Rosbergen ICM, Grimley RS, Hayward KS, Brauer SG (2019 online early). The impact of environmental enrichment in an acute stroke unit on how and when patients undertake activity. Clinical Rehabilitation.
An important study just published in  Clinical Rehabilitation about the outcomes of an enriched acute stroke unit environment (eg Providing i-pads with therapy apps/ideas, providing GRASP upper limb equipment, multiple group activities run by therapists) by Australian researcher Ingrid Rosbergen. Recommended reading for your rehabilitation team.
Although data were only collected at one Queensland hospital site, this study is a good example that can be replicated elsewhere. The researchers provide definitions of the activities they observed and counted during the behaviour observations/ mapping. As they note in their discussion: “The recently published Australian clinical stroke guidelines recommend 2 hours of daily active task practice in the rehabilitation phase after stroke…. an environmental enrichment may be an effective mechanism to increase the amount of active task practice early after stroke”.
Any time therapists spent engaged in scheduled group activities replaced one-on-one therapy time. Group activities on Monday and Friday focused on “physical activities” including balance and ambulation; Tuesday focused on “support and stroke education,” Wednesday “communication enhancement,” and Thursday “upper limb and cognitive activities.
Patients in the enriched environment spent more time completing upper limb activities and practice compared to control participants amongst other results.