Abstract Number: Esoc2026ot168 an Enriched Environment Incorporating Leisure and Music Activities in Inpatient Stroke Rehabilitation: A Randomized Controlled Trial Including Clinical Outcomes, Patient and Professional Experiences, and Cost-Effectiveness

Abstract Background and aims The subacute phase after stroke represents a critical window of heightened neuroplasticity. However, hospital environments are often poorly stimulating, leading to inactivity and boredom, which may hinder motor, cognitive and emotional recovery. Although enriched environments are a preclinical gold standard for enhancing recovery, their systematic clinical implementation remains limited. Methods This trial evaluates the effects of adding an enriched intervention, integrating recreational activities and music training, to standard rehabilitation in subacute stroke survivors. We aim to examine clinical benefits, structural brain biomarkers, sociopsychological predictors of recovery, stakeholder experiences, feasibility and cost-effectiveness. Results A randomized pragmatic controlled trial is conducted with 90 subacute stroke survivors admitted to a neurological rehabilitation unit. Participants are randomly allocated to 1) standard care, 2) standard care with increased physical training, or 3) standard care with enriched intervention. Assessments are conducted pre-, post-intervention and at one-month follow-up. The study integrates quantitative clinical assessments, qualitative interviews, and cost-effectiveness evaluation. Conclusions The primary outcome is functional independence, assessed using the Barthel Index. Secondary outcomes include motor recovery, cognitive functioning, emotional well-being, quality of life, and physical activity levels. Individual differences in treatment response are investigated to identify predictors, mediators, or moderators of the effects of the enriched intervention. Patient experience and intervention acceptability are explored through qualitative interviews, and a cost-effectiveness analysis is conducted. Conflict of interest