Enriched environments improve stroke recovery and reduce brain inflammation

WOW! You really like proving just how out-of-date you are! You don't follow research at all, do you? Are you're still employed in stroke?

Let's check how long you've been absolutely stupid and missed all the intervening research!

This enriched environment  was reported for stroke way back in 2011 by Dr. Corbett. 

• Environmental Enrichment (61 posts to December 2013)

Preconditioning with an Enriched Environment Enhances Neuroplasticity and Functional Recovery Following Cerebral Ischemia-Reperfusion Injury

THIS is the reason survivors need to be in charge, no one in the stroke medical world is putting it all together with a way to get to 100% recovery. No one seems to be up-to-date.

The latest here:

 Enriched environments improve stroke recovery and reduce brain inflammation

Chinese Medical Journals Publishing House Co., Ltd.Apr 11 2026

Stroke is one of the leading causes of death worldwide. Its recovery is often challenging as most of the stroke survivors remain chronically disabled, with motor deficits affecting a significant percentage of patients. Stroke recovery continues long after the initial injury stabilization. In the early recovery period, during the first weeks after the insult, the brain enters a prolonged phase of repair and inflammation. This chronic response can strongly influence poststroke recovery and long-term disability.

The poststroke recovery environment plays an important role in the healing process. Recent studies(Not recent at all; quit lying just to make yourself not look stupid!) suggest that environmental enrichment (EE), a recovery setting that combines greater physical activity, sensory stimulation, and social interaction, can improve recovery. However, how the stimulation affects poststroke brain inflammation and white matter pathology is not well-understood.

To address this, a team of researchers, led by Dr. Lluís Camprubí-Ferrer, from the Experimental Neuroinflammation Laboratory, Lund University, Sweden, conducted an animal-based study to understand the effect of EE on poststroke inflammation, microglial response, and myelin integrity. The study was made available online on February 25, 2026, and was published in Volume 4, Issue 1 of the journal Neuroprotection on March 01, 2026.

"EE is known for exerting beneficial effects on neuroplasticity and recovery after stroke. However, a systemic study on understanding the microglial phenotypes during the recovery period after stroke under enriched housing conditions was lacking. Our study addresses this research gap," says Dr. Camprubí-Ferrer.

The researchers induced photothrombotic (PT) stroke, a commonly used experimental model that creates a localized injury in the brain, in male mice and randomized mice into standard environment (SE) or to an EE with more space, social contact, exercise opportunities, and frequently changed objects. The mice were then monitored for sensorimotor recovery over 3 weeks. In addition, they examined the brain for signs of microglial activity and myelin damage.

The behavioral findings clearly highlighted the role of EE in PT stroke recovery. Mice housed in EE performed better on tests of paw placement, foot fault, and limb symmetry, with benefits persisting through 21 days after stroke. When the researchers combined these outcomes into an overall neurological score, the EE group showed stronger recovery.

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The tissue analysis revealed that in SE mice, larger infarcts were closely linked to stronger chronic inflammatory signals. In addition, larger lesions were associated with more myelin debris around the infarct and greater loss of myelin in white matter. In contrast, in EE mice, the usual link between infarct size and chronic inflammatory markers like galectin‐3 was largely absent. The same was true for myelin debris accumulation and white matter myelin loss. The findings suggest that enrichment weakened the tendency for larger lesions to drive stronger long-term inflammation and tissue disruption.

In white matter, higher levels of triggering receptor expressed on myeloid cells 2 (TREM2)-positive microglia were associated with better neurological recovery in EE mice. No other inflammatory or myelin marker showed such a robust relationship with behavior. This highlights TREM2-positive microglia as a potential cellular link between EE and improved functional recovery.

"Our findings suggest that interventions like EE that targets microglial marker suppression and TREM2 potentiation may contribute to post‐stroke white matter repair and improve functional outcomes," concludes Dr. Camprubí-Ferrer.

Source:

Chinese Medical Journals Publishing House Co., Ltd.

