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Research article
Anne Visser-Meily
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6444-4733
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Background: Transcranial magnetic stimulation (TMS) treatments have shown promise in improving arm recovery in stroke patients. Currently, little is known about patients’ experiences with 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 TMS 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 TMS 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: physical and psychological experienced effects (receiving something, sense of purpose, and recovery as a motivator), positive experiences (comfort, power of communication and information, interest and curiosity, no burden, no unpleasant aspects), concerns (uncertainty, equipment, logistics), and likeliness to participate in an RCT (personal drive and beliefs, and 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 TMS 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 clear, transparent and recurrent information delivery in future trials.
Trial registration: NL5952 Registered November 28, 2016.
Keywords
Stroke, Non-invasive brain stimulation, TMS, Qualitative study, Upper limb
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CURRENT STATUS: Published
View the published article at BMC Neurology.
No community comments so far
Editorial decision: Accept
On 21 Sep, 2020
Editor assigned
On 18 Sep, 2020
Submission checks complete
On 17 Sep, 2020
Editor invited
On 17 Sep, 2020
No comments provided
Review #1 received
Received 02 Sep, 2020
Reviewers invited
Invitations sent on 21 Aug, 2020
Reviewer #1 agreed
On 21 Aug, 2020
Reviewer #2 agreed
On 21 Aug, 2020
Editor assigned
On 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Version 1
Posted 18 Jun, 2020
No comments provided
Editorial decision: Major revision
On 25 Jul, 2020
Review #1 received
Received 03 Jul, 2020
Review #2 received
Received 03 Jul, 2020
Reviewer #1 agreed
On 21 Jun, 2020
Reviewer #2 agreed
On 21 Jun, 2020
Reviewers invited
Invitations sent on 20 Jun, 2020
Editor assigned
On 15 Jun, 2020
First submitted
On 14 Jun, 2020
Submission checks complete
On 14 Jun, 2020
Editor invited
On 14 Jun, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurology
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Neurology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Anne Visser-Meily
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6444-4733
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Neurology.
No community comments so far
Editorial decision: Accept
On 21 Sep, 2020
Editor assigned
On 18 Sep, 2020
Submission checks complete
On 17 Sep, 2020
Editor invited
On 17 Sep, 2020
No comments provided
Review #1 received
Received 02 Sep, 2020
Reviewers invited
Invitations sent on 21 Aug, 2020
Reviewer #1 agreed
On 21 Aug, 2020
Reviewer #2 agreed
On 21 Aug, 2020
Editor assigned
On 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Version 1
Posted 18 Jun, 2020
No comments provided
Editorial decision: Major revision
On 25 Jul, 2020
Review #1 received
Received 03 Jul, 2020
Review #2 received
Received 03 Jul, 2020
Reviewer #1 agreed
On 21 Jun, 2020
Reviewer #2 agreed
On 21 Jun, 2020
Reviewers invited
Invitations sent on 20 Jun, 2020
Editor assigned
On 15 Jun, 2020
First submitted
On 14 Jun, 2020
Submission checks complete
On 14 Jun, 2020
Editor invited
On 14 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Neurology.
Background: Transcranial magnetic stimulation (TMS) treatments have shown promise in improving arm recovery in stroke patients. Currently, little is known about patients’ experiences with 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 TMS 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 TMS 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: physical and psychological experienced effects (receiving something, sense of purpose, and recovery as a motivator), positive experiences (comfort, power of communication and information, interest and curiosity, no burden, no unpleasant aspects), concerns (uncertainty, equipment, logistics), and likeliness to participate in an RCT (personal drive and beliefs, and 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 TMS 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 clear, transparent and recurrent information delivery in future trials.
Trial registration: NL5952 Registered November 28, 2016.
This is a list of supplementary files associated with this preprint. Click to download.
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