NeuroRehabilitation - Volume 51, issue 1

Authors: Nikolaev, Vitaly A. | Nikolaev, Alexander A.

Article Type: Review Article

Abstract: BACKGROUND: Stroke is the main reason for disabilities worldwide leading to motor dysfunction, spatial neglect and cognitive problems, aphasia, and other speech-language pathologies, reducing the life quality. To overcome disabilities, telerehabilitation (TR) has been recently introduced. OBJECTIVE: The aim of this review was to analyze current TR approaches for stroke patients’ recovery. METHODS: We searched 6 online databases from January 2018 to October 2021, and included 70 research and review papers in the review. We analyzed TR of 995 individuals, which was delivered synchronously and asynchronously. RESULTS: Findings show TR is feasible improving motor …function, cognition, speech, and language communication among stroke patients. However, the dose of TR sessions varied significantly. We identified the following limitations: lack of equipment, software, and space for home-based exercises, insufficient internet capacity and speed, unavailability to provide hands on guidance, low digital proficiency and education, high cognitive demand, small samples, data heterogeneity, and no economic evaluation. CONCLUSIONS: The review shows TR is superior or similar to conventional rehabilitation in clinical outcomes and is used as complementary therapy or as alternative treatments. More importantly, TR provides access to rehabilitation services of a large number of patients with immobility, living in remote areas, and during COVID-19 pandemic or similar events. Show more

Keywords: Stroke telerehabilitation, home-based rehabilitation, motor function recovery, cognitive rehabilitation, aphasia rehabilitation, telehealth, telemedicine

DOI: 10.3233/NRE-210330

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 1-22, 2022

Authors: Tramontano, Marco | Polo, Nicoletta | Bustos, Amaranta Orejel | Lisi, Danilo | Galeoto, Giovanni | Farsetti, Pasquale

Article Type: Review Article

Abstract: BACKGROUND: The SARS-CoV-2 infection (COVID-19) has generated a threat to global health, determining the need for healthcare for large numbers of people in an extremely short time OBJECTIVE: To investigate the management changes in the neurorehabilitation services during the COVID-19 pandemic. METHODS: An electronic search was conducted in September 2021 by 2 independent reviewers in the following databases: MEDLINE (PubMed), the Physiotherapy Evidence Database, and the Cochrane Database of Systematic Reviews. All studies on organizational and welfare changes resulting from the COVID-19 pandemic in neurorehabilitation services were included. Screening of titles, abstracts, and full texts and …data extraction were undertaken independently by pairs of reviewers. RESULTS: The summary of results was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Electronic searches after the screening of title and abstract identified 80 studies, 13 studies met the inclusion criteria. A narrative summary of results of all included studies were reported in a tabular format. CONCLUSIONS: Different organizational models were adopted in neurorehabilitation during the COVID-19 pandemic impacting the therapies time frame, the physical and mental health of healthcare professionals and the caregiver’s workload. There is still uncertainty about the effectiveness of these new therapeutic strategies on the management of neurorehabilitation services and future studies should explore the effect on the patients’ needs. Show more

Keywords: Neurorehabilitation, COVID-19, SARS-CoV-2, caregivers, health professionals

DOI: 10.3233/NRE-220014

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 23-32, 2022

Authors: Sawa, Kota | Amimoto, Kazu | Ishigami, Keisuke | Miyamoto, Takuya | Setoyama, Chika | Suzuki, Rikuya | Nozomi, Kuwabara | Tamura, Miko | Miyagami, Mitsusuke

Article Type: Research Article

Abstract: BACKGROUND: The subjective postural vertical (SPV) is affected by training that requires participants to maintain balance; training to achieve sitting balance may also help SPV recovery and activities of daily living (ADLs). OBJECTIVE: This study aimed to assess the medium-term effects of balance training on the postural vertical (PV) and ADLs in patients with stroke. METHODS: Thirty-three patients with stroke were enrolled in this randomized crossover trial. The outcomes were SPV, SPV with eyes opened (SPV-EO), and the Functional Independent Measure (FIM) after the 14-day intervention of experimental or control training. Experimental training consisted of a …maximum lateral truncal tilt to the paretic side at 0.25 Hz with or without a 10° wedge, repeated 60 times. Repeated-measures two-way analysis of variance was performed with two factors: intervention and the intervention period. RESULTS: There was no interaction between the control condition and the PV, but there was interaction between the intervention period and using a wedge for SPV variability errors. FIM showed an interaction between the intervention period and the use of a wedge. CONCLUSIONS: Balance training while sitting with a wedge significantly improved the SPV and FIM. This improved cognition and perception, which facilitate difficult dynamic tasks in ADLs. Show more

