Abstract WMP22: Effects Of Visual Arts-based Interventions On Physical And Psychosocial Outcomes Among Stroke Survivors: A Systematic Review And Meta-analysis

Abstract

Background: Visual arts-based interventions may have potential effects on post-stroke physical and psychosocial outcomes, but the current evidence is unclear. Objectives: (1)To determine the effects of visual arts-based interventions on physical and psychosocial outcomes among stroke survivors, and (2)to identify the best practice of visual arts-based interventions that have optimal effects on physical and psychosocial outcomes among stroke survivors. Methods: Seventeen databases were searched. Two reviewers independently screened for the eligible studies, appraised methodological quality assessment, and extracted data. Methodological quality was assessed using the revised Cochrane risk of bias tool for randomised trials. Meta-analysis was conducted using Review Manager 5.4, and narrative synthesis was performed if there was insufficient data for meta-analysis. Grading of Recommendations Assessment, Development and Evaluation was adopted to assess the certainty of evidence. Results: Seven studies were included in this review. The pooled results suggested that visual arts-based interventions had significant effects on activities of daily living (SMD: 0.96, 95%CI: 0.24 to 1.69, p =0.009, I 2 =87%), upper limb function (SMD: 0.83, 95%CI: 0.42 to 1.24, p <0.0001; I 2 =6%), and depressive symptoms (SMD: -1.14, 95%CI: -1.67 to -0.61, p <0.0001, I 2 =70%). While the effect on hand function (SMD: 0.47, 95% CI: -0.43 to 1.37, p =0.31; I 2 =82%) and anxiety (SMD: -0.80, 95%CI: -1.71 to 0.11, p =0.08; I 2 =86%) were non-significant. Narrative synthesis showed that the effects of visual arts-based intervention on self-efficacy, social participation, and quality of life were uncertain. This review also found that five non-visual art activities with education, task orientation, sharing, feedback, and support as parts of the component of visual arts-based interventions might contribute to the benefits of physical and psychosocial outcomes after stroke. Conclusion: This review found that stroke survivors may benefit from visual arts-based interventions to improve physical and psychosocial outcomes. However, the quality of evidence was relatively low, further rigorous randomised controlled trials are recommended to strengthen the current evidence.