Physiotherapy after stroke

Many stroke survivors face a range of difficulties from movement problems, to not being able to do their everyday activities. These problems can, however, improve with rehabilitation therapy.

Beginning rehabilitation therapy

Rehabilitation means trying to restore function to as near normal as possible, and helping you adapt to life after stroke. The focus is to be able to do your usual activities, and to help you communicate, move around and be as independent as possible.

While you are in hospital, you will be assessed to find out if you need therapy. You should receive all the therapy you need and can cope with, for up to 45 minutes every day, but the amount can vary depending on your needs.

During rehabilitation, you work with therapists. The therapist assesses you, and talks to you about your goals and what you want to achieve from the therapy. Together you make plans for reaching your goals. You may have activities to practise. You may work towards building up stamina, or learn new ways of doing things.

You may not be able to go back to how you were before the stroke, but therapy can help you make the best recovery possible for you.

Physiotherapy

Physiotherapy strengthens muscles, and improves mobility, balance and coordination.

If you have lost movement in part of your body, physiotherapy can help you learn to move so that you can get around. It can help you learn to use your arm and hand in everyday activities as much as possible.

Some physiotherapists specialise in conditions caused by changes in the brain, such as stroke and other neurological conditions such as brain injury. They can be known as neuro physios or neurological physiotherapists.

In the early stages, physiotherapy focuses on preventing complications and helping your recovery. Later, it can help you find ways to enable you to do things that are important to you, such as getting in and out of bed, or doing sports. You might use equipment, or find different movements patterns to complete a task. A physiotherapist can also help you adapt an activity or task so you can do it independently.

For more information view our PDF guide Physiotherapy after stroke.

Occupational therapy

After your stroke, you may be facing a range of difficulties that make it hard for you to do the things you would like. These difficulties can include physical problems, problems with memory and thinking, problems with your vision, changes in sensation and emotional problems such as anxiety or depression.

Your occupational therapist can help you develop your skills and confidence to manage activities that are important to your health and wellbeing.

Your occupational therapist will work with you to find ways of overcoming any difficulties. They might give you therapeutic activities to practise, help you find new ways of doing things or suggest equipment that could help.

For more information view our PDF guide Occupational therapy after stroke.

Moving again

Once you are medically stable, the aim will be to get you moving and doing as much for yourself as you can as soon as possible. Depending on how much you are able to do, this may include moving around your bed, then from bed to chair. It can also include standing balance, and walking with and without support. For many people this is a gradual process, and it is important to get each step right so that you are safe and regain your confidence.

Practising your exercises and activities

Physiotherapy

During physiotherapy, you may do exercises to strengthen weak muscles and build up your stamina. Stretching exercises can reduce muscle and joint stiffness.

You may also work on specific skills that you need to improve. For example, if you are having difficulty keeping your balance, you may be asked to stand up a lot. If you have difficulty lifting your arm, you will need to do activities that make you lift and use your arm. If you are having difficulty walking you need to walk as much as possible.

There are many ways to exercise and practise. You may work on a one-to-one basis with a physiotherapist, particularly on the tasks and the movements you are learning to do. You may also work with a physiotherapy assistant, or in a group. You will have activities to practise on your own outside of therapy sessions.

Occupational therapy

A major part of your occupational therapist’s role is to work with you to improve your ability to carry out your day-to-day activities.

You should be given opportunities to practise in the most natural and homelike setting possible. This may involve going to a kitchen area to practise making a meal or cup of tea. You may practise washing and dressing with the therapist.

As time goes on, activities might be made harder, to challenge you and improve your stamina and confidence. Your therapist may teach you strategies to overcome any difficulties. For example, learning how to manage your energy levels if you experience fatigue, or how to remember things.

It is important to build up your activity levels to help you regain as much independence as possible. Your occupational therapist will advise on activities for you to practise by yourself.

Living independently

Your occupational therapist will help you develop skills so you can carry out activities as independently as possible. Some problem areas may not be apparent until you are in your own home environment. While you are in hospital, a therapist may help prepare and guide you and your family through the process of leaving hospital.

The therapist will ask about your home environment, such as the height of your chairs and bed, what kind of bath or shower you have and whether you have stairs. The therapist may do a home visit with you, so you can try out various tasks at home and check that you will be safe. They can advise on any equipment or help needed to make your life easier and safer.

Equipment

Although most people regain the ability to walk, some do not and others are only able to walk short distances such as around the house. If this is the case for you, your physiotherapist and occupational therapist will provide walking aids such as a stick or ankle splint and, if necessary a wheelchair and teach you and your family or carers how to use it.

After an assessment, they will also arrange for any other equipment you may need such as a hoist to help you get in and out of a chair or bed. You may need adaptations to the house when you go home, such as a ramp or wider doors.

Some people might find special equipment helpful, such as a non-slip plate mat, or cutlery that is easier to hold. You may need aids and equipment to make your home safer. These could include support for sitting, a raised toilet seat or an additional handrail to help you climb stairs.

For more information see our guides Equipment for independent living and mobility and Accommodation after stroke.

Information

Other resources

Stroke Association Helpline
Helpline: 0303 3033 100
Email: helpline@stroke.org.uk
Contact us for information about stroke, emotional support and details of local services and support groups.

Chartered Society of Physiotherapy
Has a register of therapists who are members of the Association of Chartered Physiotherapists interested in Neurology (ACPIN).

Physio First
Tel: 01640 684 960
Email: minerva@physiofirst.org.uk
Has an online database of qualified physiotherapists, which can be searched by location and specialism.

Apps from MyTherappy
NHS approved and recommended apps for stroke survivors and carers, ranging from communication, eating and drinking, heathly lifestyle, vision and more.

Disclaimer: The Stroke Association provides the details of other organisations for information only. Inclusion on My Stroke Guide does not constitute a recommendation or endorsement.