Keywords: Postural vertical, balance, training, stroke

DOI: 10.3233/NRE-210255

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 33-40, 2022

Authors: Yigit, Sedat | Usgu, Serkan | Albayrak, Hatice Mutlu | Yücel, Peren Perk | Yakut, Yavuz

Article Type: Research Article

Abstract: BACKGROUND: Ataxia is a clinical syndrome characterized by coordination problems and postural disorders. OBJECTIVE: This study aimed to examine the effects of functional trunk training on trunk control and upper limb functions in autosomal recessive hereditary ataxia. METHODS: Twenty patients were randomly divided into treatment and control groups. Both groups received trunk stabilization and balance exercises, and the treatment group received additional functional trunk training sessions (3 days/week for 8 weeks). The International Cooperative Ataxia Rating Scale, Trunk Impairment Scale, Modified Functional Reach Test, Nine-Hole Peg Test and Quick-Disabilities of the Arm Shoulder and Hand questionnaire …were used for assessments. RESULTS: The treatment group showed an increase in the upper limb performance bilaterally, whereas increased performance was seen only in the dominant upper limb in the control group. While the functional reach improved in the anterior-posterior (AP) and medial-lateral (ML) directions in the treatment group, it was improved only in the AP direction in the control group. Also, the mean changes in outcomes were not significantly different between the groups except for modified functional reach test. CONCLUSIONS: Functional trunk training may be a more effective method to improve upper limb performance and dynamic trunk balance in autosomal recessive hereditary ataxia. Show more

Keywords: Ataxia, trunk control, upper extremity functions, functional training

DOI: 10.3233/NRE-210320

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 41-50, 2022

Authors: Shin, Jiwon | An, HongGi | Yang, Sejung | Park, Chanhee | Lee, Yongseok | You, Sung (Joshua) H.

Article Type: Research Article

Abstract: BACKGROUND: Robot-assisted gait training (RAGT) was initially developed based on the passive controlled (PC) mode, where the target or ideal locomotor kinematic trajectory is predefined and a patient basically ‘rides’ the robot instead of actively participating in the actual locomotor relearning process. A new insightful contemporary neuroscience and mechatronic evidence suggest that robotic-based locomotor relearning can be best achieved through active interactive (AI) mode rather than PC mode. OBJECTIVE: The purpose of this study was to compare the pattern of gait-related cortical activity, specifically gait event-related spectral perturbations (ERSPs), and muscle activity from the tibialis anterior (TA) and …clinical functional tests in subacute and chronic stroke patients during robot-assisted gait training (RAGT) in passive controlled (PC) and active interactive (AI) modes. METHODS: The present study involves a two-group pretest-posttest design in which two groups (i.e., PC-RAGT group and AI-RAGT group) of 14 stroke subjects were measured to assess changes in ERSPs, the muscle activation of TA, and the clinical functional tests, following 15– 18 sessions of intervention according to the protocol of each group. RESULTS: Our preliminary results demonstrated that the power in the μ band (8– 12 Hz) was increased in the leg area of sensorimotor cortex (SMC) and supplementary motor area (SMA) at post-intervention as compared to pre-intervention in both groups. Such cortical neuroplasticity change was associated with TA muscle activity during gait and functional independence in functional ambulation category (FAC) and motor coordination in Fugl– Meyer Assessment for lower extremity (FMA-LE) test as well as spasticity in the modified Ashworth scale (MAS) measures. CONCLUSIONS: We have first developed a novel neuroimaging experimental paradigm which distinguished gait event related cortical involvement between pre- and post-intervention with PC-RAGT and AI-RAGT in individuals with subacute and chronic hemiparetic stroke. Show more

Keywords: Walkbot, Robotic assisted gait training, gait event-related spectral perturbations, electroencephalography