Journal reference:

Camprubí‐Ferrer, L., et al. (2026). Environmental enrichment modulates chronic poststroke inflammation and links white matter TREM2‐positive microglia in recovery in mice. Neuroprotection. DOI: 10.1002/nep3.70028. https://onlinelibrary.wiley.com/doi/10.1002/nep3.70028

Environmental enrichment: a neurostimulatory approach to aging and ischemic stroke recovery and rehabilitation

 If you don't have this protocol your whole fucking hospital has been incompetent for 14 years!

If your doctor and hospital hasn't created protocols on environmental enrichment since the

enriched environment talked about by Dr. Dale Corbett in 2011.

You don't have a functioning stroke hospital or doctor. Why the fuck do they consider themselves a stroke hospital? 

RUN AWAY! 

Environmental enrichment: a neurostimulatory approach to aging and ischemic stroke recovery and rehabilitation

• Review Article
• Published: 16 April 2025

• Volume 26, article number 92, (2025)
• Cite this article

Sijina Kinattingara Parambath,

Navami Krishna &

Rajanikant Golgodu Krishnamurthy

Abstract

Environmental enrichment (EE) represents a robust experimental framework exploring the intricate interplay between genes and the environment in shaping brain development and function. EE is recognized as a non-invasive intervention, easily translatable to elderly human cohorts, and extrapolated from research on animal aging models. Age is the most important risk factor for ischemic stroke. Research indicates that EE, characterized by increased sensory, cognitive, and social stimulation, leads to structural changes in the brain, such as enhanced dendritic complexity and synaptic density, particularly in the hippocampus and cortex. Tailored EE interventions for elderly stroke survivors include cognitively stimulating activities and participation in social groups. These interventions enhance cognitive function and support recovery by promoting neural repair. Additionally, EE helps to mitigate sensory deficits commonly observed in older adults, ultimately improving mental performance and quality of life. EE has shown promise in preventing relapse, enhancing attention, reducing anxiety, forestalling age-related DNA methylation alterations, and amplifying neurogenesis through heightened neural progenitor cell (NPC) populations. Aligning preclinical studies with clinical trials can enhance neurorehabilitation conditions for stroke patients, thereby optimizing the environments in which they recover. This can be achieved through the concerted efforts of multidisciplinary teams working collaboratively. This review explores how EE specifically impacts the aging brain and ischemic stroke, a major age-related neurological disorder with global health implications. The potential of enviro-mimetics and relevant clinical studies on EE’s effects on ischemic stroke survivors are discussed. This review enhances our understanding of the effects of EE on aging and ischemic stroke, motivating further research aimed at refining strategies for stroke management and recovery.

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Enriched environment-Induced Neuroplasticity in Ischemic stroke and its underlying mechanisms

If your doctor and hospital hasn't created protocols on environmental enrichment since the

enriched environment talked about by Dr. Dale Corbett in 2011.

You don't have a functioning stroke hospital or doctor. Why the fuck do they consider themselves a stroke hospital? 

RUN AWAY!

Enriched environment-Induced Neuroplasticity in Ischemic stroke and its underlying mechanisms 

Xia Bi^1*, Ping-Ping Han¹, Yu Han¹, Zhen-Kun Gao² and Xin-Ya Shen²

• ¹Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, China
• ²Shanghai University of Traditional Chinese Medicine, China

The final, formatted version of the article will be published soon.

Stroke is a common cerebrovascular disease that can interrupt local blood flow in the brain, causing neuronal damage or even death, resulting in varying degrees of neurological dysfunction. Neuroplasticity is an important neurological function that helps neurons reorganize and regain function after injury. After cerebral ischemia, neuroplasticity changes are critical factors for restoring brain function. An enriched environment promotes increased neuroplasticity, thereby aiding stroke recovery. In this review, we discuss the positive effects of the enriched environment on neuroplasticity after cerebral ischemia, including synaptic plasticity, neurogenesis, and angiogenesis. In addition, we also introduce some studies on the clinical application of enriched environments in the rehabilitation of post-stroke patients, hoping that they can provide some inspiration for doctors and therapists looking for new approaches to stroke rehabilitation.

