Evaluation of a technology-assisted enriched environmental activities programme for upper limb function: A randomized controlled trial

Abstract

Objective: To evaluate the effectiveness and feasibility of an intensive technology-assisted inpatient enriched environmental programme for upper limb function. Methods: Patients consecutively admitted to the rehabilitation unit randomly allocated to an intervention (enriched environmental programme, n?=?46)) or a control group (usual ward activity, n?=?46). Assessments were performed at baseline (T0), discharge (T1) and 3 months (T2) using validated measures. Results: At T1, the enriched environmental group showed significant improvement in upper limb func-tion, compared with the control group: Action Research Arm Test (ARAT) ?Total? (p?=?0.002), and ?Grip?, ?Pinch? and ?Gross? subscales (p?<?0.05 for all), with small effect size?=?0.04?0.16. Most participants in the enriched environmental group had clinically significant improvement >?5.7 points on the ARAT ?Total? compared with the control group (83% vs 44%, p?<?0.001). Participants in the enriched environmental group were more involved in various forms of activities during waking hours. At T2, despite no significant between-group difference in ARAT scores, the majority of participants in the enriched environmental group maintained the improvement (>?5.7 points) on ARAT ?Total? compared with the control group (91% vs 61%, p?=?0.001). Both groups improved in other measures at both T1 and T2. Conclusion: An enriched environmental programme was feasible and effective in improving upper limb function and increasing the activity of patients during their inpatient subacute care.