Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Health Sciences


Rehabilitation Sciences

First Advisor

Dr. Anne Harrison

Second Advisor

Dr. Dana Howell


Rehabilitation hospitals serve to foster a client’s independence in preparation to return home after an injury or insult. Having space in rehabilitation environments that is home-like and supportive for each client can facilitate participation in occupations and assist in learning and practicing the skills needed to transition to home. Yet, typically occupational therapists provide interventions to clients in therapy gyms with exercise and impairment based equipment. Currently the stroke population is changing and identifying the optimal rehabilitation environment is imperative to guide occupational therapy practice. This dissertation contains three studies relating to the rehabilitation environment and occupational therapy interventions. The first study focused on the perceptions of occupational therapists regarding their optimal rehabilitation environment, identifying that they would prefer to offer their clients a variety of rehabilitation environments and that there is a relationship between the environment and the type of intervention provided. A second study examined the effects of occupation-based interventions provided in a home-like environment to an individual recovering from chronic stroke with the results indicating enhanced occupational performance, resumed competence in desired roles, improvement in affected upper extremity function, and notable neuroplastic change. The final study investigated how the rehabilitation environment influenced the interventions used by the occupational therapists. The findings supported the relationship between the therapy environment and a specific intervention; working in the therapy gym with preparatory methods and being in a home-like space using occupation-based interventions. The environment influenced occupational therapy interventions and it is recommended that the occupational therapist match the client’s goals to the ideal environment for optimal intervention.