Environmental enrichment and the aging brain: is it time for standardization?

If your doctor hasn't created protocols on environmental enrichment since the

enriched environment talked about by Dr. Dale Corbett in 2011.

You don't have a functioning stroke hospital.

Environmental enrichment and the aging brain: is it time for standardization?

Author links open overlay panelMartaBalietti^a

FiorenzoConti^ab

https://doi.org/10.1016/j.neubiorev.2022.104728Get rights and content

Highlights

•

Adequate stimulation of the aging brain can delay/compensate for age-related impairment.

•

Environmental enrichment (EE) is a promising protocol to extend the “mind-span”.

•

We offer some suggestions on the key variables requiring standardization.

•

Consensus on EE experimental design would improve the bench to bedside process.

Abstract

Aging entails a progressive decline of cognitive abilities. However, since the brain is endowed with considerable plasticity, adequate stimulation can delay or partially compensate for age-related structural and functional impairment. Environmental enrichment (EE) has been reported to determine a wide range of cerebral changes. Although most findings have been obtained in young and adult animals, research has recently turned to aged individuals. Notably, EE can contribute identifying key lifestyle factors whose change can help extend the “mind-span”, i.e., the time an individual lives in a healthy cognitive condition. Here we discuss specific methodological issues that can affect the outcomes of EE interventions applied to aged rodents, summarize the main variables that would need standardization (e.g., timing and duration, enrichment items, control animals and setting), and offer some suggestions on how this goal may be achieved. Reaching a consensus on EE experiment design would significantly reduce differences between and within laboratories, enable constructive discussions among researchers, and improve data interpretation.(Long past time for the stroke medical world to have created EXACT STROKE PROTOCOLS ON THIS)

 

What is the effectiveness of sensory-motor stimulation on improving upper limb function for chronic hemiparesis in patients with stroke?

Why are we still asking this question? You are so out-of-date that you missed this enriched environment talked about by Dr. Dale Corbett in 2011 and did nothing until now?)

Margaret Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke'.

What is the effectiveness of sensory-motor stimulation on improving upper limb function for chronic hemiparesis in patients with stroke?

Author

Fair, Astyn

Otte, Taylor

Schoening, Brooke

 

ABSTRACT

Occupational therapy’s role in the rehabilitation of stroke includes the evaluation, assessment, and treatment of sensorimotor, musculoskeletal, cognitive, and psychosocial symptoms (Rowland, Cooke, & Gustafsson, 2008). Additionally, occupational therapists have been identified by the American Stroke Association as a key member of the rehabilitation team as part of a stroke survivor’s recovery (American Stroke Association, 2022). We looked at how senori-motor interventions given in occupational therapy could effect upper extremity motor function in patients who have experienced a stroke. Findings: We found that sensori-motor interventions of mirror therapy, repetitive peripheral nerve simulation and hands-on therapy, in conjunction with traditional occupational therapy services can improve upper extremity motor function in patients who have experienced a stroke.

URI

http://hdl.handle.net/10504/136299

 

Does an enriched environment affect patient activity levels at the Oxfordshire Stroke Rehabilitation Unit?

It took you over 10 years to start testing this out?

Because you are so out-of-date that you missed this enriched environment talked about by Dr. Dale Corbett in 2011 and did nothing until now?

Does an enriched environment affect patient activity levels at the Oxfordshire Stroke Rehabilitation Unit?

• E. Garratt
• S. King
• S. Stobart
• K. Biggin
• T. Gaffney

DOI:https://doi.org/10.1016/j.physio.2021.10.017

Purpose: Despite much innovation in stroke care over the past 10 years, patients remain inactive and alone, even in rehabilitation settings. Increased activity levels post stroke can improve functional outcomes, independence, and have a positive impact on quality of life. In recent years the concept of enriched environments gained traction as a potential method to increase activity levels without significant change in services resources or staffing. An enriched environment is simply one which promotes physical, cognitive and social activity through an enabling ethos and accessibility to relevant resources. The evidence base is rooted in animal models, which have shown increased potential for neuroplasticity in rats who, post-stroke, are confined in an enriched environment compared to those in an impoverished environment. It is thought there is potential for this theory to be extrapolated to human populations with preliminary positive findings coming from researchers in Australia. The aim of this project was to implement an enriched environment at the Oxfordshire Stroke Rehabilitation Unit, measure its impact on patient activity levels and evaluate the feasibility of the project.

