Adaptive Dance Activities for People With Stroke

Improving Participation in Stroke Survivors With Hemiparesis by Movement Improvisation Skill Building and Care Transition-friendly Adaptive Dance Activities: A Randomised Controlled Trial

The project will investigate the effects of a novel 12-week Movement Improvisation Skill-building and Adaptive Dance Intervention (MDI) on participation, balance, mobility, balance confidence, psychological well-being, and health-related quality of life in survivors with hemiparesis.

A 2-arm, assessor-blinded, randomised controlled trial will be conducted. Individuals who are 18-80 years old and have hemiparesis after a first-ever/recurrent ischaemic/haemorrhagic stroke will be recruited. The participants will be randomly allocated to the control group receiving usual care or the intervention group receiving MDI and usual care. Based on Bandura's principles of Self-efficacy and Outcome Expectation, MDI is an online/hybrid intervention aimed to assist survivors in developing body awareness, body sense, movement improvisational skills, and abilities in creating mental images of movements and balance during their transition of care from the acute settings to home. The outcomes will be assessed before the intervention, immediately post-intervention, and 3 and 6 months post-intervention.

Inclusion Criteria:

• a first-ever/recurrent ischaemic/haemorrhagic stroke confirmed by imaging tests,
• receiving in-patient care at an acute stroke unit,
• a National Institutes of Health Stroke Scale (NIHSS) total score of <16 (mild to moderate stroke),
• hemiparesis after stroke with the affected limb(s) scoring 1-3 on the NIHSS motor arm and/or motor leg items, respectively (drift to no effort against gravity),
• a modified Rankin Scale (mRS) score of 2-4 (slight to moderately severe disability), and
• a Montreal Cognitive Assessment (MoCA) score of >2nd percentile.

Exclusion Criteria:

• transient ischaemic attack,
• subdural or epidural haemorrhage,
• cerebrovascular event due to brain tumour or a head injury,
• neurologic, orthopaedic, muscular, rheumatic or vestibular condition that can interfere with participation in the intervention such as seizure or spinal injury,
• mental condition such as depression or schizophrenia, or
• visual or auditory impairment that cannot be corrected by visual/hearing aids.