Art participation for psychosocial wellbeing during stroke rehabilitation: a feasibility randomised controlled trial

Citation

Morris JH, Kelly C, Joice S, Kroll T, Mead G, Donnan PT, Toma M & Williams B (2019) Art participation for psychosocial wellbeing during stroke rehabilitation: a feasibility randomised controlled trial. Disability and Rehabilitation, 41 (1), pp. 9-18. https://doi.org/10.1080/09638288.2017.1370499

Abstract
Purpose: To examine the feasibility of undertaking a pragmatic single-blind randomised controlled trial (RCT) of a visual arts participation programme to evaluate effects on survivor wellbeing within stroke rehabilitation.  Methods: Stroke survivors receiving in-patient rehabilitation were randomised to receive eight art participation sessions (n = 41) or usual care (n = 40). Recruitment, retention, preference for art participation and change in selected outcomes were evaluated at end of intervention outcome assessment and three-month follow-up.  Results: Of 315 potentially eligible participants 81 (29%) were recruited. 88% (n = 71) completed outcome and 77% (n = 62) follow-up assessments. Of eight intervention group non-completers, six had no preference for art participation. Outcome completion varied between 97% and 77%. Running groups was difficult because of randomisation timing. Effectiveness cannot be determined from this feasibility study but effects sizes suggested art participation may benefit emotional wellbeing, measured on the positive and negative affect schedule, and self-efficacy for Art (d = 0.24–0.42).  Conclusions: Undertaking a RCT of art participation within stroke rehabilitation was feasible. Art participation may enhance self-efficacy and positively influence emotional wellbeing. These should be outcomes in a future definitive trial. A cluster RCT would ensure art groups could be reliably convened. Fewer measures, and better retention strategies are required.  Implications for Rehabilitation  This feasibility randomised controlled trial (RCT) showed that recruiting and retaining stroke survivors in an RCT of a visual arts participation intervention within stroke rehabilitation was feasible.  Preference to participate in art activities may influence recruitment and drop-out rates, and should be addressed and evaluated fully.  Art participation as part of rehabilitation may improve some aspects of post-stroke wellbeing, including positive affect and self-efficacy for art.   A future definitive cluster RCT would facilitate full evaluation of the value art participation can add to rehabilitation. 

Keywords
Stroke rehabilitation; art; emotions; affect; wellbeing;

Journal
Disability and Rehabilitation: Volume 41, Issue 1