A stroke can affect movement, strength, balance, sensation and confidence. Some people have weakness on one side of the body, while others find walking, standing, reaching or using an arm more difficult.

Recovery is different for each person. Physiotherapy is often one part of a wider rehabilitation plan, alongside medical care, occupational therapy, speech and language therapy and support with emotional wellbeing.

When does stroke rehabilitation begin?

Rehabilitation may begin in hospital once the medical team decides it is safe. Early sessions can focus on positioning, sitting, moving in bed, transferring between a bed and chair, standing or taking supported steps.

After leaving hospital, rehabilitation may continue at home, in an outpatient clinic or through community services. The NHS guidance on recovering from a stroke explains that a home recovery plan may include physiotherapy and exercises to help with movement.

What may a physiotherapist assess?

A neurological physiotherapy assessment may look at:

  • muscle strength and control
  • joint movement and stiffness
  • sensation and awareness of the affected side
  • sitting and standing balance
  • coordination
  • walking and the use of mobility aids
  • transfers, steps and stairs
  • fatigue, pain and confidence during movement

The assessment also considers the activities that matter to you. This might include walking safely at home, getting out of a chair, using the stairs, returning to work or taking part in family life.

How physiotherapy may support recovery

Treatment depends on how the stroke has affected you and the goals agreed with your rehabilitation team. It may include:

  • practice of everyday movements such as sitting, standing and walking
  • balance and coordination exercises
  • strength and mobility work
  • repeated practice of specific tasks
  • advice about positioning and protecting a weak arm or leg
  • assessment and practice with a walking aid where needed
  • a home exercise programme suited to your current ability

Practice should be challenging enough to be useful but safe for the individual. Exercises that suit one person after a stroke may not be appropriate for another.

Progress can take time

Some changes happen early, while others develop over months or longer. Progress is not always steady. Tiredness, illness, poor sleep or a demanding day can temporarily make movement feel harder.

Goals can be broken into smaller steps and reviewed as ability changes. Family members or carers may also be shown safe ways to support practice, transfers or walking when this forms part of the rehabilitation plan.

Managing fatigue

Fatigue after a stroke can affect physical activity, concentration and daily routines. Trying to do too much at once may leave little energy for the rest of the day.

It may help to plan demanding tasks, allow time for rest and spread rehabilitation activities through the day. Speak to your stroke team if fatigue is new, severe or becoming worse, as other medical causes may need to be considered.

Know the signs of another stroke

A new stroke is a medical emergency. Call 999 immediately if someone develops sudden facial weakness, weakness or numbness in an arm, or difficulty speaking. Sudden loss of vision, severe headache, confusion, dizziness or loss of balance also needs urgent medical attention.

The NHS provides more information about recognising symptoms using the FAST guide to stroke symptoms.

Ask about stroke rehabilitation

Crestwell Medical provides stroke and neurological rehabilitation based on the person’s movement, function and goals. We can work alongside recommendations from the hospital or community stroke team. Book an appointment to discuss ongoing rehabilitation.

This article provides general information and does not replace advice from your stroke consultant, GP or rehabilitation team.