Research Projects

RehArt Project 

Enriched Stroke Rehabilitation through Music and Leisure Activities: Exploring recovery, brain biomarkers, and aspects for implementation (RehArt) 


Research team

The research team consists of professionals from EUIT-UAB, Hospital del Mar, and Rovira i Virgili University.

The project is led by Dr. Grau-Sánchez (OCCARE research group, EUIT-UAB) and includes a multidisciplinary team with expertise in stroke rehabilitation, neuroimaging, occupational therapy, physiotherapy, physical medicine and rehabilitation, nursing, psychology, and health economics. It also includes staff from the clinical setting of the study, as well as predoctoral researchers, a Marie Skłodowska-Curie Fellow, and international advisors specialized in neurorehabilitation.

Brief description of the problem

Hospital rehabilitation environments provide insufficient stimulation, and people who have suffered a stroke remain alone and inactive for most of the day. This scenario is alarming, as there is a limited time window of increased plasticity after a stroke, during which the potential for recovery is at its maximum. Preclinical evidence from animal models highlights the importance of a stimulating and enriched environment to increase activity levels and promote changes in brain plasticity. Since enriched environments are the standard in these models, the translation of this intervention into human research has been limited.

Project’s objectives

The objective of the project is to evaluate the effect of incorporating an enriched intervention that combines recreational activities and musical training into a standard rehabilitation program for hospitalized individuals who have suffered a stroke in the subacute phase. Specifically, clinical benefits will be assessed; individual sociopsychological differences will be examined, along with the experiences of participants and their caregivers, as well as the practical and economic feasibility of the intervention.

Methodology

This is a randomized, controlled, single-blind, single-center trial that includes three types of intervention, with a total planned duration of three years. Around ninety individuals with subacute stroke will be recruited, admitted to a specialized inpatient neurological rehabilitation unit at Centro Esperanza (Hospital del Mar). This is a tertiary referral hospital in Barcelona, Spain, accredited as a reference center for intensive inpatient rehabilitation.

Participants are currently being randomly assigned to one of three groups (standard care, standard care with individualized increase in physical activity, and standard care with enriched intervention). They are also eligible according to defined inclusion criteria.

Assessments are conducted at baseline, at hospital discharge, and at a one-month follow-up, in relation to their performance in activities of daily living, as well as their motor, cognitive, and language functions, along with emotional well-being and quality of life. In addition, the impact of the lesion on brain structure and function is assessed, and psychosocial variables are collected at baseline to examine their mediating effect on recovery. Qualitative methods are also used to explore the experiences of participants and their caregivers with the intervention from a gender perspective. Finally, a feasibility and cost-effectiveness analysis will be conducted to support future clinical implementation.

Expected results

The results have the potential to positively impact participants, caregivers, and healthcare professionals. Greater recovery after stroke will enhance community reintegration and reduce caregiver burden, contributing to a person-centered approach. Furthermore, clinical rehabilitation guidelines will be improved, with the potential to modify hospital environments to increase activity levels among inpatients. Interventions such as recreational activities and musical training may represent cost-effective and easily implementable approaches. In this way, costs associated with disability can be reduced, thereby decreasing the burden on public healthcare and social resources.

