Dissertation Report (2020)

THERAPEUTIC DESIGN APPROACH FOR MOBILITY IMPAIRED PEOPLE

Seminar Report Submitted by AMAN KR. JAIN 2015UAR1149

In partial fulfillment of the requirements for the Degree of BACHELOR OF ARCHITECTURE

DEPARTMENT OF ARCHITECTURE AND PLANNING MALAVIYA NATIONAL INSTITUTE OF TECHNOLOGY, JAIPUR SESSION (2019 - 2020)

Therapeutic Design Approach for Mobility Impaired People

Seminar Report Submitted by AMAN KR. JAIN

In partial fulfillment of the requirements for the Degree of BACHELOR OF ARCHITECTURE

Coordinator Dr. Rina Surana Associate Professor Department of Architecture and Planning, Malaviya National Institute of Technology, Jaipur

Supervisor Dr. Niruti Gupta Assistant Professor Department of Architecture and Planning, Malaviya National Institute of Technology, Jaipur

Department of Architecture and Planning Malaviya National Institute of Technology, Jaipur

DECLARATION

I, Aman Kumar Jain, hereby declare that the B .Arch seminar titled “Therapeutic Design Approach for Mobility Impaired People� is the outcome of my own research, carried out under the supervision of Dr. Niruti Gupta, as partial fulfilment of the requirement for the award of Degree of Bachelor of Architecture, submitted in the Malaviya National Institute of Technology, Jaipur.

It is my original work and has not previously formed the basis of award of any degree, diploma or certificate of this or any other University. I have duly acknowledged all the sources used by me in the preparation of this seminar

Aman Kumar Jain December 2019

CERTIFICATE

This is to certify that this seminar titled “Therapeutic Design Approach for Mobility Impaired People� is a bona-fide work of Mr. Aman Kumar Jain. Certified further that, to the best of our knowledge, the work herein does not form any other thesis or dissertation on the basis of which a degree or award was conferred on an earlier occasion on this or any other candidate. The seminar is accepted for the award of degree of Bachelor of Architecture.

Coordinator Dr. Rina Surana Associate Professor Department of Architecture and Planning, Malaviya National Institute of Technology, Jaipur

Supervisor Dr. Niruti Gupta Assistant Professor Department of Architecture and Planning, Malaviya National Institute of Technology, Jaipur

ACKNOWLEDGEMENT

I wish to acknowledge my sincere gratitude to my guide Dr. Niruti Gupta whose encouragement and guidance made this work entirely possible. Thanks to Prof. Meenu Varshney, who spared his valuable time and patiently listened to my presentations. Her incisive comments paved the way forward.

My sincere thanks go to Dr. Rina Surana, the course coordinator, who guided me and my classmates throughout the process.

The unstinting support of my family Mr. Rajendra Kr. Jain, Mrs. Mamta Jain and Abhisekh Jain kept me going.

Special thanks to my friends for being a constant source of inspiration and motivation.

Aman Kumar Jain

ABSTRACT

The existing facility for therapy rehabilitation in India today mostly does not meet the expectation and requirement as they were designed without any precedence study and research. A humble human approach for such care centres is needed which impacts the psychology of the patient in such a way that will help them throughout the process of healing and possibly heal them faster. Therapeutic Design is said to have an impact on human mind through distracting them from their discomfort, making them focus on better side of the life and encouraging the mto fight throughout the recovery period.

The data were collected through analysis of literature such as journals, articles, research papers and books that were utilize with the combination of case study, face-to-face unstructured interviews were conducted in order to obtain responses of the study group. From all the data that has been collected and in comparison towards the case study, a working and functional design framework were able to construct.

The results indicate that the effect of therapeutic design approach can be used to improve the health of building occupants. On this basis, it is recommended that the design and construction of the future therapy facility to integrate the therapeutic design approach into their building design and space composition. Further research is needed to investigate further on more intricate and detail level of the research subject.

