Kevdzija Maja, Marquardt Gesine
Technische Universitaet Dresden, Faculty of Architecture, Chair of Social and Health Care Buildings and Design, Dresden, Germany.
Top Stroke Rehabil. 2022 Jan;29(1):9-15. doi: 10.1080/10749357.2020.1871281. Epub 2021 Jan 11.
Recovery from stroke aims at regaining mobility through performing activities. However, research studies on time use in rehabilitation environments consistently show low activity levels of stroke patients outside their scheduled therapies. It is not clear whether the architectural layout of clinics is related to patients' activity.
This study examined the nonscheduled (voluntary) activities of stroke patients during an ordinary day in a rehabilitation clinic to investigate whether and how the built environment contributes to stroke patients' independent activities.
Patient shadowing was used in seven neurological rehabilitation clinics. Ten patients were observed per clinic (n = 70), each patient for 12 consecutive hours (total 840 hours). Their paths, activities, locations and traveled distances were recorded in relation to the clinics' layouts.
Patients spent around 50% of the observed time in their rooms. The frequency of nonscheduled activity was low in all participating clinics (Mdn = 21,2%, IQR 6,5%-21%) compared to the scheduled activity. The median length of the nonscheduled paths for all patients was 43,42 m (average 46,97 m), with significantly longer scheduled paths (average 89,11 m, Mdn = 77,06 m, Mann-Whitney U = 536, n1 = 762, n2 = 225, < .001, two-tailed). Corridors and seating areas in the corridors were the most frequent destinations of patients' nonscheduled paths. The clinic with the most frequent nonscheduled activity had a distinctive spatial distribution of dining and living spaces.
There is a need to change the architectural layout of rehabilitation clinics to better support patients' nonscheduled activity.
中风康复旨在通过进行活动来恢复运动能力。然而，关于康复环境中时间利用的研究一直表明，中风患者在预定治疗之外的活动水平较低。尚不清楚诊所的建筑布局是否与患者的活动有关。
本研究调查了康复诊所中中风患者在平常一天的非预定（自愿）活动，以探讨建筑环境是否以及如何促进中风患者的独立活动。
在七家神经康复诊所采用患者跟踪法。每家诊所观察10名患者（n = 70），每名患者连续观察12小时（共840小时）。记录他们的路径、活动、位置和行走距离，并与诊所布局相关联。
患者在房间里度过了约50%的观察时间。与预定活动相比，所有参与诊所的非预定活动频率都较低（中位数 = 21.2%，四分位距6.5% - 21%）。所有患者非预定路径的中位数长度为43.42米（平均46.97米），预定路径明显更长（平均89.11米，中位数 = 77.06米，曼-惠特尼U = 536，n1 = 762，n2 = 225，P <.001，双侧）。走廊和走廊里的休息区是患者非预定路径最常到达的地方。非预定活动最频繁的诊所，其餐饮和生活空间有独特的空间分布。
有必要改变康复诊所的建筑布局，以更好地支持患者的非预定活动。
