Abstract Background and aims While stroke research frequently focuses on pharmacological and high-technology interventions, experimental evidence suggests that relatively simple, structured environmental enrichment can meaningfully enhance post-ischemic recovery through mechanisms related to synaptic remodeling, neurogenesis, angiogenesis, autophagy, and modulation of neuroinflammatory and oxidative processes. This project was hypothesis-generated through comparative clinical experience in stroke units in the United Kingdom and Algeria, focusing specifically on patients who did not benefit from reperfusion therapies. Despite disparities in technological resources, differences in functional recovery trajectories were observed, suggesting that cultural and environmental factors—such as social interaction, family involvement, multilingual and multisensory stimulation, and reduced post-stroke isolation—may play a significant role. This study aims to develop and assess a feasibility-oriented, low-cost, translational pilot framework exploring how culturally embedded enriched environmental factors may influence post-stroke recovery in non-reperfused patients, with the goal of informing scalable rehabilitation strategies in resource-variable settings. Methods A targeted literature review examined the neurobiological basis of neuroplasticity in enriched environments, informing a feasibility-oriented pilot study. The intervention begins in stroke units, educating staff to reduce patient passivity and provide multisensory, cognitive-linguistic, and social stimulation. Education sessions extend interventions to families and caregivers, promoting social interaction, multilingual engagement, multisensory activities, environmental variation, and dietary guidance (e.g: Mediterranean diet, fasting..) alongside standard rehabilitation. Results The literature review phase is complete and supports a strong biological rationale for enriched environments as modulators of neuroplastic recovery. The pilot implementation protocol is currently under development. This project aims to generate feasibility data and inform future studies, particularly in resource-limited settings. Conflict of interest Radia Benhamada : nothing to disclose
Radia Benhamada (Fri,) studied this question.
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