Article

OBJECTIVE: To assess the effectiveness of an enriched environmental activities
programme in an inpatient tertiary neuro-rehabilitation unit. METHODS: A total of
103 participants were randomized to an intervention group (n = 52) undertaking an
enriched environmental activities programme or a control group (n = 51) receiving
usual ward activity. PRIMARY OUTCOME MEASURE: Depression, Anxiety Stress Scale
(DASS). Other measures included: Neurological Impairment Scale; Multidimensional
Health Locus of Control, Rosenberg Self-Esteem Scale, Montreal Cognitive
Assessment (MoCA); Functional Independence Measure (FIM), and Euro-Quality of
Life-5D. Questionnaire assessments were performed at admission, discharge and
3-months post-discharge. RESULTS: Mean age of subjects was 62.5 years (standard
deviation 18.5), 63% were male; 53 had stroke and the remainder had other
neurological conditions. Compared with controls, the intervention group showed
significant improvement at discharge in: DASS: "total", "depression", and
"stress" subscales (p < 0.05 for all, with small effect sizes (eta2) =
0.04-0.05); MoCA (p = 0.048, eta2 = 0.04) and FIM motor (total and "self-care",
"mobility" subscales (p < 0.05 for all, with moderate effect sizes, eta2 =
0.0-0.08). At 3-month follow-up, significant differences were maintained in most
secondary outcomes in the intervention group. Cognitive function and activities
improved most in participants with stroke. CONCLUSION: An enriched environmental
programme can produce significant improvements in functional and cognitive
ability in inpatient neurological cohorts compared with routine ward activity
programmes.

Langue : ANGLAIS