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Article Info

Identification

DOI: https://doi.org/10.1016/j.physio.2021.10.017

Copyright

© 2021 Published by Elsevier Inc.

 

 

Patients’ experiences of a Communication Enhanced Environment model on an acute/ slow stream rehabilitation and a rehabilitation ward following stroke: a qualitative description approach

So this is the partner to this enriched environment talked about by Dr. Dale Corbett in 2011?

Finally have a communication enriched environment for your hospital to set up. Did your hospital ever setup the enriched environment described by Dale Corbett? Why not? They love being incompetent?

Patients’ experiences of a Communication Enhanced Environment model on an acute/ slow stream rehabilitation and a rehabilitation ward following stroke: a qualitative description approach

 Sarah D’Souzaa,b , Deborah Hersha , Erin Godeckea,b , Natalie Cicconea , Heidi Janssenc and Elizabeth Armstronga a School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; b Centre for Aphasia Recovery and Rehabilitation Research, La Trobe University, Melbourne, Australia; c School of Health Sciences, Hunter New England Local Health District, NSW Health, Australia 

ABSTRACT 

Background:  

 

Patients in hospital following stroke express a desire to continue therapy tasks outside of treatment activities. However, they commonly describe experiences of boredom and inactivity. An enriched environment aims to provide opportunities for physical, cognitive and social activity and informed the development of a Communication Enhanced Environment (CEE) model to promote patient engagement in language activities. 

 

Purpose: 

 

Explore patient perceptions of a CEE model, and barriers and facilitators to engagement in the model. Methods: A qualitative description study from a larger project that implemented a CEE model into acute and rehabilitation private hospital wards in Western Australia. Semi-structured interviews were conducted with seven patients, including four with aphasia, within 22 days post-stroke who had access to the CEE model. 

 

Results: 

Patients described variable experiences accessing different elements of the CEE model which were influenced by individual patient factors, staff factors, hospital features as well as staff time pressures. Those who were able to access elements of the CEE model described positive opportunities for engagement in language activities. 

 

Conclusions: 

While findings are encouraging, further exploration of the feasibility of a CEE model in this complex setting is indicated to inform the development of this intervention.
(So write up a provisional protocol on this since no followup will occur. Survivors can at least get some recovery from this.)

IMPLICATIONS FOR REHABILITATION
 

Patient access to a CEE model is challenging in a hospital setting.
Patients who were able to access elements of the CEE model described positive opportunities for engagement in language activities.
Patients’ access to the CEE model was influenced by patient factors, staff factors, hospital features as well as staff time pressures. ARTICLE HISTORY Received 15 February 2021 Revised 26 July 2021 Accepted 29 July 2021 KEYWORDS Stroke; aphasia; Communication Enhanced Environment model; enriched environment; rehabilitation 

Introduction 

 

