Stroke rehabilitation: are highly structured units more conducive to physical activity than less structured units?

Arch Phys Med Rehabil. 1996 Oct;77(10):1066-70. doi: 10.1016/s0003-9993(96)90070-2.


Objective: To determine if the physical design and organizational structure of rehabilitation units is related to the amount of patients' motor activity.

Design: An observational study was conducted; time samples of the motor activity of patients following stroke were taken between 7AM and 7PM both on weekdays and weekends.

Setting: Two rehabilitation units associated with general hospitals with different physical design and organizational structure. One unit was spread over a large area and had a highly organized daily structure; the other was small and informally organized.

Subjects: Inpatients with hemiplegia as a result of stroke who gave consent to participate.

Main outcome measure: The nature and frequency of 14 motor activities were compared between units.

Results: No significant difference was found in any of the observed motor activities between the units when using independent groups t tests (p = 0.1-0.8). Subjects in both units spent more than 70% of their day in activities largely unrelated to physical outcome (eg, conversing with visitors or doing nothing observable) and less than 20% of the day in activities that could potentially contribute to their recovery (eg, in therapy or exercising independently).

Conclusions: Rehabilitation units are not functioning as learning environments. The challenge is to identify and implement measures that will change this finding.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cerebrovascular Disorders / rehabilitation*
  • Facility Design and Construction
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Activity*
  • Rehabilitation Centers / organization & administration*