Enhancing Stroke Rehabilitation Through Structured Volunteer-Delivered Arts-Based Activity: a Pilot Study

Abstract

Background Upper Limb (UL) motor impairment affects 50-80% of stroke survivors acutely, with up to 50% reporting continued disability months or years post-rehabilitation. Effective recovery relies on intensive, repetitive, and meaningful task-oriented practice; however, studies report people with stroke are often engaged in minimal upper limb-specific training in rehabilitation. Volunteers’ role in healthcare has typically been limited to non-clinical support activities, but their potential role in stroke rehabilitation remains largely unexplored. Although the impact of art-based interventions, on psychological well-being has been well-studied, there is a significant gap in research exploring its role in enhancing physical rehabilitation outcomes recovery post-stroke. This study assesses the feasibility of a volunteer-delivered Art-Based Rehabilitation Training (ART) program in an inpatient stroke rehabilitation setting. Methods This pilot randomized controlled trial involved 28 stroke survivors in an acute rehabilitation setting. Participants were assigned to either the ART program or a self-guided art booklet. Volunteers, mostly university students were trained to deliver the ART program, with fidelity assessed during sessions. We evaluated feasibility measures: recruitment, and retention of the participants (i.e. ART intervention delivery and data collection), along with the feasibility of volunteer training, and their fidelity to the program. Results Recruitment of 28 participants over nine months was slightly below the target of 30. 78.5% of participants in the experimental group received at least 2 sessions of ART intervention and 42.8% completed all 23 ART tasks falling short of the hypothesized 90%. 67.8% of participants from both groups completed pre-post clinical and patient engagement measures and completed some intervention, also below the hypothesized 90%. Among 5 volunteers assessed, all the volunteers (100%) achieved the 80% threshold of performance, although additional training in physical assistance and verbal cues was needed. Conclusion The study did not meet feasibility targets for recruitment, intervention completion, and outcome measurement. Despite the challenges, the study demonstrated that volunteers could be trained to deliver ART intervention. A future study will need to carefully plan for system-level factors such as shortened length of stay and acuity of patient participants in rehabilitation.