PRINCIPLES AND EXAMPLES OF DESIGN OF

REHABILITATION CENTERS IN RUSSIA AND

ABROAD
Associate Professor, PhD in Engineering Julia Skripkina
Southwest State University, Kursk, Russia
Associate Professor, PhD in Cultural Studies Marina Zvyagintseva
Southwest State University, Kursk, Russia
Student Natalia Fedorchenko
Southwest State University, Kursk, Russia

This article examines and analyzes the design features of rehabilitation and medical centers in
Russia and Europe. The principles of formation of constructive, functional and aesthetic, as well
as economic, social and environmental aspects of the development of projects of rehabilitation
centers are revealed. The interrelation and influence of architecture on the process of treatment
of patients during rehabilitation is shown. On the basis of foreign and Russian experience,
conclusions are drawn about the design and design of rehabilitation centers, which take into
account the developed project of the health and rehabilitation center.
Keywords: rehabilitation, comfortable environment, medical institution, architectural solution

INTRODUCTION
Rehabilitation treatment as an independent direction appeared in Russia not so long ago,
especially acute need for it was found in Russia after the reforms of 1991 in connection with the
critical decline in the level of population health. Subsequently, this need was further intensified,
which was caused by the beginning of the demographic crisis, the lack of forces and means to
ensure timely assistance in the necessary volume and quality of medical care for the sick and
disabled.
In the process of development of restorative medicine the purview of this new direction was
expanded from the restoration of health in healthy person to restore critical functions of the
organism at all stages of prevention and rehabilitation [1].
Both in our country and abroad, the experience of creating such health and rehabilitation
centers, combining the maintenance of the General health of the population and the treatment
of patients who are shown a course of medical rehabilitation, has been successful. This
integration is effective both from a medical and from an economic point of view.
The comfortable environment should satisfy aesthetic, psychophysiological, ergonomic needs
and features of the person [2]. It includes the following components: spatial comfort, visual
comfort, functional comfort, which will provide psychological and physiological comfort for a
person.
An integrated approach involves the preparation of alternatives that take into account all
aspects of the problem – economic, social and environmental [3].

MATERIALS AND METHODS FOR SOLVING THE PROBLEM

Consider the basic principles that help you choose the right planning decisions:
1) the principle of an individual dwelling house is the most common type of rehabilitation
centers. The main centers for dependent persons existing in Russia are built on this principle.
In a country house, rehabilitation provides the necessary comfortable environment, usually
small narrow-profile centers [3];
2) the principle of open composition is more suitable for a large or multi-profile narrow center.
Open plans "let in" the external environment inside the center, keeping its clear boundaries,
while the closed composition technique is used in the urban environment to isolate the
institution from the unfavorable background, thus, a closed complex associated with the natural
environment is obtained.
3) the principle of rehabilitation village is a planning that goes beyond one volume and takes the
features of urban planning element. A rehabilitation village can be a collection of different
centers, united by a common infrastructure on one site. On the basis of this option, a settlement
is formed with a developed rehabilitation environment integrated into the natural environment.
Rehabilitation settlement may include multi-complexes, centers in the form of a country house,
sanatoriums, recreation, sports, entertainment facilities. They provide a comfortable stay of the
patient on the territory of the rehabilitation village.
In Europe, much attention is paid to the architecture of public buildings: kindergartens, schools,
universities, libraries and hospitals. Almost all new buildings are built using environmental
technologies and have a modern, concise design. Especially carefully thought out projects of
medical institutions. For restorative treatment, it is necessary to take into account not only the
quality of medical services, but also the aesthetics and convenience of the premises in which
the treatment takes place.
One of the most unusual buildings of medical institutions-the building for the treatment of youth
at the psychiatric center in Zaragoza (Spain), erected in 2011 (Fig. 1, a). The building is a long
one-story red building with a series of gable roofs, pointed at different angles and similar to a
string of electrocardiograms. Both walls and roof are covered with zinc plates; uniformity is
interrupted only by identical square Windows without frames. Inside the building there are ten
single and eight double rooms with bathrooms. There are also two common living rooms and a
dining room. The interior is decorated in bright colors. With the help of an underground tunnel,
this building is adjacent to the neuropsychiatric center "Nuestra Senora del Carmen".
Also worth noting is the project of the new North Zealand hospital in Hillerod in Denmark, which
was proposed by the Studio C. F. Møller Architects (Fig. 1, b). The citizens of North Zealand in
2020 will be able to have a new and modern hospital in green surroundings near the town of
Hilleredd for 310,000 residents of the area, with a budget of up to DKK 3.8 billion. The idea of
the new North Zealand hospital was to create a landmark for nearby Frederiksborg castle. This
hospital, where architecture and nature merge and form a safe environment for patients, is very
functional and attractive to all citizens in the area. The hospital grows out of forests and
constantly brings people closer to nature both inside and outside, creating a healing architecture
focused on the patient. The architectural and acoustic expression of the structure is also based
on an organic, soft and humane design.

