White Jennifer H, Bartley Emma, Janssen Heidi, Jordan Louise-Anne, Spratt Neil
Hunter Stroke Service, Hunter New England Local Health District , New Lambton, New South Wales , Australia .
Disabil Rehabil. 2015;37(7):593-600. doi: 10.3109/09638288.2014.935876.
Data highlight the importance of undertaking intense and frequent repetition of activities within stroke rehabilitation to maximise recovery. An enriched environment (EE) provides a medium in which these activities can be performed and enhanced recovery achieved. An EE has been shown to promote neuroplasticity in animal models of stroke, facilitating enhanced recovery of motor and cognitive function. However, the benefit of enriching the environment of stroke survivors remains unknown.
To qualitatively explore stroke survivors' experience of implementation of exposure to an EE within a typical stroke rehabilitation setting, in order to identify facilitators and barriers to participation.
Semi-structured interviews with 10 stroke survivors (7 females and 3 males, mean age of 70.5 years) exposed to an EE for a 2-week period following exposure to routine rehabilitation within a stroke rehabilitation ward. An inductive thematic approach was utilised to collect and analyse data.
Qualitative themes emerged concerning the environmental enrichment paradigm including: (1) "It got me moving" - perceived benefits of participation in an EE; (2) "You can be bored or you can be busy." - Attenuating factors influencing participation in an EE; (3) "I don't like to make the staff busier" - limitations to use of the EE.
This study provides preliminary support for the implementation of an EE within a typical stroke rehabilitation setting from a patient perspective. Reported benefits included (1) increased motor, cognitive and sensory stimulation, (2) increased social interaction, (3) alleviation of degree of boredom and (4) increased feelings of personal control. However, participants also identified a number of barriers affecting implementation of the EE. We have previously published findings on perceptions of nursing staff working with stroke survivors in this enriched rehabilitation environment who identified that patients benefited from having better access to physical, cognitive and social activities. Together, results contribute to valuable evidence for future implementation of an EE in stroke rehabilitation settings. Implications for Rehabilitation Stroke survivor access to an enriched environment (EE): RESULTS identified that participation in both individual and communal forms of environment enrichment within the stroke rehabilitation ward resulted in increased access to activities providing increased opportunities for enhanced motor, cognitive and sensory stimulation. Increased access to and participation in activities of the environmental enrichment (individual and communal) interrupted the ongoing cycle of boredom and inactivity experienced by many participants. This study provides preliminary support for the implementation of an EE within a typical stroke rehabilitation setting from a patient perspective.
数据凸显了在中风康复过程中进行高强度、频繁重复活动以实现最大程度恢复的重要性。丰富环境（EE）提供了一个可以进行这些活动并实现增强恢复效果的媒介。在中风动物模型中，丰富环境已被证明能促进神经可塑性，有助于增强运动和认知功能的恢复。然而，丰富中风幸存者环境的益处仍不明确。
定性探索中风幸存者在典型中风康复环境中接触丰富环境的体验，以确定参与的促进因素和障碍。
对10名中风幸存者（7名女性和3名男性，平均年龄70.5岁）进行半结构化访谈，这些幸存者在中风康复病房接受常规康复治疗后，接触丰富环境两周。采用归纳主题法收集和分析数据。
出现了与丰富环境模式相关的定性主题，包括：（1）“它让我动起来了”——参与丰富环境的感知益处；（2）“你可以无聊，也可以忙碌。”——影响参与丰富环境的减弱因素；（3）“我不想让工作人员更忙”——丰富环境使用的限制。
本研究从患者角度为在典型中风康复环境中实施丰富环境提供了初步支持。报告的益处包括：（1）增加运动、认知和感觉刺激；（2）增加社交互动；（3）减轻无聊程度；（4）增强个人控制感。然而，参与者也指出了一些影响丰富环境实施的障碍。我们之前发表了关于在这种丰富康复环境中与中风幸存者一起工作的护理人员看法的研究结果，他们发现患者因能更好地参与身体、认知和社交活动而受益。总之，这些结果为未来在中风康复环境中实施丰富环境提供了有价值的证据。对康复的启示 中风幸存者对丰富环境的接触：结果表明，参与中风康复病房中个体和集体形式的环境丰富活动，增加了参与提供更多增强运动、认知和感觉刺激机会的活动的机会。增加对环境丰富活动（个体和集体）的接触和参与，打破了许多参与者所经历的持续的无聊和不活动循环。本研究从患者角度为在典型中风康复环境中实施丰富环境提供了初步支持。
