2024 Feb 14;15:1282685. https://doi.org/10.3389/fneur.2024.1282685.
Li X, He Y, Wang D, Rezaei MJ. Stroke rehabilitation: from diagnosis to therapy. Frontiers in neurology. 2024 Aug 13;15:1402729. https://doi.org/10.3389/fneur.2024.1402729.
Kumagai M, Uehara S, Kurayama T, Kitamura S, Sakata S, Kondo K, Shimizu E, Yoshinaga N, Otaka Y. Effects of Alternating Bilateral Training Between Non-Paretic and Paretic Upper Limbs in Patients with Hemiparetic Stroke: A Pilot Randomized Controlled Trial. Journal of rehabilitation medicine. 2022;54. https://doi.org/10.2340/jrm.v54.1970.
Gherman B, Zima I, Vaida C, Tucan P, Pisla A, Birlescu I, Machado J, Pisla D. Robotic Systems for Hand Rehabilitation—Past, Present and Future. Technologies. 2025 Jan 16;13(1):37. https://doi.org/10.3390/technologies13010037.
Rahmawati I, Dewi R, Pertami SB, Pasaribu E. Hand exercise using a rubber ball increases grip strength in patients with non-haemorrhagic stroke. The Malaysian Journal of Nursing (MJN). 2021 Jan 2;12(3):32-6. ttps://doi.org/10.31674/mjn.2021.v12i03.005.
Baktash MQ, Naji AB. Efficacy of health belief model in enhancing exercise behavior to preventing stroke among geriatrics homes residents in Baghdad city. Indian Journal of Public Health. 2019 Feb;10(02):929. https://doi.org/10.5958/0976-5506.2019.00415.7.
Kumar S, Yadav RA, Yadav S. Effect of robotic tilt table on rehabilitation outcome in right side versus left side hemiplegia. Int. J. Yogic Hum. Mov. Sports Sci.. 2018;3:237-41.
Lim DY, Lai HS, Yeow RC. A bidirectional fabric-based soft robotic glove for hand function assistance in patients with chronic stroke. Journal of NeuroEngineering and Rehabilitation. 2023 Sep 21;20(1):120. https://doi.org/10.1186/s12984-023-01250-4.
Correia C, Nuckols K, Wagner D, Zhou YM, Clarke M, Orzel D, Solinsky R, Paganoni S, Walsh CJ. Improving grasp function after spinal cord injury with a soft robotic glove. IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2020 Apr 16;28(6):1407-15. https://doi.org/10.1109/TNSRE.2020.2988260.
Pavlović R, Vrcić M. Hand Grip Strength in Students: Differences in the Gender Dimorphism. International Journal of Physical Education, Fitness and Sport. 2021;10(4):13-21.https://doi.org/10.34256/ijpefs2143
Shenoy P, Gupta A, SKM V. Comparison of synergy patterns between the right and left hand while performing postures and object grasps. Scientific Reports. 2023 Nov 20;13(1):20290. https://doi.org/10.1038/s41598-023-47620-9.
Günaydın E, Öcalan M, Uzunkulaoğlu A, Ay S. Evaluation of the functional status of the “unaffected” hand in hemiplegic patients. Neurology Asia. 2023;28(3). https://doi.org/10.54029/2023imv.
Fernández-Solana J, Pardo-Hernández R, González-Bernal JJ, Sánchez-González E, González-Santos J, Soto-Cámara R, Santamaría-Pelaez M. Psychometric Properties of the Action Research Arm Test (ARAT) Scale in Post-Stroke Patients—Spanish Population. International journal of environmental research and public health. 2022 Nov 13;19(22):14918. https://doi.org/10.3390/ijerph192214918.
Lim DY, Lai HS, Yeow RC. A bidirectional fabric-based soft robotic glove for hand function assistance in patients with chronic stroke. Journal of NeuroEngineering and Rehabilitation. 2023 Sep 21;20(1):120.
https://doi.org/10.1186/s12984-023-01250-4.
Leon B, Basteris A, Infarinato F, Sale P, Nijenhuis S, Prange G, Amirabdollahian F. Grasps recognition and evaluation of stroke patients for supporting rehabilitation therapy. BioMed research international. 2014;2014(1):318016.
https://doi.org/10.1155/2014/318016.
Mawase F, Cherry-Allen K, Xu J, Anaya M, Uehara S, Celnik P. Pushing the rehabilitation boundaries: hand motor impairment can be reduced in chronic stroke. Neurorehabilitation and neural repair. 2020 Aug;34(8):733-45. https://doi.org/10.1177/1545968320939563.
Senarath ID, Thalwaththe ST, Pathirage LP, Kularatne SA. Effectiveness of Four-week Task-Specific Functional Exercise protocol in chronic post-stroke upper limb management: A prospective interventional trial[Inpress]. https://doi.org/10.21203/rs.3.rs-2060418/v1.
Tarvonen-Schröder S, Niemi T, Koivisto M. Clinical and functional differences between right and left stroke with and without contralateral spatial neglect. Journal of Rehabilitation Medicine (Stiftelsen Rehabiliteringsinformation). 2020 Jul 1;52(6). https://doi.org/10.2340/16501977-2699.
Aftab A, Umar M, Irshaad A, Rashid H, Rauf R. Effectiveness of motor learning program and task specific training for the treatment of chronic stroke. Rehman Journal of Health Sciences. 2021 Dec 31;3(2):80-4. https://doi.org/10.52442/rjhs.v3i2.144.
Thimabut W, Terachinda P, Kitisomprayoonkul W. Effectiveness of a Soft Robotic Glove to Assist Hand Function in Stroke Patients: A Cross‐Sectional Pilot Study. Rehabilitation Research and Practice. 2022;2022(1):3738219. https://doi.org/10.1155/2022/3738219.
Bindawas SM, Mawajdeh HM, Vennu VS, Alhaidary HM. Functional recovery differences after stroke rehabilitation in patients with uni-or bilateral hemiparesis. Neurosciences Journal. 2017 Jul 1;22(3):186-91. https://doi.org/10.17712/nsj.2017.3.20170010.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Tameem T. Mayouf, Mohammed B. Al-Jubouri
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
