Research Reports - Traumatic brain injury and post-acute decline: what role does environmental enrichment play?

Front Hum Neurosci. 2013 Apr 17;7:31

Frasca D, Tomaszczyk J, McFadyen BJ, Green RE

Objectives: While a growing number of studies provide evidence of neural and
cognitive decline in traumatic brain injury (TBI) survivors during the post-acute
stages of injury, there is limited research as of yet on environmental factors
that may influence this decline. The purposes of this paper, therefore, are to
(1) examine evidence that environmental enrichment (EE) can influence long-term
outcome following TBI, and (2) examine the nature of post-acute environments,
whether they vary in degree of EE, and what impact these variations have on
outcomes. Methods: We conducted a scoping review to identify studies on EE in
animals and humans, and post-discharge experiences that relate to barriers to
recovery. Results: One hundred and twenty-three articles that met inclusion
criteria demonstrated the benefits of EE on brain and behavior in healthy and
brain-injured animals and humans. Nineteen papers on post-discharge experiences
revealed that variables such as insurance coverage, financial, and social
support, home therapy, and transition from hospital to home, can have an impact
on clinical outcomes. Conclusion: There is evidence to suggest that lack of EE,
whether from lack of resources or limited ability to engage in such environments,
may play a role in post-acute cognitive and neural decline. Maximizing EE in the
post-acute stages of TBI may improve long-term outcomes for the individual, their
family and society.

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