Stroke physiotherapy may start in the hospital, and continues on an outpatient status after discharge. The goal is to help the patient regain as many physical skills as possible after a stroke, to enable independence and freedom of movement. Each stroke is slightly different, requiring a customized approach to the patient’s case to ensure the best outcome. Participation on the patient’s part is also an important component, as patients who work hard and follow directions for home exercises to do on their own tend to experience better results.
An early assessment by a physiotherapist may take place shortly after a stroke. This includes a review of the patient’s records to learn more about the situation, and an interview. Patients may be asked to perform some tasks, which will help the physiotherapist determine the level of disability. Some people may be able to walk, although they are unstable, for example, while others may not have any coordination on the affected side of the body.
This assessment forms the basis of a physiotherapy program. In the hospital, stroke physiotherapy can include sessions in pools, frames, and harnesses to allow people to start to develop motor skills with a reduced risk of falls and injuries. Over time, patients may be encouraged to walk and stand on their own. Balancing exercises help refine stability, while fine motor skills tasks can help people learn to write and perform other complex tasks again.
Patients may be discharged from the hospital once they are medically stable. In outpatient stroke physiotherapy, people visit a facility several times a week to undergo sessions. They may also have work to do at home, which can include stretches, exercises, and work with various props and tools. Each physiotherapist has a preferred approach based on training and experience, and people may be directed to perform different tasks as part of their therapy. Mixed approaches are not uncommon, incorporating the best of multiple stroke physiotherapy disciplines.
Over time, the number and frequency of sessions can decline. The course of stroke physiotherapy may take weeks or years, and some patients do not regain their previous level of physical fitness, flexibility, and strength. Continuing to perform exercises even after regular sessions end can help a patient retain functionality. If patients notice new or recurrent problems, they can request follow-up evaluations to determine if they need more treatment or have other medical issues that might be contributing to a symptom like sudden trouble balancing.