It is recognised that the environment can influence neural remapping during early stroke recovery [1]. However, the current hospital environment may reflect what is considered impoverished [2–10] with patients following stroke spending large proportions of their day alone and inactive [11]. Patients in hospital following a stroke express a desire to continue therapy tasks outside of treatment tasks, perceiving time outside of therapy as an opportunity to practise rehabilitation activities within the real-world environment [12]. However, boredom is commonly experienced by patients which has the potential to negatively affect their engagement in rehabilitation [13]. Patients report that a lack of meaningful activity is strongly associated with boredom [13]. Boredom is highly correlated with depression and apathy and is perceived by patients to negatively affect their participation in stroke rehabilitation [13]. Patients following stroke perceive a lack of stimulation and inactivity impacts their ability to “drive” their own rehabilitation outside of therapy, describing their time outside of their therapy as “dead and wasted” [12].(p4) Nurses have been observed to be the most common communication partner for patients after their family members [14]. However, nurses in a stroke rehabilitation unit report that time constraints often limit their capacity to comfort, talk with and provide education to patients [15]. This lack of time for communication and education has also been identified by patients who “did not like to bother the busy nurse” [16]. Aphasia is a communication disorder that occurs in approximately 30% of stroke survivors [17] and affects all modalities of communication including speaking, listening, reading and writing. Aphasia is associated with higher levels of disability and has significant negative consequences for social participation, interpersonal relationships, autonomy, capacity to work and quality of life [18]. Patients with aphasia (PWA) following stroke have been observed to spend less than 28% of their day communicating with others and 44% of their day alone during their first weeks of inpatient rehabilitation [14]. Limited opportunities for language use, and engagement in meaningful activity and social interaction may negatively impact aphasia language recovery [3] and have adverse consequences for health-related quality of life [7]. This places PWA at increased risk of developing learned non-use of language as a result of inadequate opportunities for communication [14]. An enriched environment (EE) aims to provide greater opportunities for physical, cognitive and social activity and has been shown to contribute to significant improvements in neuroplasticity, motor recovery and a trend towards significant improvements in cognition in animal stroke models [19]. Application of EE in an acute7 and rehabilitation unit [20] setting has been shown to significantly increase patient engagement in physical, cognitive and social activity. Aphasia is a complex language impairment and PWA may need support within an EE. The principles of EE informed the development of a Communication Enhanced Environment (CEE) model to facilitate engagement in language activities for patients following stroke, which incorporated the needs of those with aphasia [21]. The definition of language activities encompassed any activity that involved the use of language including both solitary (i.e., reading, writing) and interactive (i.e., talking or listening to a communication partner) language activities. This CEE model was co-designed with hospital staff and considered hospital policies and procedures and incorporated evidence-based strategies, expert opinion, [21] and staff and patient-perceived barriers and facilitators to their engagement in language activity following stroke [22]. The CEE model sought to promote access to physically enhanced communal spaces, trained communication partners, resources, and organised social activities [23]. Results from piloting the CEE model found that 71% of the model was reported to be available to the intervention group [21]. Additionally, the intervention group who had access to the CEE model engaged in higher, but not significant, levels of language activities (600 of 816 observation time points, 73%) than the control group (551 of 835 observation time points, 66%) [21]. This study sought to explore patient perceptions of communication interactions and language activity including the perceived barriers and facilitators to engagement in the CEE model during their hospital admission. The specific research questions were: i. What are patients’ perceptions of communication interactions and language activities during their hospital admission following stroke where the CEE model was implemented in usual care? ii. What do patients perceive to be barriers and facilitators to engagement in the CEE model.

 

More at link.

Efficacy of rehabilitative experience declines with time after focal ischemic brain injury

If you were to actually THINK about this you would realize that neuroplasticity is a total unknown, we don't know how to initiate it upon command. We know nothing about why a neuron gives up its job and takes on a neighboring neurons functionality.  It would make vastly more sense to stop the 5 causes of the neuronal cascade of death in the first week saving billions of neurons.

I only lost 5.4 billion neurons that first week because my doctor knew nothing and did nothing. That's 3% of my neurons, saving those would have made my 100% recovery a cinch. But going down this route allows you to blame the patient for non recovery instead of the doctor where it belongs.

 

Efficacy of rehabilitative experience declines with time after focal ischemic brain injury

