Augmented visual feedback after stroke: a creative arts-in-health feasibility study

People after stroke lose accurate movement partly due to weakness, but this is compounded by poor sensory feedback. Furthermore, motivation and engagement can impact participation in rehabilitation. To address these barriers to recovery, a novel theatrical effects program called Proximity, which provided augmented visual feedback, was set up in a stroke inpatient rehabilitation ward with a cross-disciplinary team of dancers, designers and clinicians. The overall aim of the study was to evaluate the safety, feasibility and acceptability of the program, as well as to explore potential benefits.

This exploratory feasibility study included 12 stroke and brain injury survivors and employed a mixed-methods, participatory action approach - collecting feasibility and acceptability data alongside semi-structured interviews, using an interpretive phenomenological analysis. Five different effects were adapted for Proximity: Clinical, comprising real-time screen displays with special effects to augment the life-size video images of the participants as they moved in front of the camera.

Eleven of the 12 participants reported benefits, and this was supported by the observing clinicians. The theatre-based set-up was intensive and required considerable space. The effects enabled participants, firstly, to see for themselves what they were or were not doing in their postures and movements, and secondly, to immediately self-generate and evaluate changes in performance. In turn, this appeared to enhance agency, curiosity and enjoyment. This change in atmosphere - from remedial to creative exploration - was an unexpected but welcome experience for the cross-disciplinary team and reflects contemporary thinking in the arts/health nexus.

The clinical arts-in-health program warrants further investigation using simplified equipment, under a combination of arts‑in‑health and clinical trial conditions.