Strokes are a major cause of death and disability across the world. For survivors, the recovery process is long, arduous and exhausting because it involves a whole lot of relearning lost skills.

Abilities that one took for granted such as talking, walking, eating or dressing need to be reacquired, necessitating an extended stay at an inpatient rehabilitation facility. Depression and fatigue are constant companions for stroke survivors, especially when they recover in unfamiliar clinical environments.

While it is understood that physical, cognitive and social activity can help stroke survivors, rehabilitation facilities are not designed to support this recovery approach.

Researchers at the University of Melbourne, specifically from the Florey Institute of Neuroscience and Mental Health and the Learning Environments Applied Research Network (LEaRN) at the Melbourne School of Design are now conducting workshops with experts to understand how rehabilitation facilities should be designed to support relearning after a stroke.

Based on feedback from past stroke patients, rehabilitation researchers, doctors, therapists, nurses, health policy makers, people who design hospitals and learning spaces, health environment researchers and learning environment researchers, the Florey and LEaRN researchers have developed a framework for the design of rehabilitation facilities for architects and designers.

Rehabilitation spaces need to be versatile in function since they have to promote healing and recovery in a healthcare environment as well as learning through motivation, engagement, participation and activity, much like a school.

Every stroke patient is different with unique needs. This calls for a learning environment that focuses on flexible, adaptable spaces. For instance, the patient room should be customisable so that patients with different rehabilitation needs can be easily accommodated at different times.

Corridors should be designed as multipurpose spaces that can be used for physical therapy, equipment storage and even as resting spots for patients.

Since interaction is an important part of the recovery process, rehabilitation buildings should include spaces for social activity such as cafes and lounges that would encourage patients to connect with family or friends, and even create opportunities to practice skills that would help them in the real world.

Such activities would also help ease their transition back into the community.

Rehabilitation buildings should also incorporate spaces such as a gym for physical therapy with a physiotherapist, and a kitchen and bathroom to practice cooking and showering with an occupational therapist.

Since emotional wellbeing is also an important part of a stroke patient’s recovery process, a rehabilitation facility should be designed so that elements such as light, temperature, noise and aesthetic can be controlled to decrease stress in patients.

Where rehabilitation facilities are concerned, safety is an important component of the design process, given the higher risk of patients falling in the room.

Single occupancy is encouraged in healthcare facilities for infection control; however, research suggests that patients are less likely to suffer a fall in a shared room.

If so, rehabilitation facilities should have more shared rooms.

The Florey and LEaRN researchers are now collecting data from two rehabilitation facilities in Victoria for the ENVIRONS (ENVironments for Inpatient RehabilitatiON of Stroke patients) research study to expand on the framework and to see how it holds up in practice.

Results from the data will guide the new rehabilitation facility designs that will be tested as part of the NOVEL (New and Optimised Virtual Environment Living lab) research project.

Based on the article by Ruby Lipson-Smith, University of Melbourne

Architecture & Design Team

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