Contents CHAPTER 1 : Introduction 1.1 : Inspiration 1.2 : Aim 1.3 : Objective 1.4 : Methodology

CHAPTER 2 : Research 2.1 : Mobility Impaired Community 2.2 : Existing Therapy Facilities 2.3 : Therapeutic Design Approach 2.3.1 : Integrating Nature into Architecture 2.4 : Translating therapeutic design approach through Biophilic Design 2.5 : Translating therapeutic design approach through Biophilic Design 2.6 : Establishing relationship between Mobility Impaired People and Therapeutic Design Approach a. Biophilic Design Elements 1. Framing The View 2. Pocket Garden 3. Natural Material 4. Lighting 5. Ventilation

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Contents 2.6 : Establishing relationship between Mobility Impaired People and Therapeutic Design Approach b. Sensory Design Elements 1. Impact of Color 2. Impact of Smell 3. Impact of Texture 2.7 : Conclusion CHAPTER 3 : Literature Case Study 3.1 : SOSCO rehabilitation Centre 3.2 : Maggie’s Cancer Care Center CHAPTER 4 : Bibliography

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

CHAPTER 1

Introduction There are about 120 million people with disabilities in India.

(Source: United Nations: Key issues of 120m persons with disabilities in India) According to national statistics, more than 41.32% of disabled people in the country are physically disabled. Indicability focusses on the most common types of disabilities.

The existing facility for therapy rehabilitation in India today mostly does not meet the expectation and requirement as they were designed without any precedence study and research.

Several research has been conducted worldwide to investigate and to prove the effectiveness of therapeutic design approach, but mostly none of them is focusing on the implementation of the design approach for the mobility impaired community.

Source – Hindustan Times

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

1.1 Inspiration A soldier only knows how to fight for the nation - It's his duty and means of livelihood for the whole family in some cases. But what if he gets injured and becomes unfit to serve the nation as an assigned officer on the front, life changes drastically for him, he undergoes mental trauma and it takes time to accept the disability.

This recovery time is crucial for a soldier. Rehabilitation centers are there for the soldiers that provide several kinds of therapies to firstly recover them, heal them to some extent and empowering

Source – economic times

them.

Such a centre for armed forces is called Paraplegic Rehabilitation centre, which provides post-operative care and rehabilitation to soldiers who are wounded in military or insurgency operations.

PRC aims to rehabilitate quadriplegic and paraplegic exservicemen by making them self-reliant.

Source – The Hindu

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

1.2 Aim The research aims to determine the effects of therapeutic design approach towards mobility impaired community by analyzing which design approach are the most suitable and befitting to be used in the context.

1.3 Objective To construct a theoretical design framework that will help any future designer

to

design

a

therapy

facility

using

implementation

of the therapeutic design approach.

"Ability beyond Disability".

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

1.4 Dissertation Methodology 1. Understanding Mobility Impaired Community 2. Understanding the existing therapy facilities 3. Understanding Therapeutic Design Approach 4. Understanding the benefits of elements of Therapeutic Design through evidence of tests and researches done so far.

5. Case studies utilizing these elements 6. Inferences from the case studies 7. Designing a framework how they can be used

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

CHAPTER 2

Research

2.1 Mobility Impaired Community "Mobility Impairment can be defined as inability of a person to use one or more of its extremities a lack of strength to walk, grasp or lift objects. The use of wheelchair, crutches, or a walker may be utilized to aid in mobility. Mobility impairment may be caused by a number of factors, such as a disease, an accident or a congenital disorder."

- Safety Guidelines University of Edinburgh India There are about 120 million people with disabilities in India.

Disability Chart Chart source: Sarvekshana, 36th & 47th rounds, National Sample Survey Organization, Department of Statistics, Ministry of Planning & Program Implementation, Government of India

(Source: United Nations: Key issues of 120m persons with disabilities in India) According to national statistics, more than 41.32% of disabled people in the country are physically disabled. Indicability focusses on the most common types of disabilities.

In this research the main group of people that were targeted as the focus group is those who are wheelchair bound.

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Treatment Process

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.2 Existing Therapy Facilities Until last few decades therapy facilities therapy facilities were just like prisons where patients were separated into several isolated rooms away from public attention in order to rehabilitate them, this approach was ineffective and caused exact opposite delaying rehabilitation.

Historically. people associated rehabilitation and healing as escaping into the nature, leaving regular hectic day-to-day urban life behind. This approach shows exposure to nature has health boosting

effect

on

human

body

physically

as

well

as

psychologically.

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.3 Therapeutic Design Approach One of the post-modernism movement which is identified as people centric building design that will be backup by the evidence based approach in the manufacturing of a healing built environment, in which its main objective is to incorporate the spatial organization of the building systematically so that it can communicate with the people not only physiologically but also psychologically.

