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

  title={An enriched environment increases activity in stroke patients undergoing rehabilitation in a mixed rehabilitation unit: a pilot non-randomized controlled trial},
  author={Heidi Janssen and Louise Ada and Julie Bernhardt and Patrick McElduff and Michael R P Pollack and Michael Nilsson and Neil James Spratt},
  journal={Disability and Rehabilitation},
  pages={255 - 262}
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… 
The effect of an enriched environment on activity levels in people with stroke in an acute stroke unit: protocol for a before-after pilot study
The EE is an innovative intervention that could increase activity levels in stroke survivors across all domains and promote early recovery of stroke survivors in the acute setting.
Altering the rehabilitation environment to improve stroke survivor activity: A Phase II trial
  • H. Janssen, L. Ada, J. Bernhardt
  • Medicine, Psychology
    International journal of stroke : official journal of the International Stroke Society
  • 2021
This patient-driven model of environmental enrichment incorporating access to communal and individual environmental enrichment was feasible and safe, however, the very modest increase in activity by people with stroke, and the lack of benefit in clinical outcomes three months after stroke do not provide justification for an efficacy trial.
Embedding an enriched environment in an acute stroke unit increases activity in people with stroke: a controlled before–after pilot study
Embedding an enriched environment in an acute stroke unit increased activity in stroke patients, and changes were sustained six months post implementation.
The impact of environmental enrichment in an acute stroke unit on how and when patients undertake activities
Communal activities and environmental resources were important contributors to greater activity within the enriched acute stroke unit.
Evaluation of a technology-assisted enriched environmental activities programme for upper limb function: A randomized controlled trial.
An enriched environmental programme was feasible and effective in improving upper limb function and increasing the activity of patients during their inpatient subacute care.
An enriched environmental programme during inpatient neuro-rehabilitation: A randomized controlled trial.
An enriched environmental programme can produce significant improvements in functional and cognitive ability in inpatient neurological cohorts compared with routine ward activity programmes.
Enriched, Task-Specific Therapy in the Chronic Phase After Stroke: An Exploratory Study
Enriched, task-specific therapy may provide durable benefits across a wide spectrum of motor deficits and impairments after stroke, and have implications for enriching strategies in stroke rehabilitation.
Time use and physical activity in a specialised brain injury rehabilitation unit: an observational study
Similar to stroke units, inpatients in a specialised brain injury unit spend large parts of the day sedentary, alone and doing non-therapeutic activities.
Observations of Activity Levels in a Purpose-Built, Inpatient, Rehabilitation Facility
Activity levels of inpatients undergoing rehabilitation in a new rehabilitation facility with innovative design and multidisciplinary care are investigated, comparing weekday and weekend activity levels, as well as changes over a 12-month period.


Translating the Use of An Enriched Environment Poststroke from Bench to Bedside: Study Design and Protocol Used to Test the Feasibility of Environmental Enrichment on Stroke Patients in Rehabilitation
  • H. Janssen, L. Ada, N. Spratt
  • Psychology, Medicine
    International journal of stroke : official journal of the International Stroke Society
  • 2012
This pilot study aims to enrich the environment of stroke survivors in a rehabilitation ward and measure changes in their activity (physical, cognitive, and social activity) and quality of life using the Assessment of Quality of Life 1 month postdischarge from rehabilitation.
Development of a neurological rehabilitation environment: an observational study
It is suggested that structured guidance is required from the whole multidisciplinary team to stimulate more self-directed therapy practice and recreation among stroke inpatients.
Physical, cognitive and social activity levels of stroke patients undergoing rehabilitation within a mixed rehabilitation unit
Level of physical, cognitive and social activity of stroke patients were low and remained so even though level of independence and mood improved, and the need to explore strategies to stimulate activity within rehabilitation environments is suggested.
An Enriched Environment Improves Sensorimotor Function Post-Ischemic Stroke
The results indicate significant improvements in sensorimotor function with EE poststroke but suggest a small increase in infarct volume.
Stroke rehabilitation: are highly structured units more conducive to physical activity than less structured units?
The Time Use and Activity Levels of Inpatients in a Co-located Acute and Rehabilitation Stroke Unit: An Observational Study
Abstract Purpose: Stroke patients spend a large proportion of their day alone and inactive. In one rehabilitation unit, practice changes had been implemented over several years to improve patient
Effects of Augmented Exercise Therapy Time After Stroke: A Meta-Analysis
The hypothesis that augmented exercise therapy has a small but favorable effect on ADL is supported, particularly if therapy input is augmented at least 16 hours within the first 6 months after stroke, while this meta-analysis suggests that clinically relevant treatment effects may be achieved on instrumental ADL and gait speed.
Inactive and Alone: Physical Activity Within the First 14 Days of Acute Stroke Unit Care
The physical activity patterns of stroke patients managed within acute stroke units were determined as a first step in developing an early mobilization protocol to evaluate the effect of increased levels of physical activity early after stroke compared with current standards of care.
Wii-based movement therapy to promote improved upper extremity function post-stroke: a pilot study.
An intensive 2-week protocol resulted in significant and clinically relevant improvements in functional motor ability post-stroke, which translated to improvement in activities of daily living.
Effectiveness of Virtual Reality Using Wii Gaming Technology in Stroke Rehabilitation: A Pilot Randomized Clinical Trial and Proof of Principle
VRWii gaming technology represents a safe, feasible, and potentially effective alternative to facilitate rehabilitation therapy and promote motor recovery after stroke.