What it is
A short, honest summary.
- —A stroke is a sudden interruption of blood supply to part of the brain, either by a clot (ischaemic) or a bleed (haemorrhagic).
- —The damage is to the brain. The visible effects — weakness, speech difficulty, swallowing trouble — are downstream.
- —Recovery is real and ongoing. The brain rewires for years after the event, not months.
What families notice
The signals worth taking seriously.
- 01Weakness or numbness on one side of the body
- 02Difficulty forming or understanding words
- 03Coughing or choking on water or food
- 04Loss of balance, dizziness, or fear of standing
- 05Emotional changes — frustration, withdrawal, low mood
My approach
How the work is structured.
- —A full neurological and functional assessment within the first session.
- —Programmes built around what the home actually offers — chairs, doorways, bathroom layouts.
- —Family caregivers trained on positioning, transfers, swallow safety, and daily exercise.
- —Specific, measurable goals: not 'get better,' but 'stand from a chair without support by week 8.'
What recovery looks like
A plain-language picture.
“Expect rapid gains in the first three months, steady gains through twelve months, and meaningful gains for years beyond that — provided the work continues.”
FAQ
Common questions, answered briefly.
- How soon after a stroke should physiotherapy start?
- As early as the medical team clears it — often within 48 hours in hospital. Home programmes typically begin within a week of discharge.
- Is online physiotherapy effective for stroke recovery?
- Yes, particularly for programme design, family coaching, and review. Hands-on work happens in person when needed.
- What if it's been more than a year since the stroke?
- Recovery is still available. The work changes, but it is not over.
For clinicians
Clinical detail, assessment and evidence.
Clinical summary
The picture in clinician register.
Stroke is an acute focal neurological deficit caused by infarction (≈85%) or haemorrhage (≈15%). Rehabilitation-relevant recovery is non-linear: the steepest functional gains fall within the first three months as oedema resolves and penumbral tissue recovers, with slower neuroplastic gains continuing for years. The intensity and task-specificity of practice are the strongest modifiable predictors of motor outcome.
Terminology
Terms worth being precise about.
- Hemiparesis
- Weakness affecting one side of the body, contralateral to the lesion.
- Spasticity
- Velocity-dependent increase in tone from upper-motor-neuron involvement; emerges over weeks.
- Hemispatial neglect
- Reduced awareness of one side of space, common with right-hemisphere lesions; a major rehabilitation barrier.
- Learned non-use
- Behavioural suppression of an affected limb that compounds the original deficit if not addressed early.
- Aphasia vs. dysarthria
- Aphasia is a language-processing deficit; dysarthria is a motor-speech deficit. They are managed differently.
Assessment & measures
What the first sessions measure.
- —Functional baseline within the first session — Modified Rankin Scale and a task inventory of transfers, gait, and upper-limb use.
- —Motor recovery tracked with the Fugl-Meyer Assessment; upper-limb function with the Action Research Arm Test.
- —Balance and falls risk with the Berg Balance Scale; gait with the 10-metre walk test.
- —Tone graded with the Modified Ashworth Scale; re-measured as spasticity evolves.
- —Swallow screened at intake; escalate to speech-and-language therapy where aspiration risk is suspected.
Red flags
Signs that need urgent escalation.
- Sudden new or worsening deficit — treat as recurrent stroke and arrange emergency assessment.
- Severe headache, vomiting, or a falling level of consciousness.
- New-onset seizure activity.
- Unilateral calf swelling, warmth, or pain — screen for deep vein thrombosis.
- Rapidly worsening swallow or signs of aspiration — fever, wet voice, chest changes.
Referral & MDT
When and to whom to refer.
Coordinate with the stroke physician on secondary prevention (blood pressure, antiplatelet/anticoagulation). Refer to speech-and-language therapy for dysphagia or communication, occupational therapy for ADL and upper-limb retraining, clinical psychology for post-stroke mood, and orthotics for ankle-foot orthosis assessment where foot drop limits gait.
Evidence
References and guideline anchors.
- Practice intensity and motor outcome — PLACEHOLDER — verify against current guidelines before launch.
- Early supported discharge and home-based rehabilitation — PLACEHOLDER — verify against current guidelines before launch.