A qualitative study exploring views and experiences of people with stroke undergoing transcranial direct current stimulation and upper limb robot therapy

Abstract

Background: Neurorehabilitation technologies used mainly in research such as robot therapy (RT) and transcranial direct current stimulation (tDCS) can promote upper limb motor recovery after stroke. Understanding the feasibility and efficacy of stroke rehabilitation technologies for upper limb impairments is crucial for effective implementation in practice. Small studies have explored views of RT by people with stroke; however experiences of people receiving tDCS in combination with RT have never been explored. Objective: To explore views and experiences of people with sub-acute and chronic stroke that had previously taken part in a randomised controlled trial involving tDCS and RT for their impaired upper limb. Methods: An interview study including a mixed method approach of open and closed questions. Face-to-face interviews were audio recorded. Open-ended question responses were transcribed and analyzed using thematic analysis; closed questions were analyzed using descriptive analysis. Results: Participants felt that RT was enjoyable (90%) and beneficial for their affected arm (100%). From the open question data, it was found that the intervention was effective for the impaired arm especially in the sub-acute stage. Main reported concerns were that tDCS caused painful, itching and burning sensations and RT was sometimes tiring and difficult. Participants recommended that future research should focus on designing a more comfortable method of tDCS and develop a robot that promotes hand movements. Conclusions: This study provides new knowledge about the benefits and barriers associated with these technologies are crucial to the future effective implementation of these tools in practice.

Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study

“…activity and participation). These outcomes are contrary to the only (known) previous qualitative study in the eld of non-invasive brain stimulation of Triccas et al (2018) (14), where patients felt that receiving tDCS and robotic therapy was especially effective for their strength and tightness in the affected upper limb. This discrepancy in results could be explained by the design of the studies.…”

“…One of the main concerns were feelings of anxiety about the 'electricity' within the brain and uncertainty about possible negative consequences. This nding is consistent with ndings from Triccas et al (2018) (14) who reported that patients undergoing tDCS treatment had concerns about the 'electricity' applied via the electrodes, and were insecure about possible negative consequences. Some patients found the stimulation pulses annoying.…”

“…Some patients found the stimulation pulses annoying. The somatic scalp sensation due to TMS-induced activation of super cial nerves or muscles might feel different for each person (29) The reported annoyance of the TMS pulses, however, appear less severe compared to the reported itchy, painful, and burning sensations after tDCS (14). The therapeutic potential of TMS is not limited to stroke patients, as e cacy, tolerability and safety have also been demonstrated for other neurological and psychiatric disorders.…”

“…of 21 patients who underwent tDCS combined with robotic therapy for upper limp recovery, revealed that the therapy was generally experienced as effective and comfortable (14). However, some patients also reported discomfort (e.g.…”

Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study

“…This confirms the good tolerance for this type of treatment. An interview study that explored the views and experiences of 21 patients who underwent tDCS combined with robotic therapy for upper limp recovery, revealed that the therapy was generally experienced as effective and comfortable [ 14 ]. However, some patients also reported discomfort (e.g.…”