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

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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 [n = 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 [n = 10], carers [n = 3] and staff [n = 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. A community-based environmental enrichment (EE) model combining exercise, socialisation, and creative thinking may support physical and emotional stroke recovery.The ESTEEM Program, an EE model, was well-received and acceptable for Non-Government-Organisation (NGO) staff, stroke survivors, and their carers.Future EE programs should prioritise accessible venues, reliable transport, and well-trained staff to meet diverse stroke survivor needs when planning the program. A community-based environmental enrichment (EE) model combining exercise, socialisation, and creative thinking may support physical and emotional stroke recovery. The ESTEEM Program, an EE model, was well-received and acceptable for Non-Government-Organisation (NGO) staff, stroke survivors, and their carers. Future EE programs should prioritise accessible venues, reliable transport, and well-trained staff to meet diverse stroke survivor needs when planning the program.

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