Experiences from a multimodal rhythm and music-based rehabilitation program in late phase of stroke recovery – A qualitative study

Abstract

BackgroundRehabilitative stroke interventions based on principles of multimodal stimulation have the potential to profoundly affect neuroplastic processes beyond the sub-acute phase. In order to identify important core mechanisms, there is a need to explore how interventions that combine physical, social, sensory, and cognitively challenging activities are perceived and experienced by the participants. This qualitative study, based on an interpretive interactionist perspective, explored the experiences of stroke survivors who participated in a group-based multimodal rehabilitation program based on rhythm and music.Methods and findingsWithin four weeks after completion of the multimodal rehabilitation program, face-to-face semi-structured interviews were conducted on a single occasion with 15 purposively selected individuals (mean age 65, 8 men, 7 women). The interview duration was between 13 and 44 minutes. Qualitative content analysis with an inductive approach was used to analyze data. Three categories were identified, each containing several sub-categories: To be intellectually challenged (energy-consuming activity and coordinating multiple input and output), Perceived therapeutic benefits (motor skills, cognitive skills, emotional and psychological responses), and Pros and cons with social integration (fellowship, competing with others, and instructor characteristics). From these categories, an overall theme was derived: The multifaceted layers of multimodal stimulation. Enjoying music, being part of a group with peers, a skilled instructor, and being able to manage the challenging movements, were related to positive experiences. In contrast, negative experiences were associated with not being able to perform the exercises, and with group members who dominated the conversational space.ConclusionThis study shows that access to a multimodal rehabilitation program with rhythm and music as operating ingredients may contribute to positive experiences for many individuals in a late phase after stroke in terms of motor, cognitive, as well as emotional enhancements. Important components were the music, the social interaction, the challenging exercises, and the skilled instructor.

Group-based music intervention in Parkinson’s disease – findings from a mixed-methods study

“…This is in agreement with qualitative studies on stroke survivors. 34,35 Having fun together as a group in a stimulating activity may indeed add value in terms of peer support, motivation through group accountability, and social interactions that may have effects above and beyond the intervention itself. 36…”

Integrating a gait analysis test in hospital rehabilitation: A service design approach

“…Is there a lack of certain professionals in the macro-service? In this regard, qualitative studies can provide a meaningful view of the perspectives, opinions, and priorities of the users (patients, healthcare professionals, and proxies) and reveal the underlying conceptual structure of their existing and/or desired interactions [34–36].…”

Effects of horse-riding therapy and rhythm and music-based therapy on functional mobility in late phase after stroke

“…In view of participants' own experiences of these multimodal interventions, both encounter enriching experiences that may have positive impacts on their emotional and physical state (Pohl et al, 2018a;Pohl et al, 2018b). The in-depth interviews indicate that the social interplay and the practical activities were considered as equally important among the participants themselves (Pohl et al, 2018b).…”

“…H-RT stimulates a similar rhythmical and repetitive pelvic movement of the rider as normal gait, which can provide important motor and sensory stimulus in persons with reduced mobility (Ribeiro et al, 2018). R-MT on the other hand, is based on exercises that challenge cognitive function and sensorimotor control, with the aim to improve coordination, mobility and cognition in patients with neurological deficits through the use of rhythm and music (Pohl et al, 2018a). The explicit motor component of H-RT may have resulted in the immediate and more pronounced effects of this intervention with regard to gait and functional mobility (Stergiou et al, 2017).…”