DOI: 10.3233/NRE-210304

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 51-63, 2022

Authors: Cui, Wei | Huang, Lin | Tian, Yang | Luo, Hong | Chen, Shuang | Yang, Yan | Li, Yamei | Fu, Jing | Yu, Qian | Xu, Li

Article Type: Research Article

Abstract: BACKGROUND: Mirror therapy has been gradually adopted for lower limb rehabilitation, but its efficacy and neural mechanism are not well understood. OBJECTIVE: This study aims to investigate the effect and neural mechanism of mirror therapy on lower limb rehabilitation after ischemic stroke by using resting state functional magnetic resonance imaging (rs-fMRI). METHODS: A single-blind and randomized controlled pilot study was conducted. 32 patients with ischemic stroke were included in this study and randomly divided into two groups – the control group (CT, n  = 16) and the mirror therapy group (MT, n  = 16). Both the CT and …MT groups received medication and routine rehabilitation training. In addition, mirror therapy was added to the MT group 5 times a week for 30 minutes each time over a period of 3 weeks. Patients’ motor functions, functional connectivity (FC), regional homogeneity (ReHo), and fractional amplitude of low-frequency fluctuations (fALFF) were analyzed both before and immediately after the treatment. RESULTS: Patients’ motor functions showed significant improvement in both groups compared to those before treatment (p  < 0.01). Moreover, the MT group showed significantly better improvement than the CT group after the treatment (p  < 0.05). FC, ReHo and fALFF indicated enhanced neuronal activities in motor function-related brain regions in the MT group compared to the CT group. CONCLUSION: Mirror therapy promotes the recovery of lower limb motor functions in patients with ischemic stroke. Through the comparative rs-fMRI analysis, it is found that the mirror therapy promotes the functional reorganization of the injured brain. Show more

Keywords: Ischemic stroke, mirror therapy, lower limb rehabilitation, resting-state functional magnetic resonance imaging (rs-fMRI)

DOI: 10.3233/NRE-210307

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 65-77, 2022

Authors: Ho, Hsiu-Yu | Chen, Ming-De | Tsai, Chiu-Chin | Chen, Hui-Mei

Article Type: Research Article

Abstract: BACKGROUND: Computerized cognitive training (CCT) is an emerging alternative intervention for stroke survivors. OBJECTIVE: This study investigated the effects of CCT on the cognition, activity, and participation of stroke survivors and compared the findings with those of match-dosed conventional cognitive training. METHODS: This randomized controlled trial included 39 patients with stroke who were divided into the intervention group (n  = 19; receiving CCT with Lumosity software) and the control group (n  = 20; receiving conventional cognitive training). Both the groups were trained for 20 min, twice a week, for 12 weeks. Participants were evaluated at pretest, posttest, and …4-week follow-up. Outcome measures included various cognitive function tests and the Stroke Impact Scale scores. RESULTS: The CCT group exhibited significant improvement in global cognitive function (evaluated using the Mini-Mental State Examination and Montreal Cognitive Assessment) and specific cognitive domains: verbal working memory (backward digit span test), processing speed (Symbol Digit Modalities Test), and three MoCA subtests (attention, naming, and delayed recall). CCT exerted no significant effect on activities and participation. No significant between-group differences in changes in cognitive function were noted. However, CCT significantly improved cognitive function domains immediately after training, and these effects were sustained at the 4-week follow-up. CONCLUSIONS: Cognitive function of individuals with chronic stroke could improve after administration of CCT. However, future studies with a more rigorous design and higher training dose are warranted to validate our findings. Show more

Keywords: cerebral vascular accident, computerized cognitive training, cognitive function, quality of life

