Creative art therapy to enhance rehabilitation for stroke patients: a randomized controlled trial

TLDR

The study aimed to evaluate whether adding creative art therapy to standard physical therapy improves cognition, physical function, psychological well‑being, and quality of life in stroke patients. A randomized controlled trial with blinded assessment enrolled 118 stroke patients aged ≥ 50 who received standard physical therapy; the intervention group additionally received twice‑weekly creative art therapy for four weeks, with outcomes measured using validated cognitive, anxiety/depression, functional, and quality‑of‑life scales. Compared with physical therapy alone, the art‑therapy group showed significantly greater reductions in depression, improvements in physical function and quality of life, and high patient satisfaction, while both groups improved cognition, function, and mood over time.

Abstract

Objective: To examine the efficacy of creative art therapy plus conventional physical therapy, compared with physical therapy only, in increasing cognitive ability, physical functions, psychological status and quality of life of stroke patients. Design: Randomized controlled trial with blinded assessor. Setting: An in-patient setting Participants: One hundred and eighteen stroke patients aged ⩾50 years who could communicate verbally. Interventions: All participants received conventional physical therapy five days per week. An intervention group received additional creative art therapy, twice a week for four weeks, in a rehabilitation ward. Main outcomes: Cognitive function, anxiety and depression, physical performance and quality of life were measured with the Abbreviated Mental Test, the Hospital Anxiety and Depression Scale, the modified Barthel Index scale and the pictorial Thai Quality of Life questionnaire, respectively. Results: Mean differences for the intervention group were significantly greater than the control group for depression (−4.5, 95% CI −6.5, −2.5, p< 0.001), physical functions (1.2, 95% CI 0.1, 2.3, p= 0.043) and quality of life (8.9, 95% CI 3.8, 13.8, p< 0.001).Compared with baseline measures, both groups experienced improved cognition, physical functions and quality of life and reduced anxiety and depression. Eighty-five percent of patients were satisfied with the creative art therapy and most reported improved concentration (68.5%), emotion (79.6%), self-confidence (72.2%) and motivation (74.1%). Conclusion: Creative art therapy combined with conventional physical therapy can significantly decrease depression, improve physical functions and increase quality of life compared with physical therapy alone.