An enriched environment increases activity in stroke patients undergoing rehabilitation in a mixed rehabilitation unit: a pilot non-randomized controlled trial

Abstract

Purpose: An enriched environment (EE) facilitates physical, cognitive and social activity in animal models of stroke. The aim of this pilot study was to determine whether enriching the environment of a mixed rehabilitation unit increased stroke patient activity. Methods: A non- randomized controlled trial was conducted. Direct observation was used to determine the difference in change in physical, cognitive, social or any activity over 2 weeks in patients exposed to an enriched versus non-enriched environment. Results: Stroke patients in the EE (n = 15) were 1.2 (95% CI 1.0–1.4) times more likely to be engaged in any activity compared with those in a non-enriched environment (n = 14). They were 1.7 (95% CI 1.1–2.5) times more likely to be engaged in cognitive activities, 1.2 (95% CI 1.0–1.5) times more likely to be engaged in social activities, 0.7 (95% CI 0.6–0.9) times as likely to be inactive and alone and 0.5 (95% CI 0.4–0.7) times as likely to be asleep than patients without enrichment. Conclusions: This preliminary trial suggests that the comprehensive model of enrichment developed for use in a rehabilitation unit was effective in increasing activity in stroke patients and reducing time spent inactive and alone.

Implications for Rehabilitation

• Stroke patients within a mixed rehabilitation unit who are exposed to an enriched environment (EE) are more likely to be engaged in activity than those not exposed to the enriched environment.

• Patients in enriched conditions are less likely to be “inactive and alone” or asleep during waking hours.

• These results suggest a comprehensive model of enrichment is effective in increasing activity levels.

• Environmental enrichment
• physical activity leisure activities
• social activity
• stroke

Acknowledgements

We would like to thank the Nursing Unit Manager, Robyn Walker, and all other rehabilitation team members and patients of Rankin Park Centre who were involved or participated in this trial. We also wish to thank Nicholas Buckley, Ruby Hooke, Dr Frini Karayanidis and Dr Karen Drysdale for collecting and interpreting the cognitive data presented in this publication. We thank as well Dr Tiffany Shubert for permitting us to use the Variety of Activity Questionnaire in our trial.