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 includes 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 which are crucial to the future effective implementation of these tools in practice.

Keywords:

• Non-invasive brain stimulation
• robot
• rehabilitation technology
• mixed methods analysis
• perceptions
• cerebrovascular accident

Acknowledgements

We would like to thank the participants and their carers for their support for this research. We also would like to thank the following: (1) REACH HIGH Scholars Program – The research work disclosed in this publication is partially funded by the REACH HIGH Scholars Program – Post-Doctoral Grants. The project is part-financed by the European Union, Operational Program II – Cohesion Policy 2014 -2020 Investing in human capital to create more opportunities and promote the wellbeing of society – European Social Fund; (2) Strategic Educational Pathways Scholarship Scheme (Malta) – The scholarship is part-financed by the European Union – European Social Fund and (3) University of Southampton for funding this research project.