A randomised controlled trial of expressive arts-based intervention for young stroke survivors

Abstract

Background Stroke causes lasting brain damage that has numerous impacts on the survivor’s physical, psychosocial, and spiritual well-being. Young survivors (< 65 years old) tend to suffer more because of their longer overall survival time. Expressive arts-based intervention is considered a holistic approach for stroke rehabilitation because it allows participants to express their thoughts and emotions through the arts. The group environment also promotes mutual support among participants. The creative art-making process helps expand participants’ creativity and imagination as well as promote a sense of aesthetic appreciation. Previous studies have shown the effectiveness of the arts-based intervention in managing stroke and its psychosocial-spiritual comorbidities. Nevertheless, a systematic study has not been conducted, including in young survivors. This trial plans to investigate the effectiveness of an expressive arts-based intervention on bio-psychosocial-spiritual outcomes in young Chinese stroke survivors. Methods/design A single-blind, two-arm cluster randomised control trial with a waitlist control design will be adopted. One hundred and fifty-four stroke survivors, aged 18–64 years with modified Rankin Scale scores of 1–4, will be screened and randomised to either an expressive arts-based intervention group or a treatment-as-usual waitlist control group. The intervention group will receive a 90-min session once a week for a total of 8 weeks. All participants will be assessed three times: at baseline, 8 weeks, and 8 months after the baseline. Study outcomes include measures of depression and anxiety, perceived stress, perceived social support, hope, spiritual well-being, quality of life, salivary cortisol, blood pressure, and heart rate. Discussion This study is expected to contribute to the current knowledge on the effectiveness of an arts-based intervention on the holistic wellness of young stroke survivors. The findings will help stroke survivors and healthcare professionals make better choices in selecting practices that will yield maximum benefits, satisfaction, adherence, and sustainability. In addition, the examination of the relationships between bio-psychosocial-spiritual variables will help contribute to the development of holistic care for the survivors. Trial registration ClinicalTrials.gov, NCT03729648. Registered 31 October 2018 - Retrospectively registered, (329 words)

Are neuroaesthetic principles applied in art therapy protocols for neurorehabilitation? A systematic mini-review

“…Papers were classified by the type of arts used for rehabilitation: visual arts, music, arts in virtual reality, or therapy programs based on the combined use of various arts (visual arts, music, theater, dance, writing, etc.). Among the 26 studies, we found 8 quantitative studies (reported in Table 1 ), 13 qualitative studies (Carmi and Mashiah, 1996 ; Pachalska et al, 2008 ; Michaels, 2010 ; Beesley et al, 2011 ; Symons et al, 2011 ; Baumann et al, 2013 ; Vija and Lusebrink, 2014 ; Demers and McKinley, 2015 ; Morris et al, 2016 ; Sit et al, 2017 ; Smith et al, 2017 ; Vaudreuil et al, 2019 ), and 5 feasibility studies (Worthen-Chaudharia et al, 2013 ; Morris et al, 2014 ; Ellis-Hill et al, 2015 ; Cucca et al, 2018 ; Chan et al, 2021 ) ( Supplementary material ). We performed a risk of bias analysis on the quantitative studies shown in Figure 2 .…”

Evaluation of a community-based performance arts programme for people who have experienced stroke in the UK: protocol for the SHAPER-Stroke Odysseys study

“…12 Arts-based programmes (such as 'Stroke Odysseys (SO)' discussed below) are one such approach that shows promising results in enhancing the well-being, self-esteem, social life and rehabilitation experiences of patients with stroke. 13 Indeed, over the past decade, several studies conducted in this patient population have consistently shown a positive impact of different art modalities on psychological (eg, enhancement in confidence and a better sense of control), social (eg, increased social interactions and peer support) and functional (eg, improvement in physical abilities) outcomes. 12 Nonetheless, despite the growing body of research on the benefits of art interventions, the process of scaling-up these interventions, embedding them into healthcare and its associated challenges are not yet well established.…”

“…The evidence summarised above suggests that there is a need for more holistic rehabilitation programmes, especially non-pharmacological and non-invasive modalities, to address the psychosocial needs and improve the quality of life of stroke survivors 12. Arts-based programmes (such as ‘Stroke Odysseys (SO)’ discussed below) are one such approach that shows promising results in enhancing the well-being, self-esteem, social life and rehabilitation experiences of patients with stroke 13. Indeed, over the past decade, several studies conducted in this patient population have consistently shown a positive impact of different art modalities on psychological (eg, enhancement in confidence and a better sense of control), social (eg, increased social interactions and peer support) and functional (eg, improvement in physical abilities) outcomes 12…”

Complementary Medicine and Expressive Arts Therapy: Adjuvant for Recovery Following Neurosurgical Procedures

“…A study by Cheung and colleagues (2010) found that patients suffering from serious psychiatric illnesses experienced a decrease in psychiatric symptoms after engaging in a drama therapy program [ 27 ]. Storytelling as a component of a creative expression program (CrExp) improves memory and communication skills in patients with mild cognitive impairment (MCI) who are at risk for developing Alzheimer’s disease and dementia [ 28 ].…”