DOI: 10.3233/NRE-210271

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 79-89, 2022

Authors: Salgueiro, Carina | Urrútia, Gerard | Cabanas-Valdés, Rosa

Article Type: Research Article

Abstract: BACKGROUND: Telerehabilitation has been proposed as an effective strategy to deliver post-stroke specific exercise. OBJECTIVE: To assess the effectiveness and feasibility of core stability exercises guided by a telerehabilitation App after hospital discharge. METHODS: Extension of a prospective controlled trial. Subacute stage stroke survivors were included at the time of hospital discharge where they had participated in a previous 5-week randomized controlled trial comparing conventional physiotherapy versus core stability exercises. After discharge, patients from the experimental group were offered access to telerehabilitation to perform core stability exercises at home (AppG), while those from the control group …were subject to usual care (CG). The Spanish-version of the Trunk Impairment Scale 2.0 (S-TIS 2.0), Function in Sitting Test (S-FIST), Berg Balance Scale (BBS), Spanish-version of Postural Assessment for Stroke Patients (S-PASS), the number of falls, Brunel Balance Assessment (BBA) and Gait were assessed before and after 3 months intervention. RESULTS: A total of 49 subjects were recruited. AppG showed greater improvement in balance in both sitting and standing position and gait compared with CG, although no statistically significant differences were obtained. CONCLUSION: Core stability exercises Telerehabilitation as a home-based guide appears to improve balance in post-stroke stage. Future studies are necessary to confirm the effects as well as identifying strategies to increase telerehabilitation adherence. Show more

Keywords: Telerehabilitation, exercises, core stability, balance, gait, stroke, trunk function

DOI: 10.3233/NRE-210332

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 91-99, 2022

Authors: Lasprilla, Juan Carlos Arango | Rodríguez-Irizarry, Walter | Oliveras-Rentas, Rafael E. | Ramos-Usuga, Daniela | Gonzalez, Isabel | Perez, Paula Karina | Romero-García, Ivonne

Article Type: Research Article

Abstract: BACKGROUND: Despite numerous calls throughout the years for an increase in ethnic, cultural, and racial diversity within the field of psychology, it remains an elusive reality for Hispanic neuropsychology practitioners in the United States (U.S.). OBJECTIVE: 1. Determine the background and current work situation of Hispanic clinical neuropsychologists in the U.S. (e.g., professional training, assessment and diagnostic procedures used, rehabilitation techniques employed, populations targeted, teaching responsibilities, and research activities), and 2. Examine issues related to perceived discrimination in the field of neuropsychology and what this means for our profession. METHODS: The sample consisted of 107 Hispanic …neuropsychologists residing among the 50 United States, District of Columbia, and Puerto Rico who took a survey of professional practices and experiences in clinical neuropsychology. RESULTS: Our findings confirm that Hispanic neuropsychologists in the U.S. are culturally diverse, present with varied levels of bilingualism, have been faced with discrimination during training and in their workplace, and compare favorably with non-Hispanic neuropsychologists in terms of education and clinical training. CONCLUSIONS: Transforming neuropsychology into a diverse and inclusive field requires intentional, strategic, and systematic interventions in education, academia, training, professional organizations and in research. Show more

Keywords: Hispanic, neuropsychology, United States, diversity

DOI: 10.3233/NRE-210333

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 101-121, 2022

Authors: Lee, Jeong Jae | Park, Chanhee | You, Joshua (Sung) H.

Article Type: Research Article

Abstract: BACKGROUND: While excessive ankle plantarflexion is a common neuromuscular impairment resulting from insufficient coordination of selective ankle neuromotor control and kinematics during gait. We recently developed a wearable, inexpensive and sustainable wearable ankle-tubing gait training (WAGT) aimed at improving selective ankle motor control and kinematic coordination. OBJECTIVE: We investigated the effects of WAGT on tibialis anterior (TA) and gastrocnemius (GCM) muscle electromyography (EMG) activity, TA: GCM muscle imbalance ratio, and ankle joint kinematics during gait in hemiparetic stroke patients. METHODS: A convenience sample of 33 participants (15 non-stroke healthy adults and 18 hemiparetic stroke patients) underwent …standardized electromyography and kinematic biomechanical tests under conventional gait training (CGT) and WAGT conditions. Analysis of variance (ANOVA) was used to determine the significance of differences in the TA: GCM muscle activation, muscle imbalance ratio, and ankle joint kinematics before and after the intervention and between the two groups at P  < 0.05. RESULTS: WAGT was more effective than CGT in improving TA muscle activation (P  < 0.01), TA: GCM muscle imbalance ratio (P  < 0.01), and kinematic movement (P  < 0.01) in adults with or without hemiparetic stroke. CONCLUSIONS: This study demonstrated that WAGT is relatively ease to design, wear and affordable to most clinicians and patients, hence it is suitable for many health care applications to correct gait-related movement abnormalities presented in the hemiparetic stroke patients. Show more

Keywords: Stroke, ankle-tubing gait, wearable, electromyography, joint kinematics

DOI: 10.3233/NRE-210277

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 123-132, 2022

Authors: Lindsey, Hannah M. | Lazar, Mariana | Mercuri, Giulia | Rath, Joseph F. | Bushnik, Tamara | Flanagan, Steven | Voelbel, Gerald T.

