Zenodo · Dec 9, 2025
Theatre-Based Therapy in Physical Rehabilitation: A Comprehensive Review, Mechanistic Framework, and Research Agenda
By Baghmaleki MK
Background: Conventional physical rehabilitation frequently overlooks psychosocial drivers of recovery such as motivation, self-efficacy, and social engagement. Theatre-based therapy (TBT)- encompassing drama therapy, active theatre workshops, and embodied role play - offers a multimodal stimulus combining motor practice, narrative meaning, affective engagement and group synchrony. Objective: To synthesize empirical evidence on TBT applied to physical rehabilitation, propose a multilevel mechanistic model linking theatrical practice to physical outcomes, and present a pragmatic research agenda including a trial blueprint. Methods: A targeted, hybrid narrative–systematic review (2000–2025) of peer-reviewed trials, longitudinal studies, systematic reviews and high-quality qualitative studies was conducted across PubMed/PMC, Scopus and Web of Science. Anchor studies and recent systematic reviews were prioritized for mechanistic synthesis and clinical translation. Key claims are supported with primary sources (see in-text citations). Results: Evidence (including an RCT in older adults) shows TBT can improve balance, reduce falls risk, increase motor confidence and meaningfully enhance psychosocial outcomes (mood, social connectedness, quality of life) in older adults and neurological populations. Mechanisms operate across four interacting domains: sensorimotor integration, emotional/motivational activation, cognitive engagement, and social synchrony. Heterogeneity of interventions and small sample sizes limit definitive effect-size estimates; nevertheless, the aggregate signal supports larger multisite RCTs with objective motor measures and mechanistic substudies. Conclusions: Theatre-based therapy is a promising, low-risk adjunct to standard rehabilitation with plausible mechanistic pathways to improve physical outcomes and adherence. Research priorities include adequately powered RCTs, objective biomechanics and neurophysiological measures, and economic evaluation.