The goal of this clinical trial is to learn whether adding group leisure activities and musical training can help people recover better after a stroke during their hospital rehabilitation. The study will include adults who had a recent stroke and are staying in the neurological rehabilitation unit.

The main questions the study aims to answer are:

Does adding leisure activities and musical training help people become more independent in their daily activities? Does this combined approach improve movement, thinking skills, mood, and quality of life more than standard rehabilitation alone?

Researchers will compare three groups to see which approach works best:

Standard hospital rehabilitation. Standard rehabilitation plus individual musical training. Standard rehabilitation plus group leisure activities and group musical training.

Participants will:

Take part in their usual rehabilitation sessions in the hospital. Depending on their assigned group, also do individual or group musical training and/or group leisure activities.

Complete evaluations at the start of the study, at hospital discharge, and one month later.

Have a brain scan and wear a wrist device that tracks daily movement. Share their experiences in an interview.

Stroke rehabilitation often takes place in environments where patients spend most of their day inactive, alone, or without access to stimulating activities. This is concerning given the limited sensitive period of heightened neuroplasticity following stroke, during which recovery potential is maximized. Preclinical evidence shows that enriched environments-characterized by social, cognitive, and physical stimulation-combined with task-specific training significantly enhance recovery. However, translation of enriched interventions to clinical stroke rehabilitation remains limited.

This trial aims to evaluate the effect of adding group leisure activities and musical training (enriched intervention) to a standard rehabilitation program delivered at the hospital, comparing this enriched intervention with standard care alone and standard care combined with individual musical training. A randomised controlled trial will be conducted to test the clinical effectiveness of these interventions in enhancing recovery, studying structural brain biomarkers, and individual differences (including variables that are influenced by biological and cultural differences between men and women) in the recovery response. Moreover, the experiences of patients and healthcare professionals will be explored, as well as feasibility and cost-effectiveness of the intervention.

This project represents an opportunity to enhance translational research, applying preclinical and basic research findings to clinical practice, and testing a novel intervention that potentially improves recovery of patients and meets their needs. Modifying hospital environments with opportunities for leisure activities contributes to enhancing health services, introducing cultural and human occupation aspects in patient care.

Inclusion Criteria:

• Age 18 or older.
• Diagnosis of an ischemic or hemorrhagic stroke, confirmed by neuroimaging.
• Less than 4 weeks since stroke onset at the time of enrollment.
• Less than 48 hours since doctor's evaluation at the time of enrollment.
• No history of previous stroke with residual motor and/or cognitive deficits.
• Ability to provide informed consent and follow study procedures.
• Absence of neurological or mayor psychiatric conditions, or if present, only clinically stable conditions.
• Ability to understand Spanish and/or Catalan and/or English.

The evaluation, including performance outcomes and self-reported questionnaires, will be administered by a research assistant who is blinded to each participant's group allocation. Although participants are necessarily aware of the rehabilitation activities they receive, they are not told which activities are considered experimental, nor are they informed about the study hypotheses or comparisons.