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

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.