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

Janssen, Heidi; Ada, Louise; Bernhardt, Julie; McElduff, Patrick; Pollack, Michael; Nilsson, Michael; Spratt, Neil J

doi:10.3109/09638288.2013.788218

Cited by 181 publications

(213 citation statements)

References 46 publications

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“…1,3,4 Recent clinical studies have also shown that stroke rehabilitation in the early postacute phase is most effective when performed in an engaging environment that provides novel and multisensory stimulation. 25,26 This is further supported by studies showing additive effects of social activity, exercise, music, and dance on cognitive improvement in healthy elderly individuals and in patients with Parkinson disease. 10 In the present study, we show that sustained improvement can occur in late phase after stroke as a result of multimodal intervention.…”

Section: July 2017mentioning

confidence: 51%

“…3 Enriched environment includes several different components, such as social stimulation, sensorimotor and cognitive stimulation, and exercise. 2,4,25 Several studies show that enriched environment is more effective than any of the individual components in promoting recovery after brain injury. 1,3,4 Recent clinical studies have also shown that stroke rehabilitation in the early postacute phase is most effective when performed in an engaging environment that provides novel and multisensory stimulation.…”

Section: July 2017mentioning

confidence: 99%

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Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke

Käll

Lundgren‐Nilsson

Samuelsson

et al. 2017

Stroke

Self Cite

102

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Recently, multimodal interventions, such as music therapy, rhythm-and music-based therapies (R-MT), dance, and horseriding therapy (H-RT), have demonstrated promising results when applied to people with various neurologic conditions. [5][6][7][8][9][10][11][12][13] These interventions share important core components but differ from each other with respect to their combinations of Background and Purpose-Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke. Methods-Participants were assigned to rhythm-and-music therapy, horse-riding therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3-and 6-month follow-up. Results-One hundred twenty-three participants were assigned to rhythm-and-music therapy (n=41), horse-riding therapy (n=41), or control (n=41). Post-intervention, the perception of stroke recovery (mean change from baseline on a scale ranging from 1 to 100) was higher among rhythm-and-music therapy

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Section: July 2017mentioning

confidence: 51%

Section: July 2017mentioning

confidence: 99%

Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke

Käll

Lundgren‐Nilsson

Samuelsson

et al. 2017

Stroke

Self Cite

102

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“…417 Särkämö et al 442 performed a single-blind RCT to determine whether listening to music everyday can facilitate the recovery of cognitive functions after stroke. Two months of daily listening (95 minutes daily) to self-selected music after acute stroke improved verbal memory, focused attention, and depressive symptoms compared with listening to an audio book or not listening to music.…”

Section: Enriched Environmentmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,179

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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“…For example, tablet technology allows for patients to engage in cognitive exercises and games that can be tailored to their specific impairments and made progressively more challenging as they improve. Along these lines, Janssen et al [81] have reported encouraging preliminary results in a study where EE was incorporated into a stroke rehabilitation unit.…”

Section: Therapeutic Interventions Across the Lifespanmentioning

confidence: 92%

Exercise and Environmental Enrichment as Enablers of Task-Specific Neuroplasticity and Stroke Recovery

et al. 2016

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Improved stroke care has resulted in greater survival, but >50 % of patients have chronic disabilities and 33 % are institutionalized. While stroke rehabilitation is helpful, recovery is limited and the most significant gains occur in the first 2-3 months. Stroke triggers an early wave of gene and protein changes, many of which are potentially beneficial for recovery. It is likely that these molecular changes are what subserve spontaneous recovery. Two interventions, aerobic exercise and environmental enrichment, have pleiotropic actions that influence many of the same molecular changes associated with stroke injury and subsequent spontaneous recovery. Enrichment paradigms have been used for decades in adult and neonatal animal models of brain injury and are now being adapted for use in the clinic. Aerobic exercise enhances motor recovery and helps reduce depression after stroke. While exercise attenuates many of the signs associated with normal aging (e.g., hippocampal atrophy), its ability to reverse cognitive impairments subsequent to stroke is less evident. It may be that stroke, like other diseases such as cancer, needs to use multimodal treatments that augment complimentary neurorestorative processes.

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

Abstract: 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.

Cited by 181 publications

References 46 publications

Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke

Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke

Guidelines for Adult Stroke Rehabilitation and Recovery

Exercise and Environmental Enrichment as Enablers of Task-Specific Neuroplasticity and Stroke Recovery

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