Article Type: Research Article

Abstract: BACKGROUND: Traumatic brain injury (TBI) often results in chronic impairments to cognitive function, and these may be related to disrupted functional connectivity (FC) of the brain at rest. OBJECTIVE: To investigate changes in default mode network (DMN) FC in adults with chronic TBI following 40 hours of auditory processing speed training. METHODS: Eleven adults with chronic TBI underwent 40-hours of auditory processing speed training over 13-weeks and seven adults with chronic TBI were assigned to a non-intervention control group. For all participants, resting-state FC and cognitive and self-reported function were measured at baseline and at a …follow-up visit 13-weeks later. RESULTS: No significant group differences in cognitive function or resting-state FC were observed at baseline. Following training, the intervention group demonstrated objective and subjective improvements on cognitive measures with moderate-to-large effect sizes. Repeated measures ANCOVAs revealed significant (p  < 0.001) group×time interactions, suggesting training-related changes in DMN FC, and semipartial correlations demonstrated that these were associated with changes in cognitive functioning. CONCLUSIONS: Changes in the FC between the DMN and other resting-state networks involved in the maintenance and manipulation of internal information, attention, and sensorimotor functioning may be facilitated through consistent participation in plasticity-based auditory processing speed training in adults with chronic TBI. Show more

Keywords: Chronic traumatic brain injury, functional magnetic resonance imaging, functional connectivity, cognitive rehabilitation, neuronal plasticity

DOI: 10.3233/NRE-210264

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 133-150, 2022

Authors: Kim, Heejun | Park, Chanhee | You, Joshua (Sung) H.

Article Type: Research Article

Abstract: BACKGROUND: Accurately diagnosing dynamic postural sway (DPS) is essential for effective and sustainable intervention in children with cerebral palsy (CP). We developed an accurate, inexpensive, and wearable DPS measurement system to measure DPS accurately and consistently during walking and functional activities of daily living. OBJECTIVE: We investigated the validity and reliability of this PostureRite system in children with CP, and the link between PostureRite and clinical measures including gross motor function measure (GMFM), pediatric balance scale (PBS), and fall efficacy scale (FES). METHODS: Twenty-one participants were categorized as follows: 11 healthy adults (3 females, mean age, …25.00±1.00 years) and 10 children with CP (mean age, 11.10±6.28 years). We determined the concurrent validity of PostureRite by comparing DPS data to the gold standard accelerometer measurement results. We determined test-retest reliability by measuring DPS data on three occasions at 2-h intervals. We assessed PostureRite measurement sensitivity to ascertain differences between healthy children and children with CP DPS measurements. RESULTS: Random and mixed intraclass correlation coefficients (ICC2,k and ICC3,k ) were obtained; an independent T -test was performed (P  < 0.05). Concurrent validity analysis showed a good relationship between the gold standard accelerometer and PostureRite (ICC2,k  = 0.973, P  < 0.05). Test-retest reliability demonstrated a good relationship across the three repeated measures of the DPS data (ICC3,k  = 0.816–0.924, P  < 0.05). Independent T -test revealed a significant difference in DPS data between healthy adults and children with CP (P  < 0.05). CONCLUSIONS: We developed a portable, wireless, and affordable PostureRite system to measure DPS during gross motor function associated with daily activity and participation, and established the concurrent validity, test-retest reliability as sensitivity, and clinical relevance by comparing the DPS obtained from the participants with and without CP. Show more

Keywords: Validity, reliability, sensitivity, dynamic postural sway, cerebral palsy

