There are very few patients who can resist the power of a balloon. It seems they automatically hit it back when it comes directly to them or they lean forward and over to take a swipe when it doesn't.
A trial of a beach ball with helium did not offer sufficient results like the human air in a balloon. The best balloons I have encountered are the ones that come with the large rubber band that is usually tied to one end. I remove the rubber band and hit another therapist with it then blow up the balloon. We work on sitting and standing balance with and without UE support. Having one foot elevated on a stool while standing can increase the challenge for the patient and using a balloon in group activity seems paramount for success.
There have been times I feel like Oliver Sacks when working with some of the more lethargic and difficult-to-motivate patients. I simple blow up a balloon and the patients respond almost immediately by hitting it back or holding it, squeezing it and then letting it go. It is wonderful to see the response with a balloon when nothing else works.
Now all I need is my multi-colored wig, red bulbous nose and big purple shoes to match all the balloons I blow up. Maybe I would look like a Killer Klown from outer space (just in time for Halloween), but at least the patients would be moving more than they did before the introduction of balloons.