а) b)
Fig. 1. European medical institutions:
a) the youth treatment unit at the psychiatric centre in Zaragoza (Spain)
b) the draft of the New North Zealand hospital in Hillerød (Denmark)

It is generally believed that the interior of a hospital should look like a white, completely sterile
and cold room, but Maggie's cancer Centre in Manchester breaks this stereotype (Fig. 2, a).
The design of the centre in Manchester is designed in such a way that each of its components,
including the garden, radiated a comfortable home atmosphere. The design of the center is
replete with natural accents. Natural light, greenery and garden are among them. The linear
configuration is broken by elements of landscape design, and along the entire Western facade
extends a wide veranda, which is protected from precipitation by a large canopy. Patients of the
center take part in the beautification of the landscape, charging with the healing energy of
nature in the open air.
Rehabilitation center Veilige Veste in Leeuwarden, the Netherlands, Is also very interesting (Fig.
2, b). The name of the project "Veilige Veste" is translated as "safe fortress", it very accurately
describes the essence of the project. It is a new centre for the rehabilitation of girls who have
become victims of trafficking. The project of the center was developed by architects from the
Dutch Studio KAW Architecten. The incredible efforts of the architects were aimed at creating a
sense of security and peace in the residents of the house. The center looks like a new building,
but in fact, it is a completely rebuilt police station, built in the 70s. The structure is faced with
relief white square slabs. Since the facade has a reflective property, it seems that it is in a
dynamic state. The first floor of 1600 square meters is occupied by treatment rooms, offices and
meeting rooms. On the second and third floors there are living rooms for 48 girls. On the third
floor there is also a cozy garden, where the girls, despite the fact that they are on the street, feel
safe. The Veilige Veste project is the first building in the Netherlands to be rebuilt to the
standards of a "passive house", or energy-saving. This house consumes incredibly little energy,
thanks in part to good thermal insulation.

а) b)
Fig. 2. European medical centres:
a) Maggie's cancer Centre in Manchester
b) Rehabilitation centre Veilige Veste in Leeuwarden, (Netherlands)

Fortunately, the quality of medical facilities in Russia has improved recently. Some of them, in
their organization and design are not inferior to foreign [4].
The complex of the Center of pediatric Hematology, Oncology and immunology consists of a
polyclinic, medical buildings and a hotel block under the conditional name "Tree of life "(Fig. 3,
a). At the same time, the Center can serve 400 children, 250-300 inpatient beds are planned.
The single complex includes various functional blocks: medical, educational and polyclinic,
research, as well as a boarding house for children undergoing medical rehabilitation. It is a kind
of residential building with apartments-blocks consisting of three living rooms for mother and
child [3].
The overall solution of the complex is a few bright volumes, similar to multi-colored cubes with
colored inserts on the facades. The Facade solution uses bright, contrasting colors – orange,
purple, turquoise, yellow, red. The tent block is a high-rise hotel towers raised above the ground
on columns, almost completely colored as an accent, and the facades of medical buildings are
more laconic, white or black, with bright inserts.
The Red Cross rehabilitation center is a futuristic building and looks like a bunker prepared in
case of bombing and nuclear winter (Figure 3, b). The hospital decided to strengthen from all
sides because of the special location-construction is planned in the village of Egvenikot in the
far East of Russia. This village is located in the Chukotka Autonomous Okrug on the Bering sea.
The building can be approached by wild animals, so to protect patients, the architectural Bureau
Norm Architects came up with the concept of a high-tech fortified yaranga – the national home
of local peoples. Due to the dome shape, the rehabilitation center really resembles a traditional
house of Chukchi and Koryaks – but the internal equipment corresponds to the current trends of
the centers of recovery from diseases. There are private rooms, a dining room and rooms for
work and study there.

