Physical barriers to mobility of stroke patients in rehabilitation clinics

Abstract

Regaining independent mobility and general independence is the main goal of physical rehabilitation in stroke patients. The patients requiring rehabilitation stay as inpatients in rehabilitation clinics for a period of several weeks to several months. During this time, mobile patients are required to go to therapies and other scheduled appointments on their own. The aim of this study is to provide evidence that specific architectural design features of rehabilitation clinics hinder the independent mobility of stroke patients and to identify the main issues caused by the building design. Patients (n = 50) and staff members (n = 46) from five large German rehabilitation clinics participated in the study. Three methods were used to collect the data: patient questionnaire, staff questionnaire and patient shadowing (observation). Both staff and patients identified the major issues that stroke patients encounter in the built environment of rehabilitation clinics: wayfinding problems, insufficient dimensions of spaces (corridors), physical obstacles, uneven floor surfaces and large distances between patient rooms and therapy rooms. Shadowing data showed that the patients in the earlier stages of rehabilitation, mainly using a wheelchair, encounter the most barriers related to the built environment. Design recommendations for more mobility supportive rehabilitation clinics are made based on the study findings.