Mobility-Supporting Rehabilitation Clinics: Architectural Barriers and Facilitators to Mobility of Stroke Patients

Maja Kevdzija (TU Dresden)

Although inpatients undergoing rehabilitation should avoid bed rest and be active in the first months after the stroke onset to achieve maximum recovery, research studies show that they are inactive in their rooms for around 50% of the day. Besides experiencing various post-stroke impairments that limit their mobility, patients often encounter barriers in the built environment. Avoidance of these barriers and the lack of motivating spaces outside of patients' rooms are possible contributing factors to their low activity levels. This research study aims at investigating the potential of the architectural design to support and motivate the independent mobility of stroke patients by identifying architectural features that hinder or facilitate mobility.

Comparative floorplan analysis and post-occupancy evaluation in seven rehabilitation clinics were used as methods to investigate this relationship. Post-occupancy evaluation included shadowing ten patients per clinic over the course of one day (n = 70), patient questionnaires (n = 60) and staff questionnaires (n = 59).

Five major categories of barriers were identified: wayfinding issues, insufficient dimensions of corridors, physical obstacles, floor surfaces and large distances. Spatial characteristics of the identified barriers were then examined using floor plan analysis. Although physical barriers usually limit mobility, it was found that they can act as mobility facilitators in certain cases. Statistically highly significant relationship was found between patients’ lower mobility levels and the higher number of encountered barriers, which suggests that the design of rehabilitation clinics should be in closer connection with the patients’ mobility levels. The results also show that a large number of small common rooms with views of nature could potentially motivate patients to be more active during their free time in the clinic.

Final results of the PhD research study will be presented together with the design recommendations for mobility-supporting rehabilitation clinics based on the study results.