Development of a neurological rehabilitation environment: an observational study

Clin Rehabil. 1997 May;11(2):146-55. doi: 10.1177/026921559701100208.


Background: Engagement in therapeutic activity among stroke inpatients is advocated by many rehabilitation professionals. However, there is a lack of published evidence to indicate whether this is currently being achieved.

Objective: To investigate the extent and types of 'rehabilitation' activities on a new neurological rehabilitation ward, and examine change in patients' behaviour related to the new environment and new initiatives.

Design: Five one-week observation periods were conducted over two years, with a total of 67 patients being observed. A comparison was made with results of an earlier study of stroke patients' activities conducted at the same hospital.

Results: Patients spent an average 43 min per day with therapists (9% of the working day) and this was only marginally supplemented by self-exercise (2% of the working day--approximately 10 min). However, the provision of a new rehabilitation environment was associated with a marked decrease in the time patients spent at their bedsides, and a decrease in time spent passively gazing or watching others.

Conclusions: Overall there was some positive change in patients' behaviour. We suggest that structured guidance is required from the whole multidisciplinary team to stimulate more self-directed therapy practice and recreation.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Diseases / rehabilitation*
  • Cerebrovascular Disorders / rehabilitation*
  • Female
  • Health Facility Environment*
  • Hospital Units / organization & administration
  • Humans
  • Leisure Activities
  • Male
  • Middle Aged
  • Observer Variation
  • Occupational Therapy / methods*
  • Patient Education as Topic
  • Program Evaluation
  • Prospective Studies
  • Social Environment
  • Time Factors