Environmental enrichment in post-stroke rehabilitation: a scoping review of clinical applications

Abstract

Introduction Preclinical research demonstrated that exposure to the Environmental Enrichment (EE) following stroke can stimulate neurogenesis and support the recovery of motor and cognitive functions. Implementation of EE in clinical studies is still understudied. This scoping review aims to map the content of EE in post-stroke rehabilitation, exploring described interventions and implementation strategies.Methods Two independent reviewers conducted a literature search for studies explicitly referring to interventions based on EE and involving adult participants with stroke, in five databases, from their inception to January 27, 2026. The reporting of the interventions and the methodological quality were assessed.Results Nine studies were included. Two main paradigms of treatment approaches can be identified: environment modification and implementation of specific treatment protocols. Most studies satisfied at least 50% of the methodological quality criteria, and the quality of reporting was overall poor, mostly for control groups.Conclusions The EE construct, when implemented in clinical settings, is still heterogeneous. Despite this, two categories of intervention can be identified, but it is unclear how they can be defined and integrated. Improving the methodological quality and reporting could help to map the literature, define the ways in which EE is applied and evaluate its effects.

The authors' abstract, as published at the source. Physical Therapy Reviews, 2026 · DOI ↗