title: An enriched environmental programme during inpatient neuro-rehabilitation: A randomized controlled trial.
abstract: 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.
  
  
  METHODS
  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 (η2) = 0.04-0.05); MoCA (p = 0.048, η2 = 0.04) and FIM motor (total and "self-care", "mobility" subscales (p < 0.05 for all, with moderate effect sizes, η2 = 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.
  
  
  CONCLUSIONS
  An enriched environmental programme can produce significant improvements in functional and cognitive ability in inpatient neurological cohorts compared with routine ward activity programmes.
authors.affiliation: Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34-54 Poplar Road, Parkville, Melbourne VIC 3052, Australia. fary.khan@mh.org.au.
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Alaeldin
authors.initials: A
authors.lastname: Elmalik
authors.forename: Matthew
authors.initials: M
authors.lastname: Lowe
authors.forename: Louisa
authors.initials: L
authors.lastname: Ng
authors.forename: Isabella
authors.initials: I
authors.lastname: Reid
authors.forename: Mary P
authors.initials: MP
authors.lastname: Galea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000066530:Neurological Rehabilitation / Q000379:methods*; D017060:Patient Satisfaction; D010812:Physical Stimulation / Q000379:methods; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D012047:Rehabilitation Centers; D012648:Self Care; D020377:Self Efficacy; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome