Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Stroke; Limb Restoration Rehabilitation
Objective :The aim of this study was to analyse the outdoor environment at Unicare Bakke, a rehabilitation centre in Norway, in order to identify and develop accessible and useful outdoor environments for physiotherapy.
Design: A combined quantitative/qualitative design. Methods used were place analyses, diary questionnaires and walk through interview with the physiotherapists and filming the patients at 10 different locations in order to analyse the accessibility.
Setting: Unicare Bakke, a private rehabilitation centre close to Halden in Norway, that provides care in the diagnosis categories of stroke, leg amputees and orthopedics.
Participants: 12 physiotherapists and five in-patients, two were stroke patients and three were leg amputees. The patients used different aids.
Interventions: Not applicable
Main Outcome Measure: The aim of the study was to survey how the physiotherapists use the outdoor environment, in order to identify important elements of accessibility and outdoor rehabilitation. During the process, accessibility problems were crystalized to be the most crucial factor for physiotherapeutic use of the outdoors and therefor accessibility got much bigger place than first planned in the study.
Results: The most common physiotherapeutic outdoor intervention was movement training and the most valued quality in the outdoor environment was variation in ground material.The outdoor environment proved to be high in preference and supportive for people with both high and low psychological well-being. Simultaneously, large areas were inaccessible for people with moderate to severe impairments and in particular restorative areas. The accessibility problems were a combination of a big natural variety in form of hills and different beddings and lack of effort in making the environment accessible.
Conclusions: The possibilities for physiotherapy and restoration are big for patients with mild impairment while it is highly limited for patients with moderate to severe impairment. As a result, the physiotherapists don´t get use of the outdoor environment to the desired extent.