Communications derived from the project
  • Tamiazzo, J., Kolliopoulou, E., Ramírez, C., Codern-Bové, N., de Diego-Alonso, C., Carles-Lavila, M., Lorente, S., Raghavan, P., & Grau-Sánchez, J. (2026, May). 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 [Oral presentation]. European Stroke Organisation Conference (ESOC 2026), Maastricht, Netherlands.
  • Grau-Sánchez, J. (2026, March 20–21). Rehabilitation with meaning: Applied neuroscience in daily life [Workshop]. XXIV National Congress of Occupational Therapy Students (CENTO), Málaga, Spain.
  • Grau-Sánchez, J. (2026, March 20–21). Boredom and loneliness in rehabilitation: The role of enriched environments in post-stroke recovery [Oral presentation]. XXIV National Congress of Occupational Therapy Students (CENTO), Málaga, Spain.
  • Tamiazzo, J., & Grau-Sánchez, J. (2026, March 18). How to protect your brain against stroke [Oral presentation]. Cervella’t 2026, Institute of Neurosciences, UAB, Barcelona, Spain.
  • Grau-Sánchez, J., Pons-Batet, B., Vargas-Arjona, I., Valles-Valverde, S., Ramírez, C., de Diego-Alonso, C., Carles-Lavila, M., Codern-Bové, N., Raghavan, P., & Duarte, E. (2026, February 9–12). Enhancing stroke inpatient rehabilitation through enriched environments: A randomized controlled trial integrating leisure activities and music therapy [Poster presentation]. 19th World Federation of Occupational Therapy (WFOT) Congress, Bangkok, Thailand.
  • Grau-Sánchez, J., Tamiazzo, J., de Diego-Alonso, C., & Kolliopoulou, E. (2025, December 10–12). Incorporating occupational complexity into cognitive reserve models for post-stroke recovery [Oral presentation]. 2nd Congress of Innovation in Comprehensive Rehabilitation and Occupational Therapy, Spain.
  • Kolliopoulou, E., Tamiazzo, J., de Diego-Alonso, C., & Grau-Sánchez, J. (2025, December 10–12). Enriched stroke rehabilitation through music- and leisure-based activities: Exploring recovery, brain biomarkers, and implementation aspects [Oral presentation]. 2nd Congress of Innovation in Comprehensive Rehabilitation and Occupational Therapy, Spain.
  • Grau-Sánchez, J. (2025, June 14). Advancing stroke recovery through enriched rehabilitation: The use of music and leisure activities to promote neuroplasticity [Oral presentation]. 1st Scientific Conference of Occupational Therapy, European University Cyprus, Nicosia, Cyprus.
  • Vargas-Arjona, I., Valles-Valverde, S., Pons-Batet, B., Codern-Bové, N., Ramírez, C., Carles-Lavila, M., Duarte, E., & Grau-Sánchez, J. (2025, May 14–16). Enriched hospital environments in stroke rehabilitation: Exploring the lived experience and studying practical and economic feasibility [Oral presentation]. XIV International Congress of Occupational Therapy Students (CIETO), Miguel Hernández University, Alicante, Spain.
  • Pons-Batet, B., Vargas-Arjona, I., Valles-Valverde, S., Codern-Bové, N., Ramírez, C., Carles-Lavila, M., Duarte, E., & Grau-Sánchez, J. (2025, May 14–16). Enriched environments in the hospital rehabilitation of stroke survivors: A clinical trial protocol [Oral presentation]. XIV International Congress of Occupational Therapy Students (CIETO), Miguel Hernández University, Alicante, Spain.
  • Grau-Sánchez, J. (2025, May 22–24). RehArt Project: Innovation in hospital environments for stroke recovery [Oral presentation]. First International Congress of the General Council of Colleges of Occupational Therapists, Madrid, Spain.
  • Grau-Sánchez, J., Codern-Bové, N., Ramírez, C., Carles Lavila, M., Duarte, E. (2025, May 22–24). RehArt Project: Innovation in Hospital Environments for Stroke Recovery [Oral presentation]. 1st International Congress of the General Council of Occupational Therapy Colleges, Madrid, Spain.
  • Vargas Arjona, I., Vallès Valverde, S., Pons Batet, B., Codern-Bové, N., Ramírez, C., Carles Lavila, M., Duarte, E., & Grau-Sánchez, J. (2025, May 14–16). Enriched Hospital Environments in Stroke Rehabilitation: Exploring Patient Experience and Assessing Practical and Economic Feasibility [Oral presentation]. 14th International Congress of Occupational Therapy Students & 8th International Congress of Occupational Therapy, Miguel Hernández University, Alicante, Spain.
  • Pons Batet, B., Vargas Arjona, I., Vallès Valverde, S., Codern-Bové, N., Ramírez, C., Carles Lavila, M., Duarte, E., & Grau-Sánchez, J. (2025, May 14–16). Enriched Environments in Hospital Stroke Rehabilitation: Protocol of a Clinical Trial [Oral presentation]. 14th International Congress of Occupational Therapy Students & 8th International Congress of Occupational Therapy, Miguel Hernández University, Alicante, Spain.
  • Kolliopoulou, E., Tamiazzo, J., de Diego Alonso, C., & Grau Sánchez, J. (2025, December 10–12). Enriched stroke rehabilitation through music- and leisure-based activities: Exploring recovery, brain biomarkers, and implementation aspects [Oral presentation]. 2nd Congress on Innovation in Comprehensive Rehabilitation and Occupational Therapy, Spain.
  • Grau Sánchez, J., Tamiazzo, J., de Diego Alonso, C., & Kolliopoulou, E. (2025, December 10–12). Incorporating occupational complexity into cognitive reserve models for post-stroke recovery [Oral presentation]. 2nd Congress on Innovation in Comprehensive Rehabilitation and Occupational Therapy, Spain.
  • Grau-Sánchez, J., Pons Batet, B., Vargas Arjona, I., Vallès Valverde, S., Ramírez, C., de Diego Alonso, C., Carles Lavila, M., Codern-Bové, N., Raghavan, P., & Duarte, E. (2026, February 9–12). Enhancing inpatient stroke rehabilitation through enriched environments: A randomized controlled trial integrating leisure activities and music therapy [Scientific poster]. 19th World Federation of Occupational Therapy Congress, Brisbane, Australia.