"A concept that embodies the vision of well-designed architectural spaces that encourage healing and human well-being." - Johan Basson

2.3.1 Integrating Nature Into Architecture Several approaches are there to create a healing environment, almost all of them will manipulate use of natural environment by integrating it with the building design, this integration is often referred to biophilic Design.

Blurring the lIne Source –Detail Magazine

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.4 Translating therapeutic design approach through Biophilic Design An urban setting people and nature are getting seperated .

Merging nature into architecture throgh design, utilizing spatial attributes such that it allows nature to sweep in, is what we call biophilic architecture.

Human and nature can be

reconnected through biophilic

architecture.

Therapeutic Approach through Biophilic Design can be can be categorized into two different types of strategies leading into further diferent types of architectural approaches establishing some kind of connection with natural environment.

Categorization of Biophilic Design into Organic and Vernacular Approach.

Source : Matthew T. Blair (2014)

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.5 Translating therapeutic design approach through Sensory Design Mobility Impaired community, since is losing one of its senses, other senses will get heighten which could be utilized as one of the design approach. Usually it would focus on how user is communicating with the surrounding area.

Due to the fact that sensory information has the power to evoke a range of emotional responses, triggered by the use of certain colors, smell and texture, can effect a patient psychologically.

Alvar alto mentioned while he was designing the Paimio Sanatorium, he designed the facility as a healing machine while intigrating the design with 5 senses manipulation.

Source - www.theguardian.com/

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6 Establishing relationship between Mobility Impaired and Therapeutic Design Approach THERAPEUTIC DESIGN ELEMENTS 1. Biophilic Design a. Framing the View b. Pocket Garden c. Natural Material d. Lighting f. Ventilation 2. Sensory Design a. Texture b. Color c. Smell

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.1 Benefits – Framing the View An experiment was conducted in an hospital to test whether the availability of a window in a patient's room affects the healing rate. Results indicated that the patients that were placed inside the room with an access to the window were able to recover mush faster and check out of the hospital mush quicker in comparison to those who didn't have the access to window.

- Roger S Ulrich (1984) Chalmers University of Technology (Centre for Healthcare Architecture) Studies have shown that simple changes like view to a green landscape becomes a mental focusing tool of distraction allowing recovery to manifest quickly.

Such views will give patients feeling that they are free in the outside environment rather than being enclosed in an institutional care.

Openings in the Facade Source – www.archdaily.com ( Sylvana Hospital / 2b architects)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

View Source – www.archdaily.com ( Sylvana Hospital / 2b architects) Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.1.1 Application 1. BIOPHILIC DESIGN - ( Integration of built and nature) a. Framing the View The easiest way is to provide an opening through building facade, especially in areas where the patient is spending most of the time (Wards, Therapy rooms and activity rooms) The opening can either be a balcony where one can step out and relax amidst the view of outside or it can just be a window having openable shutters, In worst cases it could be a window having fixed glass, just providing a view.

Planning and orientation of the built environment should be as per the surroundings. The view will induce stress reduction sensation. In patient.

Ward Interiors Source – www.archdaily.com ( WE architecture and CREO ARKITEKTER A/S' Proposal for New Medical Center Moscow)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Extended Balconies Source – www.archdaily.com ( The House of Silence ) Natura Futura Arquitectura)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.2 Benefits – Pocket Gardens Benefits of having indoor gardens or pocket gardens were divided into three categories : 1. Improvement in Indoor Air Quality NASA is using indoor plants to clean the air in space stations. It reduces levels of pollutants in the air and increases relative humidity.

2. Human well-being People felt significantly more care-free or playful and more friendly or affectionate in the room with indoor plants.

This study was conducted in a computer lab. Subjects were randomly assigned to be tested in the computer lab when plants were absent or when they were present. Interior plants, when present, were placed around the sides of the room. Subjects' blood pressure and emotions were monitored while they performed a slightly stressful computer task. When plants were added to the lab, the subjects were more productive (12% quicker reactions on the computer task) and less stressed (systolic blood pressure lower). They also reported feeling more attentive when the plants were present.

- Lohr, V.I., C.H. Pearson-Mims, and G.K. Goodwin (1996) Department. Of Horticulture (Washington State University)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.2 Benefits – Pocket Gardens 3. Health Improvement This category will discuss on the possibility of the effect of having an interior plant on general discomfort and pain reduction.

