Effectiveness of Art Therapy and Physical Activity in Improving Quality of Sleep in Children with Hemiplegic Cerebral Palsy: A Quasi-experimental Pilot Study

Abstract

Introduction: Hemiplegic Cerebral Palsy (CP) is characterised by abnormalities in movement and posture, along with sensory and tone abnormalities. It also represents significant impairments in cognition and sleep quality. Art activity involves playfulness, creativity, improvisation, and brings benefits to cognition and the alleviation of mental suffering. Physical activity shows considerable improvement in sleep quality as it concentrates on cardiorespiratory fitness and increases total energy expenditure. Aim: To evaluate the effect of art therapy and physical activity on sleep quality in children with hemiplegic CP. Materials and Methods: This quasi-experimental pilot study was performed among six ambulant children with hemiplegic CP in December 2022 at MGM School of Physiotherapy, Aurangabad, Maharashtra, India. Both male and female children aged between 4 to 12 years were included in the study. Pretest scores were recorded using the Paediatric Sleep Questionnaire (PSQ). The participants then underwent a physiotherapy protocol lasting one hour, which included art therapy along with upper limb physical activities for four weeks. Art therapy included colouring pictures, drawing geometrical shapes, line-drawing connections, thumbprints, and vegetable prints. The protocol was given for one month, which included three sessions of art therapy and physical activity each week. Parents and children were encouraged to follow the protocol before sleep. At the end of one month, postscoring of all outcome measures was calculated, and statistical analysis was done using the paired t-test. Results: From the results, the median pretest and post-test PSQ scores were 0.68 and 0.49, respectively. Interquartile Range (IQR) value for the outcome measure was 0.0675 and 0.0775, which was significant. Conclusion: Art therapy, along with physical activity, improved sleep quality in children with hemiplegic CP.