Norhayati Hussein (Malaysia)
Hospital Rehabilitasi Cheras
Neurological Rehabilitation Unit, Department of Rehabilitation Medicine
Dr Norhayati Hussein is a Consultant Rehabilitation Physician at Hospital Rehabilitasi Cheras (HRC), Kuala Lumpur, Malaysia. She completed her post-graduate study in University Malaya and pursued Clinical Fellowship in Neurorehabilitation in Western University, Ontario, Canada. She was involved in the 16-19th editions of web-based Evidence-Based Review of Stroke Rehabilitation - EBRSR (www.ebrsr.com). She also co-authored book chapters in Stroke Recovery and Rehabilitation (Stein et al), Ischemic Stroke Therapeutics: A Comprehensive Guide (Ovbiagele &Turan) and contributed to a chapter in Braddom’s Rehabilitation Care: A Clinical Handbook (Cifu & Lew). She is currently the national representative for Asia-Oceanian Society for NeuroRehabilitation (AOSNR). She also leads the Malaysian Association of Rehabilitation Physician (MARP) SIG Stroke and Neurorehabilitation and is part of the Stroke Academy under the auspice of Malaysian Stroke Council. She now heads the Neurological Rehabilitation Unit, Hospital Rehabilitasi Cheras, Malaysia and holds special interest in stroke rehabilitation and rehabilitation of neuropathy & neurodegenerative disorders.

Presenter of 1 Presentation

 Conference Calendar

ENVIRONMENTAL ENRICHMENT, REHABILITATION OUTCOME AND THE PANDEMIC: ESTABLISHING A CONNECTION

Session Name
0310 - Stroke Rehabilitation and Recovery (ID 102)
Session Type
Oral Presentations
Date
27.10.2021, Wednesday
Session Time
12:00 - 13:00
Room
ORAL PRESENTATIONS 1
Presenter
Lecture Time
12:30 - 12:40

Abstract

Background and Aims

Environmental Enrichment (EE) for stroke patients encompass a dynamic environment which encourages socialization, sensori-motor activities and cognitive stimulation beyond direct therapy time. Pandemic impact of physical distancing potentially affects socialization, an important EE element. Due to pandemic-appropriate measures in hospital-setting, patients narrated reduced socialization opportunity caused by restricted communal and group activities. The aim is to establish the inpatient stroke rehabilitation outcome trend based on pre/post-EE implementation phases; prior and during pandemic.

Methods

Environmental Enrichment (EE) initiatives were implemented in structured stages based on the Exploration-Planning-Implementation-Sustainment (EPIS) Framework. EE Exploration-Planning Phase occurred in 2018. EE Implementation Phase (2019-2020) focus on multi-faceted activities using various apparatus, incorporating self-directed tasks and communal sessions with caregivers' involvement. A chronological timeline-matching approach was used to match EE implementation initiatives and rehabilitation impact indices comprising of Absolute Functional Gain (AFG) and Rehabilitation Efficiency Index (REI) utilizing Modified Barthel Index. Trending was compared for 2018 (Pre-EE Implementation/Pre-Pandemic), 2019 (EE Implementation/Pre-Pandemic) and 2020 (EE-Implementation/Pandemic) phases.

Results

Compared to 2018, there was incremental improvement in AFG and REI in 2019 (EE-Implementation/Pre-Pandemic). When compared to 2019, marginal reduction of AFG and REI was noted in 2020 (EE-Implementation/ Pandemic). Median (IQR) for AFG were 17.5(11-30), 22(13-35), 20 (9-33.5) for 2018, 2019 and 2020 respectively. Median (IQR) for REI were 0.8 (0.5-1.3), 1.1 (0.5-1.5), 1.0 (0.5-1.3) for 2018, 2019, 2020 respectively.

Conclusions

Environmental enrichment potentially promotes post-stroke recovery and improve stroke rehabilitation outcome. Although pandemic-appropriate measures may affect EE socialization component, an active effort is important to implement and embed EE initiatives in the inpatient rehabilitation setting.

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