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

Abstract

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.

HeART of Stroke: randomised controlled, parallel-arm, feasibility study of a community-based arts and health intervention plus usual care compared with usual care to increase psychological well-being in people following a stroke

“…The majority of people who took part in the HoS groups highly valued them, with many reporting increased confidence both within and outside the groups. The numbers who declined the intervention were similar to those reported in the Morris et al study 47 48. Study retention was good (with follow-up data available for 84% of participants) and high data completion rates (>80% for the candidate primary outcome measures).…”

“…Modifying the description of the HoS intervention, such as referring to it as ‘an opportunity to reconnect with and gain confidence in everyday life’, rather than calling it an arts intervention could be one way to enhance recruitment. Morris et al suggested that provision of taster sessions may be another means of improving study enrolment, 48 although we note a risk of jeopardising equipoise or increasing the likelihood of resentful demoralisation. Additionally, we could extend the eligibility criteria by providing additional support so that those who require support with toileting needs could attend, although this would have cost implications.…”

“…This is the first study to formally test the feasibility of an arts and health intervention for people poststroke in the community. While there are two other RCTs of arts and health interventions in stroke,46–48 both of these involved inpatients in a rehabilitation setting rather than people living in the community. One involved a creative art intervention that, unlike HoS, was highly prescribed, making direct comparisons difficult.…”

“…The most common reason for people declining participation in the current study was because they felt the intervention “wasn’t for them”. Similarly Morris et al 48 reported that the majority of people who declined participation in their feasibility study of a visual arts participation programme did so because they were ambivalent about art participation. Modifying the description of the HoS intervention, such as referring to it as ‘an opportunity to reconnect with and gain confidence in everyday life’, rather than calling it an arts intervention could be one way to enhance recruitment.…”

“…They found improvements favouring the intervention group post-treatment in measures of mood, cognition, physical functioning and quality of life. Morris et al ’s47 48 UK randomised controlled feasibility study (n=81) compared an artist-delivered visual arts participation programme (up to eight sessions including individual and group delivery formats) with usual care. They concluded that the intervention was feasible to deliver and appeared to offer promise in the domains of emotional well-being and self-efficacy.…”