DOI: 10.3233/NRE-210331

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 151-159, 2022

Authors: Xie, Huan | Gao, Min | Lin, Yan | Yi, Yaping | Liu, Ye

Article Type: Research Article

Abstract: BACKGROUND: The optimization and standardization of emergency nursing and monitoring procedures are of great significance for thrombolytic treatment of acute cerebral infarction. OBJECTIVE: Studies on the emergency nursing and monitoring procedure on cognitive impairment and neurological function in patients with acute cerebral infarction are still limited. METHODS: The study was a randomized controlled trial and 134 patients with acute cerebral infarction were recruited. They were randomly arranged into the control group (n  = 67) receiving normal nursing procedure and the intervention group (n  = 67) receiving emergency nursing and monitoring procedure after pre-intervention assessment. The cognitive …impairment, neurological function and levels of inflammatory biomarkers and neuron-specific enolase of the participants were evaluated and analyzed. RESULTS: Emergency nursing and monitoring procedure improved Mini-mental State Examination and Montreal Cognitive Assessment scores of patients with cerebral infraction compared with the control group. It also improved the scores of National Institutes of Health Stroke Scale, activities of daily living scale, Fugl-Meyer scale in the participants. Emergency nursing and monitoring procedure led to significantly decreased neuron-specific enolase and inflammatory cytokines in the serum of the participants. CONCLUSION: Emergency nursing and monitoring procedure are beneficial for cognitive impairment and neurological function recovery in patients with acute cerebral infarction. Show more

Keywords: Emergency nursing and monitoring procedure, cerebral infraction, cognitive impairment, neuron-specific enolase

DOI: 10.3233/NRE-210310

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 161-170, 2022

Authors: Cheng, Ju-Yu | Yang, Yea-Ru | Yeh, Nai-Chen | Cho, Hsin | Wang, Vinchi | Li, Jui-Chang | Wang, Ray-Yau

Article Type: Research Article

Abstract: BACKGROUND: Inadequate ankle control influences walking ability in people after stroke. Walking on inclined surface activates ankle muscles and movements. However, the effect of inclined treadmill training on ankle control is not clear. OBJECTIVE: To investigate the effects of inclined treadmill training on ankle control in individuals with inadequate ankle control after chronic stroke. METHODS: This was a randomized single-blinded study. Eighteen participants were randomly assigned to receive 12 sessions of 30 min inclined (n  = 9) or regular (n  = 9) treadmill training and 5 min over-ground walking training. The outcomes included ankle control during walking, muscle strength of …affected leg, walking performance, and stair climbing performance. RESULTS: Inclined treadmill training significantly improved ankle dorsiflexion at initial contact (p  = 0.002), increased tibialis anterior activities (p  = 0.003 at initial contact, p  = 0.006 in swing phase), and decreased dynamic plantarflexors spasticity (p  = 0.027) as compared with regular treadmill training. Greater improvements were also shown in stair climbing with affected leg leading (p  = 0.006) and affected knee extensors strength (p  = 0.002) after inclined treadmill training. CONCLUSIONS: Inclined treadmill training was proposed to improve inadequate ankle control after chronic stroke. Inclined treadmill training also improved the stair climbing ability accompanied with increased muscle strength of the affected lower extremity. Show more

Keywords: Rehabilitation, ankle, inclined treadmill training, stroke, walking

DOI: 10.3233/NRE-220002

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 171-180, 2022

Authors: Afridi, Ayesha | Rathore, Farooq Azam

Article Type: Other

Abstract: BACKGROUND: Stroke and other traumatic brain injuries are the leading causes of global disability in adults. Environmental enrichment for neurological diseases is a relatively new concept within rehabilitation. These are interventions to enhance the level of somatic and social stimulation by providing an engaging environment. OBJECTIVE: To assess the effects of environmental enrichment on well-being, functional recovery, activity levels and quality of life in people who have stroke or non-progressive brain injury. METHODS: Multiple global databases were searched on 26 October 2020. Aim was to include only the randomized controlled trials that compared environmental enrichment with …standard services. RESULTS: A single RCT study with 53 participants with stroke was included. It compared the environmental enrichment (physical, cognitive and social activities such as reading material, board and card games, gaming technology, music, artwork, and computer with Internet) with standard services in an inpatient rehabilitation setting. The evidence was of very low quality and follow up was of 3 months only. CONCLUSIONS: The current data are inconclusive and there is a need for well-designed large-scale trials to study the role of environmental enrichment in the functional recovery of neurological diseases. Show more

Keywords: Environmental enrichment, rehabilitation, stroke, recent advances

DOI: 10.3233/NRE-228021

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 181-183, 2022