What a fucking stupid question. Wasn't this enriched environment talked about by Dr. Dale Corbett in 2011 good enough for clinical application? You mean to tell me 7 years have passed and you are finally getting around to using this? Such incompetence should be rewarded with firing and shaming.
This incompetency is why stroke survivors need to be running stroke associations. Dale Corbett back in 2011 should have been able to hand off his research to the stroke associations and had them write it into a protocol and pushed that to all the stroke doctors and therapists in the world. That is what a great stroke association would be able to do.
Is environmental enrichment ready for clinical application in human post-stroke rehabilitation?
Matthew W. McDonald1, 2, 
Kathryn S. Hayward3, 4, 
Ingrid C. Rosbergen5, 6, 
Matthew S. Jeffers1, 2 and 
Dale Corbett1, 2* - 1Cellular & Molecular Medicine, University of Ottawa, Canada
- 2Canadian Partnership for Stroke Recovery, Canada
- 3Stroke Division, Florey Institute of Neuroscience and Mental Health, Australia
- 4NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Australia
- 5Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Australia
- 6Allied Health Services, Sunshine Coast Hospital and Health Service, Australia
Environmental enrichment has been widely used as a means to enhance brain plasticity mechanisms (e.g. increased dendritic branching, synaptogenesis, etc.) and improve behavioural function in both normal and brain-damaged animals. In spite of the demonstrated efficacy of environmental enrichment for enhancing brain plasticity it has largely remained a laboratory phenomenon with little translation to the clinical setting. Impediments to the implementation of enrichment as an intervention for human stroke rehabilitation and a lack of clinical translation can be attributed to a number of factors not limited to: i) concerns that environmental enrichment is actually the "normal state" for animals, whereas standard housing is a form of impoverishment, ii) difficulty in standardizing EE conditions across clinical sites, iii) the exact mechanisms underlying the beneficial actions of enrichment are largely correlative in nature, iv) a lack of knowledge concerning what aspects of enrichment (e.g. exercise, socialization, cognitive stimulation) represent the critical or active ingredients for enhancing brain plasticity, and v) the required "dose" of enrichment is unknown, since most laboratory studies employ continuous periods of enrichment, a condition that most clinicians view as impractical.
In this review we summarize preclinical stroke recovery studies that have successfully utilized EE to promote functional recovery and highlight the potential underlying mechanisms. Subsequently, we discuss how EE is being applied in a clinical setting and address differences in preclinical and clinical EE work to date. It is argued that the best way forward is through the careful alignment of preclinical and clinical rehabilitation research. A combination of both approaches will allow research to fully address gaps in knowledge and facilitate the implementation of environmental enrichment to the clinical setting.
In this review we summarize preclinical stroke recovery studies that have successfully utilized EE to promote functional recovery and highlight the potential underlying mechanisms. Subsequently, we discuss how EE is being applied in a clinical setting and address differences in preclinical and clinical EE work to date. It is argued that the best way forward is through the careful alignment of preclinical and clinical rehabilitation research. A combination of both approaches will allow research to fully address gaps in knowledge and facilitate the implementation of environmental enrichment to the clinical setting.
Keywords:
environmental enrichment, stroke rehabilitation, stroke recovery, clinical translation, neuroplasticity, Stroke, Adjunctive therapy, precision medicine
Received: 28 Mar 2018;
Accepted: 14 Jun 2018.
Edited by:
Amanda C. Kentner, MCPHS University, United States
Reviewed by:
Markus Wöhr, Philipps University of Marburg, Germany
Avi Avital, Department of Physiology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology
Copyright: © 2018 McDonald, Hayward, Rosbergen, Jeffers and Corbett. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Dr. Dale Corbett, University of Ottawa, Cellular & Molecular Medicine, Ottawa, Canada, dcorbett@uottawa.ca
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