Effects of visual arts-based interventions on physical and psychosocial outcomes of people with stroke: A systematic review and meta-analysis

Background: Stroke is the leading cause of disability worldwide. People with stroke face a variety of physical and psychosocial issues as a result of their disability. Visual arts-based interventions refer to providing participants with structured visual arts-based activities and non-judgemental and safe environments to improve their health-related outcomes. Recent evidence showed that visual arts-based interventions had the potential to promote the holistic well-being of people with stroke. However, evidence of the effects of visual arts-based interventions on physical and psychosocial outcomes of people with stroke is limited. Objective: (1) To investigate the effects of visual arts-based interventions on physical and psychological outcomes in people with stroke, and (2) to identify the effective regimen of visual arts-based interventions to improve physical and psychosocial outcomes in people with stroke. Design: A systematic review and meta-analysis. Setting: Not applicable. Participants: 483 people with stroke were included in this review. Methods: Fourteen English and five Chinese databases were searched from the date of their inception to February 2022 using keywords based on the Population, Intervention, Comparison, Outcome, and Study framework. Two reviewers independently assessed trial eligibility and risk of bias 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. Narrative synthesis was performed when meta-analysis was inappropriate to conduct. The Grading of Recommendations, Assessment, Development, and Evaluation Approach was used to assess the certainty of evidence. Results: Seven randomised controlled trials were included. A meta-analysis reported statistically significant effects of visual arts-based interventions on depressive symptoms (Standardized mean difference [SMD]: −1.14, 95% confidence interval [CI]: −1.67 to −0.61; three studies; moderate quality of evidence), ...