Subjects were rested in a two rooms : One having plants and other is a controlled environment, Subjects reported that room with plants were significantly more interesting and comfortable and helped them concentrate on something else other than discomfort.

- Lohr, V.I., C.H. Pearson-Mims, and G.K. Goodwin (1996) Department. Of Horticulture (Washington State University) This indicates plants will not only help in providing medicinal properties and decorative value, but it also helps in providing tolerance to pain and stress.

Accessible Pocket Gardens Source – www.assistivetechnologyblog.com

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.2.1 Application 1. BIOPHILIC DESIGN - ( Integration of built and nature) b. Pocket Garden Important for the patient to have a physical access to the nature where they can make an interaction with the nature to help in the process of healing and therapy.

Pocket Gardens should provide a walk path that will encourage people to walk around and experience the elements that has been provided. Amenities such as park benches, water fountain is seen as welcoming and point of interest to attract people towards pocket garden.

It should be placed strategically, so that it comes across transit areas and

Pocket Garden Source – Arte Axis Design Group ( SOSCO Rehabilitation Centres)

becomes a place of interaction.

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Pocket Gardens Source – www.archdaily.com WE architecture and CREO ARKITEKTER New Medical Center Moscow Proposal) Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Pocket Gardens Source – www.archdaily.com WE architecture and CREO ARKITEKTER New Medical Center Moscow Proposal)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.3 Benefits – Natural Material 1. BIOPHILIC DESIGN - ( Integration of built and nature) c. Natural Materials Humans are connected to nature and feel comfortable when the surroundings in terms of interiors feel more natural.

Use of natural materials like timber can promote health boosting effect in terms of psychology.

Falling Waters Interior Source – www.archdaily.com

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Use of Earthy light materials Source – www.archdaily.com WE architecture and CREO ARKITEKTER New Medical Center Moscow Proposal) Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.4 Benefits – Lighting Climate and Sunlight influences the length of hospital stay and sleep-wake pattern among hospitalized patients. This is due to the fact that natural sunlight is said to have health boosting capabilities and should be used in planning healthcare facilities.

- Roger S Ulrich (1984) Chalmers University of Technology (Centre for Healthcare Architecture) Light impacts human health in four mechanisms : enabling performance of visual tasks, controlling body circadian system, affecting the mood and perception, and facilitating direct for critical chemical reactions within the body.

Patients exposed to an amplified concentration of natural sunlight percieve less stress, require less medication and even fell less pain.

Use of Daylight Source – www.archdaily.com ( Schmidt Hammer Lassen Architects)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Use of Daylight Source – www.archdaily.com ( Schmidt Hammer Lassen Architects)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.4.1 Application 1. BIOPHILIC DESIGN - ( Integration of built and nature) d. Lighting Light when used with a deliberate thought could result in evoking sense of calmness and relaxation, this is how we've been manipulating human psychology though use of light in religious places.

An approach such as skylight or skywell, or integration of patterned wall ,or decorative windows will help to emulate the feeling of peacefulness.

The use of sun-shading devices such as louvers light shelf and building orientation will provide the required effect of natural lighting.

Use of Natural Lighting inducing holistic and divine effect on psychology Source – www.flickr.com ( The Church of Light Tadao Ando)

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Pocket Gardens Source – www.archdaily.com ( The House of Silence Natura Futura Arquitectura) Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.5 Benefits – Ventilation Ventilation may be defined as the process in which stale air in a place is replaced with new clean air, normally outdoor air.

This can be achieved by providing a functioning cross-ventilation

2.6.5.1 Application 1. BIOPHILIC DESIGN - ( Integration of built and nature) e. Ventilation Good Indoor air quality can be achieved by providing ample fenestrations to ensure cross ventilation. It can also be done by using mechanical means like exhausts and air conditioners.

Cross- Ventilated Space Source – www.trendir.com

Biophilic Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.6 Impact of Color The role of color is important not only because it influences aesthetic and technical aspects of human-made environment but also it affects human beings psychologically.

Many researchers suggest that more cool tones such as blues and greens should be introduced into the space balanced with use of natural materials., these hues help to keep a calm and comfortable environment for the patients.

