Music Upper Limb Therapy – Integrated (MULT-I) supports a positive transformation in sense of self post stroke: a thematic analysis

Abstract

Purpose

To understand how the experience of Music Upper Limb Therapy – Integrated (MULT-I) interconnects with the experience of stroke.

Methods

Thematic analysis of semi-structured interviews and video-recorded MULT-I sessions from a larger mixed-methods study. Thirty adults with post-stroke hemiparesis completed pre-intervention interviews, of whom fifteen participated in MULT-I. Thirteen of the participants in MULT-I completed post-intervention interviews.

Results

The experience of stroke was characterized by five themes: (1) sudden loss of functional abilities, (2) disrupted participation, (3) desire for independence, (4) emotional distress and the need for support, and (5) difficulty negotiating changes in sense of self. The experience of MULT-I was characterized by three themes: (1) MULT-I activated movement and empowered personal choice, (2) MULT-I created a safe place to process emotional distress and take on challenges, and (3) MULT-I fostered a sense of belonging and a positive transformation in sense of self. These themes combined create a framework which illustrates the process by which MULT-I addressed each challenge described by survivors of stroke, facilitating a positive transformation in sense of self.

Conclusion

MULT-I promotes physical, emotional, and social wellbeing following a stroke. This integrated approach supports a positive transformation in sense of self. These findings have implications for improving psychosocial well-being post stroke.

IMPLICATIONS FOR REHABILITATION

• The experience of stroke is characterized by disruptions in physical, emotional, and social well-being

• Survivors of stroke describe difficulty obtaining support for emotional distress and experience negative perceptions of their sense of self

• MULT-I addresses functional needs post stroke through motivating physical movement and participation, while also supporting autonomy and providing psychosocial support that facilitates a positive transformation in sense of self

Keywords:

• Stroke
• self
• experience
• upper limb rehabilitation
• music therapy

Acknowledgements

The authors are grateful for the contributions of Jessica Battaglia, OTR/L, Daniel Geller, EdD, MPH, OTRL/L, Marc Ross, MD, Adrian Christian, MD; Javier Urrutia, MA, MT-BC; and Zena Moore, MS for assisting with the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research is supported in part by a New York University Clinical Translational Science Award UL1TR000038 from the National Center for Advancing Translational Sciences (NCATS), F31NS127527 from the National Institute of Neurological Disorders and Stroke (NINDS), and U54NS081765, National Institutes of Health, and in part by grants from the GRAMMY Foundation® and the John and Jennifer Clay Foundation.