Effects of Group Leisure Activities and Musical Training on Hospital Stroke Rehabilitation.

Stroke rehabilitation often takes place in environments where patients spend most of their day inactive, alone, or without access to stimulating activities. This is concerning given the limited sensitive period of heightened neuroplasticity following stroke, during which recovery potential is maximized. Preclinical evidence shows that enriched environments-characterized by social, cognitive, and physical stimulation-combined with task-specific training significantly enhance recovery. However, translation of enriched interventions to clinical stroke rehabilitation remains limited.

This trial aims to evaluate the effect of adding group leisure activities and musical training (enriched intervention) to a standard rehabilitation program delivered at the hospital, comparing this enriched intervention with standard care alone and standard care combined with individual musical training. A randomised controlled trial will be conducted to test the clinical effectiveness of these interventions in enhancing recovery, studying structural brain biomarkers, and individual differences (including variables that are influenced by biological and cultural differences between men and women) in the recovery response. Moreover, the experiences of patients and healthcare professionals will be explored, as well as feasibility and cost-effectiveness of the intervention.

This project represents an opportunity to enhance translational research, applying preclinical and basic research findings to clinical practice, and testing a novel intervention that potentially improves recovery of patients and meets their needs. Modifying hospital environments with opportunities for leisure activities contributes to enhancing health services, introducing cultural and human occupation aspects in patient care.

• Verbal learning and memory measured by the Rey Auditory Verbal Learning Test [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Quality of life measured by the EQ-5D-5L. [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Experiences with rehabilitation assessed through semi-structured interviews with participants [Срок оценки: 1-month Follow-up (Day 52)]
• Motor impairment assessed by the Fugl-Meyer Assessment of Motor Recovery [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Upper limb functional performance assessed by the Action Research Arm Test [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Fine manual dexterity assessed by the Nine-Hole Peg Test [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Gross manual dexterity assessed by the Box and Blocks Test [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Grip strength assessed by hand dynamometry [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Global cognitive functioning assessed by the Montreal Cognitive Assessment [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Working memory and attention assessed by the Digit Span subtest [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Executive functioning assessed by the Behaviour Rating Inventory of Executive Function - Adult Version [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]
• Cognitive flexibility, processing speed, and visual attention assessed by the Trail Making Test [Срок оценки: Baseline (Day 1), Post-intervention (Day 22), 1-month Follow-up (Day 52)]