Exercising, Socialising, and Thinking: an Environmental Enrichment Model (ESTEEM) after stroke-a mixed methods pilot study of the ESTEEM program.

Abstract

Measure the benefits and experiences of stroke survivors, carers and staff involved in the piloting of the Exercising, Socialising and Thinking: An Environmental Enrichment Model (ESTEEM) Program. Concurrent triangulation mixed-methods were used; (i) physical (leg strength, endurance, falls efficacy and frailty), psychological (anxiety and depression) and quality of life outcomes were collected at baseline, post-intervention, and 3-month follow-up, and (ii) inductive analysis of semi-structured interviews with end-users, described the experience of participation in and delivery of the ESTEEM Program. Stroke survivors [<i>n</i> = 25, median age 76 (IQR = 68-79) years, 40% female] demonstrated significant improvements at (i) post-intervention, in leg strength [1.2 repetitions, 95% confidence interval (CI) (0.22, 2.3)] and walking endurance [31m, (2.3, 60)] and, (ii) 3-month follow-up, in leg strength [0.99 repetitions (0.01, 2.0)], frailty [-0.79 (-1.3, -0.34)], anxiety [-1.8 (-3.1, -0.45)], depression [-2.1 (-3.5, -0.83)] and QoL [0.30 (0.13, 0.47)]. Stroke survivors [<i>n</i> = 10], carers [<i>n</i> = 3] and staff [<i>n</i> = 5]) perceived the Program to be beneficial, desirable and "worth the effort" of attending. The ESTEEM Program may benefit both physical and emotional recovery after stroke and is acceptable to end-users. Results will inform future clinical research to determine the effectiveness of the ESTEEM Program.