Date of Award
Master of Architecture (MArch)
Advancements in technology, research, and practice are scientifically establishing the relationship between the mind, body, and built environment. In modern TBI rehabilitation medicine, a team of specialists works together to assess the physical, mental, and emotional effects of brain injuries on individual patients and to develop and carry out a plan of action that helps them to overcome, compensate for, and cope with changes in their levels of ability. TBI rehabilitation can integrate holistic practices that better consider an integrated mind-body relationship as well as the built environment as potentially significant factors in supporting functional ability.This thesis investigates the potential role of architecture, and specifically the design of a setting for traumatic brain injury rehabilitation, based on an ecological framework. Ecology is the study of organism-environment systems. In 2001, the World Health Organization adopted a model of ability/ disability that broadens the understanding of contributing factors to include the social and physical environment. Ecological psychology serves as a promising roadmap for the new era of neuroscience where a more holistic approach includes the mind-body and environment. Initial research began with a literature review of the principles, basis, history, and current state of neuroscience, brain injury, and ecological approaches to psychology, design, and science as applied to traumatic brain injury and the design of settings for TBI rehabilitation. Ecological approaches to design call for the design of the built environment to be in synergy with the natural processes of the planet rather than continuing the damaging patterns of industrial history. Ecological validity in science calls for real-world functioning results from research. Building on principles within ecological psychology, ecological design, and ecological validity, six architectural design guidelines were developed to address these obstacles that focus not just on the patient, but on the entire ecosystem that surrounds the TBI patient community in rehabilitation. These design guidelines include community interaction, encouragement of movement, therapy throughout, authenticity, respite, and multisensory stimulation. The design guidelines were applied to the design of a prototypical regional comprehensive inpatient rehabilitation hospital for traumatic brain injury, one of the most common emerging prototypical building types for TBI rehabilitation where patients live for weeks or months during recovery. The site selected was in a mid-size regional city on an existing medical campus in a mixed-use walkable community. The primary program elements include an inpatient wing, administrative, outpatient, clinical, therapy, and public areas. A site in Knoxville TN was then analyzed for constraints and opportunities with respect to the overlay of a building program for a Traumatic Brain Injury Rehabilitation Hospital based on the design guidelines. The thesis project proposes a rehabilitation facility designed according to ecological principles in science, psychology, and architecture with the intent to address the needs and rehabilitation of TBI patients more holistically. The proposal includes a series of distinct features from site design, building organization, spatial affordances, and building systems selected for their ecological impact. The constraint of a steeply sloped site presented a design opportunity to provide an atrium connector that facilitates community engagement with patients who possess a variety of physical and cognitive abilities through multisensory stimulation, multiple modes of vertically traversing the sloped site and multistory building, a rich regional material palette, a west-facing translucent solar screen for variable multisensory effects, and openness, connectivity, and order for intuitive wayfinding. The inpatient wings were designed for more diverse sensory experience with a variety of space scales, multi-function family areas, and outdoor porches. The sustainable design approach includes investigation of emerging laminated timber construction usage for institutional settings as well as environmental control systems that are earth-coupled, save energy, and provide a greater degree of personal control. The ecologically derived design guidelines permeated all scales of design from site selection to details and informed all program areas including multisensory and diverse therapy locations and patient spaces.
Hoskins, Lisa, "An Ecological Approach to Rehabilitation for Traumatic Brain Injury" (2021). All Theses. 3529.