Jeff Biernaskie  ¹ , Garry Chernenko, Dale Corbett

Affiliations

• PMID: 14762143
• PMCID: PMC6793570
• DOI: 10.1523/JNEUROSCI.3834-03.2004

Free PMC article

Abstract

To maximize the effectiveness of rehabilitative therapies after stroke, it is critical to determine when the brain is most responsive (i.e., plastic) to sensorimotor experience after injury and to focus such efforts within this period. Here, we compared the efficacy of 5 weeks of enriched rehabilitation (ER) initiated at 5 d (ER5), ER14, or ER30 after focal ischemia, as judged by functional outcome and neuromorphological change. ER5 provided marked improvement in skilled forelimb reaching ability and ladder-rung- and narrow-beam-walking tasks and attenuated the stroke-induced reliance on the unaffected forepaw for postural support. ER14 provided improvement to a somewhat lesser extent, whereas recovery was diminished after ER30 such that motor function did not differ from ischemic animals exposed to social housing. To examine potential neural substrates of the improved function, we examined dendritic morphology in the undamaged motor cortex because our previous work (Biernaskie and Corbett, 2001) suggested that recovery was associated with enhanced dendritic growth in this region. ER5 increased the number of branches and complexity of layer V neurons compared with both social housing and control animals. Dendritic arbor after ER14 (although increased) and ER30 did not differ from those exposed to social housing. These data suggest that the poststroke brain displays heightened sensitivity to rehabilitative experience early after the stroke but declines with time. These findings have important implications for rehabilitation of stroke patients, many of whom experience considerable delays before therapy is initiated.

Figures

Figure 2.

Single-pellet reaching test. A ,…

Figure 1.

Typical areas of infarction resulting…

Figure 3.

Staircase reaching test. The mean…

Figure 4.

Narrow-beam-walking task. Four days after…

Figure 5.

Cylinder test of forelimb use…

Figure 6.

Ladder-rung walking test. A ,…

 

Altering the rehabilitation environment to improve stroke survivor activity: A Phase II trial

Why?  Because you are so out-of-date that you missed this enriched environment talked about by Dr. Dale Corbett in 2011?

Altering the rehabilitation environment to improve stroke survivor activity: A Phase II trial

Show all authors

Heidi Janssen, Louise Ada, Sandy Middleton, ...

First Published April 13, 2021 Research Article Find in PubMed 

https://doi.org/10.1177/17474930211006999

Article information

 

Abstract

Background

Environmental enrichment involves organization of the environment and provision of equipment to facilitate engagement in physical, cognitive, and social activities. In animals with stroke, it promotes brain plasticity and recovery.

Aims

To assess the feasibility and safety of a patient-driven model of environmental enrichment incorporating access to communal and individual environmental enrichment.

Methods

A nonrandomized cluster trial with blinded measurement involving people with stroke (n = 193) in four rehabilitation units was carried out. Feasibility was operationalized as activity 10 days after admission to rehabilitation and availability of environmental enrichment. Safety was measured as falls and serious adverse events. Benefit was measured as clinical outcomes at three months, by an assessor blinded to group.

Results

The experimental group (n = 91) spent 7% (95% CI −14 to 0) less time inactive, 9% (95% CI 0–19) more time physically, and 6% (95% CI 2–10) more time socially active than the control group (n = 102). Communal environmental enrichment was available 100% of the time, but individual environmental enrichment was rarely within reach (24%) or sight (39%). There were no between-group differences in serious adverse events or falls at discharge or three months or in clinical outcomes at three months.

Conclusions

This patient-driven model of environmental enrichment was feasible and safe. However, the very modest increase in activity by people with stroke, and the lack of benefit in clinical outcomes three months after stroke do not provide justification for an efficacy trial.(Really, that was your conclusion? Other research suggests otherwise.)

Keywords Stroke, clinical trial, rehabilitation, environmental enrichment, activity, recovery

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Altering the rehabilitation environment to improve stroke survivor activity: A Phase II trial

Is this any different than what you should have known about this enriched environment talked about by Dr. Dale Corbett in 2011?

Or Margaret Yekutiel who wrote a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke'? Or didn't you know about that book? 20 years and you are THAT FUCKING INCOMPETENT?

When the fuck are you going to improve your stroke doctors ability to implement 100% recovery protocols?

Altering the rehabilitation environment to improve stroke survivor activity: A Phase II trial

Show all authors

Heidi Janssen, Louise Ada, Sandy Middleton, ...

First Published April 13, 2021 Research Article Find in PubMed 

https://doi.org/10.1177/17474930211006999

Article information

 

Abstract

Background

Environmental enrichment involves organization of the environment and provision of equipment to facilitate engagement in physical, cognitive, and social activities. In animals with stroke, it promotes brain plasticity and recovery.

