Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study
Abstract Background Transcranial magnetic stimulation (TMS) treatments have shown promise in improving arm recovery in stroke patients. Currently, little is known about patients’ experiences with repetitive TMS treatment, and this lack of knowledge may affect optimal implementation in clinical pract...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12883-020-01936-5 |
| _version_ | 1818436752515268608 |
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| author | Eline CC van Lieshout Lilliane D Jacobs Maike Pelsma Rick M Dijkhuizen Johanna MA Visser-Meily |
| author_facet | Eline CC van Lieshout Lilliane D Jacobs Maike Pelsma Rick M Dijkhuizen Johanna MA Visser-Meily |
| author_sort | Eline CC van Lieshout |
| collection | DOAJ |
| description | Abstract Background Transcranial magnetic stimulation (TMS) treatments have shown promise in improving arm recovery in stroke patients. Currently, little is known about patients’ experiences with repetitive TMS treatment, and this lack of knowledge may affect optimal implementation in clinical practice. The aim of this explorative study was to gain insight in the perceived effects and experiences of the design and delivery of a rTMS treatment for upper limb recovery from the perspectives of stroke patients. Methods This qualitative study was conducted as part of a randomized controlled trial (RCT) in a specialized rehabilitation center. Data were collected through face-to-face semi-structured interviews with 13 stroke patients who completed a 10-day rTMS intervention for upper limb recovery. The interviews were recorded, transcribed verbatim and analyzed using thematic analysis. Results The major themes that emerged from the patients’ feedback were the following: positive experiences of the treatment (experienced physical effects, comfort, therapeutic relationship, receiving information, learning about the brain, no burden of added rTMS treatment session, no unpleasant aspects), concerns (effects of stimulation of the brain, equipment, logistics), general experience of recovery, experienced psychological effects (grateful, sense of purpose, recovery as extra motivation to exercise, disappointment and hope of group allocation), and motivation to participate (personal benefit and cognitions, altruism). Important components related to the positive experience of the design and delivery of the treatment included comfort (i.e. moment of relaxation) and the sensation of a painless treatment without side-effects. Key concerns included uncertainty and anxiety about possible negative consequences and group allocation. Conclusions This study demonstrates that rTMS is well accepted by stroke patients with an upper limb paresis. Besides the expectation of a therapeutic benefit, the patients reported various psychological effects. Positive experiences, such as the provision of a short moment of relaxation each day, could have practical implications for clinical stroke rehabilitation settings aimed at improving patient satisfaction. Explanation about and feedback from routine motor recovery progression monitoring at fixed times post-stroke is also valued by patients. Negative emotions may be limited or avoided by transparent and recurrent information delivery in future trials. |
| first_indexed | 2024-12-14T17:13:46Z |
| format | Article |
| id | doaj.art-2950a1e7fa4345dd9bfa68131f19f680 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-14T17:13:46Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-2950a1e7fa4345dd9bfa68131f19f6802022-12-21T22:53:28ZengBMCBMC Neurology1471-23772020-10-0120111310.1186/s12883-020-01936-5Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative studyEline CC van Lieshout0Lilliane D Jacobs1Maike Pelsma2Rick M Dijkhuizen3Johanna MA Visser-Meily4Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht UniversityCenter of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, and De Hoogstraat RehabilitationCenter of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, and De Hoogstraat RehabilitationBiomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht UniversityCenter of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, and De Hoogstraat RehabilitationAbstract Background Transcranial magnetic stimulation (TMS) treatments have shown promise in improving arm recovery in stroke patients. Currently, little is known about patients’ experiences with repetitive TMS treatment, and this lack of knowledge may affect optimal implementation in clinical practice. The aim of this explorative study was to gain insight in the perceived effects and experiences of the design and delivery of a rTMS treatment for upper limb recovery from the perspectives of stroke patients. Methods This qualitative study was conducted as part of a randomized controlled trial (RCT) in a specialized rehabilitation center. Data were collected through face-to-face semi-structured interviews with 13 stroke patients who completed a 10-day rTMS intervention for upper limb recovery. The interviews were recorded, transcribed verbatim and analyzed using thematic analysis. Results The major themes that emerged from the patients’ feedback were the following: positive experiences of the treatment (experienced physical effects, comfort, therapeutic relationship, receiving information, learning about the brain, no burden of added rTMS treatment session, no unpleasant aspects), concerns (effects of stimulation of the brain, equipment, logistics), general experience of recovery, experienced psychological effects (grateful, sense of purpose, recovery as extra motivation to exercise, disappointment and hope of group allocation), and motivation to participate (personal benefit and cognitions, altruism). Important components related to the positive experience of the design and delivery of the treatment included comfort (i.e. moment of relaxation) and the sensation of a painless treatment without side-effects. Key concerns included uncertainty and anxiety about possible negative consequences and group allocation. Conclusions This study demonstrates that rTMS is well accepted by stroke patients with an upper limb paresis. Besides the expectation of a therapeutic benefit, the patients reported various psychological effects. Positive experiences, such as the provision of a short moment of relaxation each day, could have practical implications for clinical stroke rehabilitation settings aimed at improving patient satisfaction. Explanation about and feedback from routine motor recovery progression monitoring at fixed times post-stroke is also valued by patients. Negative emotions may be limited or avoided by transparent and recurrent information delivery in future trials.http://link.springer.com/article/10.1186/s12883-020-01936-5StrokeNon-invasive brain stimulationTMSQualitative studyUpper limb |
| spellingShingle | Eline CC van Lieshout Lilliane D Jacobs Maike Pelsma Rick M Dijkhuizen Johanna MA Visser-Meily Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study BMC Neurology Stroke Non-invasive brain stimulation TMS Qualitative study Upper limb |
| title | Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study |
| title_full | Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study |
| title_fullStr | Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study |
| title_full_unstemmed | Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study |
| title_short | Exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery: a qualitative study |
| title_sort | exploring the experiences of stroke patients treated with transcranial magnetic stimulation for upper limb recovery a qualitative study |
| topic | Stroke Non-invasive brain stimulation TMS Qualitative study Upper limb |
| url | http://link.springer.com/article/10.1186/s12883-020-01936-5 |
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