Effects of the powerball® system on muscle strength, coordination, fatigue, functionality and quality of life in people with multiple sclerosis. A randomized clinical trial.
Aitor Blázquez-Fernández, Gemma López-Hazas-Jiménez, Diego Fernández-Vázquez and 5 others
PMID 38431591WHAT IT FOUND
Adding PowerBall to physiotherapy did not improve grip strength, the main outcome, versus physiotherapy alone in people with multiple sclerosis.
Coordination improved in both groups, so adding it did not show a clear benefit.
Key findings
01Grip strength, the study's main outcome, did not differ between groups, and strength, pinch, fatigue, self-reported manual dexterity and quality-of-life scores did not change significantly within either group.
02The only significant within-group changes were on the Box and Block Test. The group receiving conventional physiotherapy plus PowerBall improved on both sides, and the conventional physiotherapy-only group also improved.
03The group receiving conventional physiotherapy plus PowerBall had 100% adherence, rated satisfaction 89.10 out of 100, and reported no adverse effects.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study analysed 25 participants, which is small for detecting differences. The primary outcome was null, and the between-group analysis found no significant differences for any outcome. The only positive signals were within-group changes on the Box and Block Test, and the control group also improved, so conventional therapy, practice or learning cannot be separated from the device. Participants came from two MS associations and had EDSS scores of 2 to 7, upper-limb tone not greater than 2, and muscle balance of at least 3, so results may not apply to people with more severe upper-limb weakness. The PowerBall protocol was supervised by a physiotherapist, so it does not show whether a home-based unsupervised programme would work. The study did not control the exercise intensity of the PowerBall, and rest periods were not set at 3 minutes or longer. The groups differed at baseline: the PowerBall group was older, had longer disease duration and more progressive MS.
The easy way to misread this
Do not read the Box and Block Test changes as proof that PowerBall improves coordination. The between-group analysis found no significant differences for any outcome, including grip strength, and the physiotherapy-only group also improved on the same test.