Is environmental enrichment useful for stroke and other non-progressive brain injury? A Cochrane Review summary with commentary

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.