Stroke rehabilitation

Stroke rehabilitation is carried out both inside and outside hospital.

Inside hospital

The Royal College of Physicians' Guidelines on Stroke recommend that treatment is carried out in designated stroke units. A multi-disciplinary team, including doctors, nurses, neurological physiotherapists, occupational therapists, speech and language therapists and psychologists should be involved.

In hospital, physiotherapists will work with people who have had strokes to teach them the necessary skills to return to their home environment. They will also work closely with occupational therapists to make sure that the person will be able to move safely around their home.

While people who have suffered a stroke will have had neuro-physiotherapy in hospital, it's often not the best time to get the most out of physiotherapy. People are often too shell-shocked or ill to make sense of what has happened or to be motivated. Because having a stroke is a a life-changing event, they will need to grieve for the lifestyle left behind and begin to adjust to a set of new and challenging circumstances.

Outside hospital

Physiotherapy after discharge from hospital is very important but the provision of services is often lacking. People who have had a stroke may have had a physiotherapist and/or occupational therapist visit to assess their homes, and to help them and their relatives to prepare the home environment for them to come home to.

People who have had strokes may be offered some physiotherapy at home, which could be a one-off session or a limited course of therapy. What is provided is often defined, not by clinical need, but by the availability of resources.

Not everybody who has a stroke will be admitted into hospital. In this case physiotherapy should be arranged through the patient's GP. This may take place at home, in the local hospital, or at a specialist unit, depending on the local services available.

Sometimes there will be a waiting list for physiotherapy, and people may be frustrated by this and eager to carry on with the work done in hospital. They may also want more treatment than the NHS physiotherapy team can offer or want ongoing treatment when NHS input is being curtailed.

In these cases people who have had strokes will need to see a private neurological physiotherapist with experience in treating people with stroke. Details on how to find one can be found here.

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