Traditional umbrella painting activity improved upper extremity function and decreased depression in stroke survivors in Northern Thailand

Abstract

Background: Upper extremity (UE) dysfunction and depression often occur after a stroke. Strategies to promote UE function and reduce depression require task-related training. Objectives: This study aimed to investigate the effectiveness of conventional rehabilitation combined with traditional umbrella painting activity on UE function and depression in stroke survivors. Materials and methods: Twenty-two participants from rehabilitation units in Chiang Mai province, northern Thailand, were recruited according to the inclusion criteria and divided into experimental and control groups of 11 each. The experimental group received conventional rehabilitation combined with traditional umbrella painting activity for 140 minutes a day, three days a week, for a period of eight weeks, while the control group received conventional rehabilitation alone for the same amount of time. The instruments used were: 1) the Functional Test for Hemiplegic Upper Extremity (FTHUE) - Thai version; and 2) the Patient Health Questionnaire (PHQ-9)-Thai version. Statistics used were the Wilcoxon Signed Ranks test and the Mann-Whitney U test. Results: The UE function was significantly higher at the post-test than at the pretest (p<0.004) with a large effect size (d=1.59), and depression was significantly reduced at the post-test compared to the pre-test (p<0.003) with a large effect size (d=1.62), whereas the control group did not change. However, the function of UE and depression in these participants were not significantly different between the two groups both before and after the intervention (p<0.05). Conclusion: Findings indicate that conventional rehabilitation combined with traditional umbrella painting activity appears to be more effective for improving UE function and decreasing depression in stroke survivors than conventional rehabilitation alone. This can be an alternative treatment for occupational therapists in their clinical practices.