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

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.

The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial.

OBJECTIVE: To determine the effectiveness of neck and shoulder stretching exercises for relief neck pain among office workers. DESIGN: Randomized controlled trial. SETTING: An outpatient setting. PARTICIPANTS: A total of 96 subjects with moderate-to-severe neck pain (visual analogue score ⩾5/10) for ⩾3 months. INTERVENTIONS: All participants received an informative brochure indicating the proper position and ergonomics to be applied during daily work. The treatment group received the additional instruction to perform neck and around shoulder stretching exercises two times/day, five days/week during four weeks. MAIN OUTCOMES: Pain, neck functions, and quality of life were evaluated at baseline and week 4 using pain visual analogue scale, Northwick Park Neck Pain Questionnaire, and Short Form-36, respectively. RESULTS: Both groups had comparable baseline data. All outcomes were improved significantly from baseline. When compared between groups, the magnitude of improvement was significantly greater in the treatment group than in the control group (-1.4; 95% CI: -2.2, -0.7 for visual analogue scale; -4.8; 95% CI: -9.3, -0.4 for Northwick Park Neck Pain Questionnaire; and 14.0; 95% CI: 7.1, 20.9 for physical dimension of the Short Form-36). Compared with the patients who performed exercises <3 times/week, those who exercised ⩾3 times/week yielded significantly greater improvement in neck function and physical dimension of quality of life scores (p = 0.005 and p = 0.018, respectively). CONCLUSION: A regular stretching exercise program performed for four weeks can decrease neck and shoulder pain and improve neck function and quality of life for office workers who have chronic moderate-to-severe neck or shoulder pain.