Pedagogy and Enriched Environment for Rehabilitation - Holistic, Optimised, Methodical, and Empathetic care

Confronting the grand challenge of delivering sustainable and high-quality healthcare across Europe requires innovative solutions, particularly given increasing demand and patient volume. The situation is further complicated by the trend towards early hospital discharge, leading to a growing demand for effective home-based care. An innovative approach is especially pertinent in the care of stroke victims, since recent research in neuroplasticity has shown that the brain’s capacity for regeneration and change within the first three months post-stroke is larger than previously believed. As such, the most significant window for stroke rehabilitation is in the patient’s home environment rather than in hospital. This project aims to respond to these challenges through the development of an innovative, evidence-based approach called PEER (Pedagogy and Enriched Environment for Rehabilitation). At the core of PEER is the translation of Enriched Environment (EE) research from animals to clinical applications. Animal-based stroke model studies have demonstrated that enriching the physical and social everyday environment is powerful in enhancing plasticity, leading to both motor and cognitive improvement of 25-50% compared to a control group. It is the ambition of this project to bridge the gap between new knowledge within basic neuroscience, animal studies and clinically applied rehabilitation science. PEER expands existing EE methodologies by incorporating a personcentred approach that fuses pedagogical principles such as co-design and individual-environmental scaling. We intend to tailor home-based EE to the unique needs of the individual, promoting exploratory behaviour as a critical aspect of their rehabilitation. PEER aims to facilitate the transition between hospital and home care for stroke patients, focusing on fostering exploratory behaviour and optimising the home environment for rehabilitation. By intertwining principles from neuroplasticity, pedagogy and rehabilitation science, PEER seeks to promote patient engagement, improve rehabilitation outcomes, and enhance the sustainability and efficiency of home-based healthcare across diverse European contexts.
Our aim is to produce a universally valid set of principles and guidelines applicable across traditional health and care domains, fulfilling the requirement of cooperation and coordination. Moreover, our project has a substantial capacity-building component, providing healthcare professionals, patients and their families with new insights and skills to support a more equitable and sustainable future for home care. Our interdisciplinary consortium, encompassing experts from diverse fields such as didactics and pedagogy, movement science, physio- and occupational therapy, rehabilitation medicine and neuroscience aligns well with the call's emphasis on interdisciplinary research. We will adhere to the Medical Research Council's guidance on developing and evaluating complex interventions. The short-term effects of PEER will be evaluated, examining its acceptability, feasibility, engagement, relevance and potential for successful implementation and transferability to other settings.
The economic and social impacts of PEER are anticipated to be significant. By enhancing home care effectiveness, PEER could potentially decrease personal and systemic healthcare costs. Further, by improving rehabilitation outcomes and promoting patient engagement, PEER promises to improve patients' quality of life, offering a tangible social benefit. In summary, this project strives to make a substantial contribution to home-based EE, creating a universally applicable set of guidelines. By doing so, we hope to instigate considerable change in home care practitioners' practices, fostering a more equitable and sustainable future for healthcare.