Art skill-based rehabilitation training for upper limb sensorimotor recovery post-stroke: A feasibility study

Abstract

Objective The objective of this study was to assess the feasibility of delivering Art skill-based Rehabilitation Training (ART), a novel upper limb motor training program, to patients with stroke as an adjunct to standard care in an inpatient setting. Design Feasibility study. Setting Inpatient stroke rehabilitation unit at a university hospital. Participants Thirty-eight patients admitted to a stroke rehabilitation unit with upper limb motor impairment were enrolled in the ART program facilitated by trained non-healthcare professionals between December 2017 and June 2021. Intervention The ART program included nine, one-hour sessions of supervised tracing and freehand drawing tasks completed with both hands. This program was intended to be delivered at a frequency of three times per week over a duration of 3 weeks or for the length of inpatient stay. Main outcome measures Feasibility outcomes included ART program adherence, acceptability, and safety. Results Thirty-two (84%) participants with subacute stroke completed the ART program and 30 (79%) were included in the study analysis. Participants completed 93–100% of the ART tasks in a median [IQR] of 8 [6–10] ART sessions over a median [IQR] duration of 15 [7–19] days. ART program facilitators effectively provided upper limb assistance to patients with more severe upper limb impairments. Adherence and acceptability were high and no study-related adverse events occurred. Conclusion The ART program was feasible to deliver and highly acceptable to patients with stroke. Further research is warranted to explore the impact of ART on upper limb sensorimotor function and use.

A scoping review of the use of creative activities in stroke rehabilitation

“…Among the included studies, 11 categorized the interventions under the domain of Art Therapy, 18,19,[24][25][26][27][28][29][30][31][32] while six studies are categorized under Occupational Therapy. 10,17,[20][21][22][23] These creative activity interventions are also named "creative art-based activities," "group interactive art therapy," "visual arts", "handicraft activities," "handicraft training," or "manual training."…”

“…Implementation unit: In Art Therapy, nine studies reported units of implementation for creative activities, with 63.6% (n = 11) were group-based 19,[25][26][27][28][29][30] and 18.2% (n = 11) were individual-based. 18,31 In Occupational Therapy, only three studies reported the implementation unit, with 33.3% (n = 6) were group-based 10,23 and 16.7% (n = 6) were individualbased. 21 These diverse approaches are influenced by various factors, such as research objectives, participant needs, and research feasibility.…”

“…Implementer: The implementers of creative activities in the field of Art Therapy can be art professionals or healthcare personnel without art background; 54.5% (n = 11) studies in Art Therapy have reported the involvement of individuals with an artistic background in the intervention implementation, [26][27][28][29][30][31] while 27.3% (n = 11) of the studies conducted the intervention solely with non-artistic background individuals. 19,25,32 All creative activities in the Occupational Therapy are implemented by rehabilitation therapists, physicians, or nurses without an artistic background.…”

“…Activities and Materials: Six studies chose a single form of activity for intervention, 18,20,23,24,31,32 and 11 studies combined multiple forms and materials for intervention. 10,17,19,21,22,[25][26][27][28][29][30] The selection of activities and materials was based on the interests and abilities of the participants.…”

“…Tasks and goals setting: Creative activities in Art Therapy, 54.5% (n = 11) did not set specific tasks for participants, 19,[24][25][26][27]32 and researchers allowed participants to engage in free creative expression based on materials; 36.4% (n = 11) set goals and tasks for the participants. 18,28,29,31 In Occupational Therapy, 33.3% (n = 6) did not set specific tasks, 10,23 while 16.7% (n = 6) set individualized tasks, with the main purpose of exercising limb function. 22 Outcomes of interest: The included studies focused on outcomes related to the mental health, physical health, and overall well-being of stroke patients.…”