Aims

To assess the feasibility and safety of a patient-driven model of environmental enrichment incorporating access to communal and individual environmental enrichment.

Methods

A nonrandomized cluster trial with blinded measurement involving people with stroke (n = 193) in four rehabilitation units was carried out. Feasibility was operationalized as activity 10 days after admission to rehabilitation and availability of environmental enrichment. Safety was measured as falls and serious adverse events. Benefit was measured as clinical outcomes at three months, by an assessor blinded to group.

Results

The experimental group (n = 91) spent 7% (95% CI −14 to 0) less time inactive, 9% (95% CI 0–19) more time physically, and 6% (95% CI 2–10) more time socially active than the control group (n = 102). Communal environmental enrichment was available 100% of the time, but individual environmental enrichment was rarely within reach (24%) or sight (39%). There were no between-group differences in serious adverse events or falls at discharge or three months or in clinical outcomes at three months.

Conclusions

This patient-driven model of environmental enrichment was feasible and safe. However, the very modest increase in activity by people with stroke, and the lack of benefit in clinical outcomes three months after stroke do not provide justification for an efficacy trial.(You didn't do this correctly then.)

Keywords Stroke, clinical trial, rehabilitation, environmental enrichment, activity, recovery

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EXPRESS: Altering the rehabilitation environment to improve stroke survivor activity (AREISSA): a Phase II trial.

You are attacking the problem from the wrong side. The problem is that doctors are doing ABSOLUTELY NOTHING to assist your recovery. Have them stop the 5 causes of the neuronal cascade of death in the first week. That would assist your recovery vastly more than rehab which only fully works 10% of the time.  And just why the fuck are you studying environmental enrichment? Hasn't it been proven enough by this enriched environment talked about by Dr. Dale Corbett in 2011?

Or Margaret Yekutiel who wrote a whole book about it in 2001, 'Sensory Re-Education of the Hand After Stroke'? Or didn't you know about that book? 20 years and you are THAT FUCKING INCOMPETENT?

I will never follow the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 
Politeness will never solve anything in stroke.

 The latest here:

EXPRESS: Altering the rehabilitation environment to improve stroke survivor activity (AREISSA): a Phase II trial.

Show all authors

Heidi Janssen, Louise Ada, Sandy Middleton, ...

First Published March 19, 2021 Research Article 

https://doi.org/10.1177/17474930211006999

Article information

   

Abstract

Background: 

Environmental enrichment involves organisation of the environment and provision of equipment to facilitate engagement in physical, cognitive and social activity. In animals with stroke, it promotes brain plasticity and recovery.

Aims: 

To assess the feasibility and safety of a patient-driven model of environmental enrichment incorporating access to communal and individual environmental enrichment.

Methods: 

A non-randomised cluster trial with blinded measurement involving people with stroke (n=193) in 4 rehabilitation units was carried out. Feasibility was operationalised as activity 10 days after admission to rehabilitation and availability of environmental enrichment. Safety was measured as falls and serious adverse events. Benefit was measured as clinical outcomes at 3 months, by an assessor blinded to group.

Results: 

The experimental group (n=91) spent 7% (95% CI -14 to 0) less time inactive, 9% (95% CI 0 to 19) more time physically, and 6% (95% CI 2 to 10) more time socially active than the control group (n=102). Communal environmental enrichment was available 100% of the time, but individual environmental enrichment was rarely within reach (24%) or sight (39%). There were no between-group differences in serious adverse events or falls at discharge or 3 months nor in clinical outcomes at 3 months.

Conclusions: 

This patient-driven model of environmental enrichment was feasible and safe. However, the very modest increase in activity by people with stroke, and the lack of benefit in clinical outcomes 3 months after stroke do not provide justification for an efficacy trial.(Really, that was your conclusion?)

Clinical Trial Registration: ANZCTR 12613000796785

Words: 245

Keywords Clinical trial, Rehabilitation, Stroke, activity, environmental enrichment, recovery

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