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Updated: Jul 18, 2026
The Use of the Puzzle Box as a Means of Assessing the Efficacy of Environmental Enrichment
Published on: December 29, 2014
Real-world environmental enrichment rehabilitation paradigm in people with severe traumatic brain injury: a pilot
Devina S Kumar1, Barry A Bodt2, James C Galloway2,3
1Burke Neurological Institute, White Plains, New York, USA.
Background:
The use of Environmental Enrichment (EE) has been widely studied in animal models. However, the application of the same in humans is limited to rehabilitation settings.
Objective:
To investigate the feasibility of a community-based EE paradigm in adults with brain injury.
Methods:
Six individuals diagnosed with traumatic brain injury enrolled in the study. The Go Baby Go Café instrumented with a body weight harness system, provided physical and social enrichment as participants performed functional tasks for 2 hours, three times a week, for 2 months. Feasibility and safety outcomes were recorded throughout sessions. Clinical measures including 10-meter walk, timed up and go, jebsen hand function, 6-minute walk, and trail making tests were obtained pre and post intervention.
Results:
All participants completed the study. The attendance was 100% and adherence was 87%. Positive changes in clinical measures were statistically significant for the timed up and go (p = 0.0175), TUG-cognitive (p = 0.0064), 10-meter walk (p = 0.0428), six-minute walk (p = 0.0196), TMT-A (p = 0.034). Changes in JHFT were not significant (p = 0.0506), with one subject recording values counter to the trend.
Conclusion:
The Café was a comprehensive EE-based intervention that was feasible, safe, and has the potential to enhance motor and cognitive function in individuals with brain injury.
