{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:43:32Z","timestamp":1778611412838,"version":"3.51.4"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Stroke is a leading cause of long-term disability and mortality worldwide. Survivors can experience a range of physical and emotional challenges, often leading to depression, anxiety, and a poorer quality of life. Creative arts therapies (CATs), an umbrella term encompassing music, art, dance\/movement, drama, and creative writing therapies, have increasingly been explored in stroke survivor populations as interventions to improve psychological outcomes. Qualitative analysis suggests these therapies can be helpful, but the exact efficacy of CATs in stroke rehabilitation, as well as the optimal intervention types and treatment protocols, has yet to be established. This systematic review and meta-analysis plans to evaluate the effect of CATs on depression, anxiety, and quality of life among adults recovering from stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This protocol has been prospectively registered with PROSPERO (CRD420251237926). Eligible studies will include primary quantitative research involving creative arts interventions. Searches will be conducted in Medline, Embase, and PsycInfo from inception to December 2025. Two reviewers will independently screen records, extract data, and assess study quality and the certainty of the evidence using the RoB 2, ROBINS-I, and GRADE tools. Restricted maximum likelihood random-effects meta-analyses of Cohen\u2019s\n                      <jats:italic>d<\/jats:italic>\n                      effect sizes and risk ratios will be performed to calculate pooled effect sizes for each outcome. Subgroup analyses will explore moderators such as the effect of study design, intervention type, session frequency, and patient setting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Dissemination of results<\/jats:title>\n                    <jats:p>Results will be disseminated through a peer-reviewed publication, conference presentations, and clinical networks to inform evidence-based guidelines on the use of CATs in multidisciplinary stroke care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0341629","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T18:43:30Z","timestamp":1769193810000},"page":"e0341629","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Creative arts therapies for stroke patients: A systematic review and meta-analysis protocol"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4268-475X","authenticated-orcid":true,"given":"Vikram","family":"Arora","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Thabane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0162-3595","authenticated-orcid":true,"given":"Jude","family":"Hynes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Sutoski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohit","family":"Bhandari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"issue":"02","key":"pone.0341629.ref001","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1055\/s-0038-1649503","article-title":"Global burden of stroke","volume":"38","author":"M Katan","year":"2018","journal-title":"Semin Neurol"},{"issue":"10069","key":"pone.0341629.ref002","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/S0140-6736(16)30962-X","article-title":"Stroke","volume":"389","author":"GJ Hankey","year":"2017","journal-title":"The Lancet"},{"issue":"1","key":"pone.0341629.ref003","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1192\/bjp.bp.111.107664","article-title":"Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis","volume":"202","author":"L Ayerbe","year":"2013","journal-title":"Br J Psychiatry"},{"key":"pone.0341629.ref004","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.neubiorev.2018.04.005","article-title":"Post stroke depression: the sequelae of cerebral stroke","volume":"90","author":"J Das","year":"2018","journal-title":"Neurosci Biobehav Rev"},{"issue":"8","key":"pone.0341629.ref005","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1111\/ijs.12357","article-title":"Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies","volume":"9","author":"ML Hackett","year":"2014","journal-title":"Int J Stroke"},{"issue":"3","key":"pone.0341629.ref006","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1177\/1747493019896958","article-title":"Frequency of anxiety after stroke: an updated systematic review and meta-analysis of observational studies","volume":"15","author":"P Knapp","year":"2020","journal-title":"Int J Stroke"},{"issue":"1","key":"pone.0341629.ref007","doi-asserted-by":"crossref","first-page":"9268","DOI":"10.1038\/s41598-024-59837-3","article-title":"Analysis of factors associated with depressive symptoms in stroke patients based on a national cross-sectional study","volume":"14","author":"W Xiao","year":"2024","journal-title":"Sci Rep"},{"key":"pone.0341629.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2022\/6506326","article-title":"Prevalence, severity, and predictors of poststroke depression in a prospective cohort of Jordanian patients. 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