Observations of activity levels in a purpose-built, inpatient, rehabilitation facility

Background: Effective rehabilitation should include high levels of physical activity. The impact of the environmental design on activity levels has had minimal consideration. Purpose: This study investigates activity levels of inpatients undergoing rehabilitation in a new rehabilitation facility with innovative design and multidisciplinary care, comparing weekday and weekend activity levels, as well as changes over a 12-month period. Method: An observational study reporting participants’ location, people present, body position, and activity type on 2 weekdays and 1 weekend day using behavior mapping techniques. Fifteen participants were observed in a mixed rehabilitation unit with neurological, orthopedic, and other health conditions. Results: Results were calculated as the proportion of observations participants spent in each location, position, and performing activities (physical, cognitive, social), and time spent alone and inactive. On average, participants were engaged in activity for 86% (standard deviation [SD] = 9) of the day, with physical activity accounting for 51% (SD = 11), cognitive activity 28% (SD = 10), and social activity 42% (SD = 16). There was more physical activity (mean difference [MD] 8% absolute, confidence interval [CI] = [4, 12], p <.01) and less social activity (MD −6% absolute, CI [−11, −1], p =.02) on weekdays compared to weekends. Overall, participants were alone and inactive for 12% (SD = 9) of the day. Participants observed in 2016 displayed similar results to those observed in 2015. Conclusion: High levels of activity were achieved in this facility that underwent environmental redesign, construction of new facilities, and implementation of evidence-based strategies.