Sensory Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.6.1 Application 1. SENSORY DESIGN - ( Interaction of Patients

with

their

Surrounding

Environment) a. Color The effect of color can be obtained through use of finishes such as paint and through manipulation of lighting and decorative glass or the use of natural materials with their natural colors.

Use of colors - Paimio Sanatorium Architect Alvar Alto followed a humane approach, used different colors for different areas Yellow Rubber Flooring in common areas– Extension of Sunlight spreading warmth Cool Blue painted ceiling, fabric in wards – Feeling of comfort Source – www.divisare.com/

Sensory Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.7 Impact of Smell Exposed to odors could result in health effects ranging from none , to mild discomfort , to more serious symptoms. Strong odors may cause some people to feel a burning sensation that leads to coughing, wheezing or other breathing problem. People who smell strong odors may get headache or feel dizzy or nauseous. If an odor lasts a long time or keep occurring, it could also affect mood anxiety or stress level.

- Department of Health New York

2.6.7.1 Application While presence of pleasant smell will positively affect the health on different degree, Eg : Sandalwood, Patchouli, Jasmine and Frankincense can stimulate a chemical that can promote confidence.

Source – www.mygardenlife.com

Sensory Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.6.8 Impact of Texture Proper material choice, will stimulate the user senses and stimulate the feeling of belonging thus creating a sustainable comfortable environment.

Wood finishes always give a humble, homely feeling comforting the patient.

Carpet is a good flooring choice as well. It provides excellent traction, no glare and no risk of slipping, and the fear of falling is reduced. It also reduces and absorbs ambient noise, another reason why carpet is suggested in corridors and hallways.

2.6.8.1 Application As some of the senses of mobility impaired people don't work other senses will heighten. Using diffeent textures at different places in a building will provide a patient with sense of direction. Patients will associate different spaces with different textures, bringing them sense of security and self-aware.

Use of Natural Material Finishes Source – www.archdaily.com ( The House of Silence Natura Futura Arquitectura)

Several Texture that can be utilized are wooden and stone on wall and as floor finish.

Sensory Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Falling Waters Interior Source – www.archdaily.com Sensory Design

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.7 Conclusion The data and the information that has been synthesized throughout the earlier chapter was utilized and used to create a theoretical design framework that can help in manufacturing a functioning therapy facility that can help in boosting the health of a patient in just in term of the program offered by such facility but also through implementation of passive therapeutic design approach through the implementation of biophilic design and sensory design.

Results obtained through research fulfilled the objectives that were outlined earlier : Effect of therapeutic design approach has been identified, identifying which therapeutic design approach are suitable and susceptible to be used in the study context and last objective was to providing a theoretical design framework for designing such therapy facilities using therapeutic design approach.

CHAPTER 3

Literature Case Study 3.1 SOSCO Rehabilitation Centre

3.1.1 Introduction

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Exploded Isometric - Medical Therapy Block

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Pocket Gardens Between Therapy Blocks

Sanctuary Garden connecting all Therapy Blocks

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

3.1 Maggie’s Cancer Care Centre 3.1.1 Introduction

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Integration of Nature into Architecture

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Internal Courtyard

Small Meeting Rooms

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Site Identification

Location of existing PRC's

Lucknow City Masterplan

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

Site Identification Site Neighbourhood - Site is located in cantonement area of Lucknow and is defence land which can only be used for defense related activities.

The Site is located near army hospital and all the other required facilities are in close proximity itself. It is a corner plot and has a private road on one side while on the other edge Cariappa Road is there.

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People

2.7 Bibliography 1. www.censusindia.gov.in 2. Hindustan Times 3. Economic Tiems 4. The Hindu 5. Safety Guidelines University of Edinburgh 6. Architecture as medicine – www.scribd.com 7. Healing Architecture – www.issuu.com 8. Applied Trauma Theory and its application 9. Matthew T. Blair (2014) 10. - Roger S Ulrich (1984) Chalmers University of Technology (Centre for Healthcare Architecture) 11. www.archdaily.com 12. - Lohr, V.I., C.H. Pearson-Mims, and G.K. Goodwin (1996) Of Horticulture (Washington State

University)

13. www.assistivetechnologyblog.com 14. Arte Axis Design Group 15. www.flickr.com 16. www.positivepsychologyprogram.com 17. OMA Architects

Dissertation Report - Therapeutic Design Approach for Mobility Impaired People