Feasibility of a home-based environmental enrichment paradigm to enhance purposeful activities in adults with traumatic brain injury: a case series

Abstract

Purpose

To assess the feasibility, safety, and functional recovery of an Environmental Enrichment (EE) inspired paradigm for enhancing daily activities in people with traumatic brain injury.

Methods

Two TBI-Caregiver dyads participated in the six-month study. A preinstalled harness provided the support structure that enabled the family to perform task-specific functional and cognitive goals. The pre- and post-intervention evaluations included the safety, feasibility, and clinical outcomes such as the 10-m walk test, the Timed Up and Go test, the Jebsen Hand Function test, the Six-Minute Walk test, and the Trail Making Test. The Actigraph GT9X recorded the Caregiver-TBI step count during days spent in harness and out of harness.

Results

The study was feasible, safe, and both TBI subjects improved in functional outcomes. Analysis of Actigraph GT9X yielded mixed results.

Conclusion

A partnership with caregivers and adults with TBI to design an EE-focused community program could improve functional activities in real life. To optimize this intervention, caregivers will likely need an alternate approach to record time spent in the harness.

IMPLICATIONS FOR REHABILITATION

• The complexities of the real world encourage meaningful activities and participation.

• Autonomy in everyday activities is an important long-term objective for adults with brain injury.

• Community-tailored harnesses designed to prevent falls encourages physical activity and social interaction.

Keywords:

• Environmental enrichment
• traumatic brain injury
• community rehabilitation
• caregiver
• house harness

Acknowledgments

We would like to thank the families for their valuable contribution, commitment, and participation in the study. The writers also express their sincere gratitude to Steve and Ralph Cope of Enliten LLC.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Informed consent

Signed by participants. No face recognition pictures have been used.