а) b)
Fig. 3 Russian medical institutions:
a) Complex of the Center of pediatric Hematology, Oncology and immunology in Moscow;
b) the Red Cross Rehabilitation center.

RESULTS AND DISCUSSION

On the basis of foreign and Russian experience in the design of medical facilities, a project of a
health and rehabilitation center was developed (Fig. 4). The project of this center used the
principle of open composition. On the plan it is a complex multi-level figure consisting of two
curved at 90 degrees four-story rectangles and adjacent three-, two- and one-story forms.

Fig. 4 Health and rehabilitation center

In four-storey blocks there is a hospital, medical and diagnostic Department and administrative
part. In the three- and two-storey part there is a reception and lobby block, Department of
rehabilitation treatment, Department of psychological and pedagogical treatment.
The proposed color scheme is perfect for rehabilitation medical institution, as it uses natural
shades of glass, wood and metal.
Exterior decoration of the building (wall fence) is carried out by covering the structure of the
hinged facade in white. When designing facades, compositional techniques are used in the form
of a clear allocation of the surface of the hinged facade with vertical and horizontal seams and
rhythmic division of the volume of the building into window openings made of plastic profile and
blind wall surfaces combined into a single ornamental pattern, which gives architectural
expressiveness to the facades.
The total volume of the health and rehabilitation center has a patio in the recess of the form,
which allows patients to relax in privacy, regardless of weather conditions: if a side wind or
sultry sun, for example, patients can go to rest in the courtyard.
The entrance to the center is made in the form of a glass volume with an atrium inside. The
atrium plays the role of a foyer, a common lobby and a walking area for patients undergoing
treatment. The entrance is through, you can go directly to the patio. Inside the three-storey part
there is a winter garden surrounded by glass walls and an atrium.
Constant visual environment with intense aggressive visual elements has a strong impact on
the human psyche, so the rehabilitation of patients should be carried out in a natural
environment devoid of visual discomfort [6]. Clean air, pleasant climate, favorable environment
and a certain distance from residential buildings (direct transport accessibility) are also
necessary for the placement of medical and preventive institutions.
When checking proposals for new development of territories for construction, an
analysis of possible environmental conflicts is carried out. First of all, compliance of
project proposals with legal documents on nature, landscapes and water resources
protection is monitored, then the degree of intervention in nature and landscape is
assessed, measures to protect temporary impacts are planned [7].

CONCLUSIONS

Healthcare facilities today differ from the previous ones mainly by a flexible approach to the
placement of medical technologies, new structural and spatial planning solutions, the use of
modern materials and construction technologies, as well as by free planning, which takes into
account the specific urban situation.
When designing this rehabilitation center, more attention is paid to creating a comfortable
environment that contributes to the effective work of medical staff and the speedy recovery of
patients. It is for this purpose that the boring typical corridor layout is rejected, so that patients
and staff feel more comfortable.
In addition, the architectural design of this structure includes a comprehensive solution of
compliance with structural, functional and aesthetic requirements to the object, as well as
economic, social, environmental, sanitary, engineering and technical aspects developed in the
architectural part of the documentation for the project and implemented during construction.

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